Virtual Library
Start Your Search
Takahiro Oto
Author of
-
+
EP1.18 - Treatment of Locoregional Disease - NSCLC (ID 208)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Treatment of Locoregional Disease - NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
-
+
EP1.18-08 - Pulmonary Lobectomy and Completion Pneumonectomy for Ipsilateral Lung Cancer After Radical Resection (Now Available) (ID 1218)
08:00 - 18:00 | Author(s): Takahiro Oto
- Abstract
Background
Ipsilateral reoperation such as lobectomy and completion pneumonectomy after radical resection of lung cancer is a high-risk operation. We evaluated outcomes after these operations in our hospital.
Method
We retrospectively reviewed the records of 27 patients who underwent ipsilateral lobectomy or completion lobectomy for new primary lung cancer or recurrence after pulmonary lobectomy or bi-lobectomy between 1998 and 2017.
Result
9 patients underwent completion lobectomy, of which 4 were right and 5 were left, and 18 patients underwent lobectomy. Mean operative time was 308.7±27.4 minutes, and mean blood loss was 706.9±254.3mL. Blood loss was significantly higher in completion pneumonectomy patients as compared to lobectomy patients, whereas operative time was not different between the operations. There was no perioperative mortality, but intraoperative complications were seen in 4 cases (14.8%), which were 2 pulmonary artery injury, superior venous cava injury and azygos vein injury. Perioperative morbidity was seen in 8 cases (29.6%), and postoperative bronchopleural fistula occurred in one case. Fourteen patients had Pathological stage IA disease, 6 had IB, and 5 stage II or over. As clinical outcome, 5-year overall survival rate was 71.1%.
Conclusion
Pulmonary lobectomy or completion pneumonectomy for ipsilateral lung cancer after radical resection were performed in 27 patients without perioperative mortality. Our results strongly suggests that this strategy is a meaningful option for new or recurrent ipsilateral lung cancer.
-
+
P2.01 - Advanced NSCLC (ID 159)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Advanced NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
-
+
P2.01-82 - Lung Cancer in Lung Transplant Recipients (Now Available) (ID 2334)
10:15 - 18:15 | Author(s): Takahiro Oto
- Abstract
Background
Long-term immunosuppression is considered to increase the chance of developing malignancy, which is one of the leading causes of death after organ transplantation. Lung cancer in lung transplant recipients can originate from de-novo occurrence, transplanted donor’s lung and progression/recurrence of the recipient’s lung cancer. We conducted a survey of lung cancer in lung transplant recipients in our institution and report the case series.
Method
All 189 recipients who underwent lung transplantation (97 brain-dead donor lung transplantation, 90 living donor lobar lung transplantation, 2 hybrid lung transplantation) since October 1998 until December 2018 at Okayama University Hospital were retrospectively reviewed.
Result
Lung cancer was diagnosed in 4/189 (2.1%) of 16/189 (8.5%) all malignant diseases, in lung transplant recipients with a median follow-up of 4.5 years. Whereas de novo lung cancer occurred in one patient, patient-baring lung cancer was histologically detected in resected lung in three patients, leading to progression after transplantation in the two recipients. One recipient who had a previous history of lung cancer with over 5-year disease free period, experienced no recurrence afterword. All three recipients who had advanced lung cancer died relatively early from the diagnosis of lung cancer, regardless of cancer treatment.
Lung cancer in lung transplant recipients could be difficult to detect by radiological screening and biopsy due to severely deteriorated lung condition, especially in idiopathic interstitial pneumonitis. Additionally, recipients with advanced lung cancer seem to have poor prognosis.
Case Underlying disease Occurrence LTx - Lung cancer Degree of progression Treatment/Prognosis #1 LAM De novo 10 years Chest wall invasion Right pneumonectomy (10 months)→chemotherapy (9 months)→death #2 IIP Resected recipient’s lung 15 months Mediastinal lymph-nodes Lymph-node resection (10 months) →death #3 IIP Resected recipient’s lung 3 months Pleural Dissemination chemotherapy (6 months)→death #4 BO Resected recipient’s lung nil nil nil
LAM: lymphoangioleiomyomatosis IIP: idiopathic interstitial pneumonitis BO: bronchiolitis obliterans LTx: lung transplant
Conclusion
Lung cancer in lung recipients should be screened carefully ever since listing for transplantation.
-
+
P2.18 - Treatment of Locoregional Disease - NSCLC (ID 191)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment of Locoregional Disease - NSCLC
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
-
+
P2.18-12 - Prognostic Nutrition Index Affects Prognosis of Trimodality Therapy for Locally Advanced Lung Cancer with High T Factor (Now Available) (ID 1644)
10:15 - 18:15 | Author(s): Takahiro Oto
- Abstract
Background
Pretreatment nutritional status critically affects the clinical outcomes. Induction chemoradiotherapy (iCRT) followed by surgery (trimodality therapy) is a high-invasive treatment option for patients with locally advanced non-small cell lung cancer (LA-NSCLC). LA-NSCLC is a heterogeneous disease. Direct invasion into the surrounding structures easily promotes the invasion-related symptoms which inpair quality of life, but lymph node metastasis rarely causes its related symptoms until the bulky metastatic lymph nodes invade the surrounding structures. These differences of disease extent are expected to affect not only clinical outcome of treatment but also nutritional condition before initiation of treatment. While the prognostic nutritional index (PNI) is known to be correlated with the clinical outcomes after surgery in patients with early NSCLC, the significance of the PNI in LA-NSCLC patients undergoing trimodality therapy has not yet been well examined. In this study, we investigated the clinical impact of PNI in the LA-NSCLC patients who underwent iCRT followed by surgery considering the heterogeneity of disease extent.
Method
We enrolled 127 patients who received trimodality therapy at our institution between 1999 and 2016. The PNI was examined at all three time-points in the patients: before iCRT, before surgery, and after surgery.
Result
Fifty-five and 72 patients were diagnosed as clinical T1/2 (cT1/2) and cT3/4 diseases, respectively, and, 42 and 85 patients were cN0/1 and cN2/3, respectively. The PNI significantly decreased as the treatment progressed among all 127 patients. Patients with cT3/4 disease showed significantly lower PNI values before and after surgery than those with cT1/2 disease. By contrast, the PNIs were equivalent at all time-points between patients with cN2/3 and cN0/1 disease. We performed receiver-operating characteristic curve analysis to determine the cutoff the pre-iCRT PNI for overall survival (OS) in all (n = 127), cT3/4 (n = 72) and cN2/3 patients. The ROC curve analyses indicated that a significant cutoff was identified only in cT3/4 patients. Univariate and multivariate analyses revealed that high pre-iCRT PNI values were significantly correlated with better survival in cT3/4 patients. By contrast, the prognostic impact of pre-iCRT PNI values could not be observed in cN2/3 patients
Conclusion
The nutritional status deteriorates as the treatment progresses during trimodality therapy. Intensive perioperative nutritional intervention is required especially for cT3/4 LA-NSCLC patients receiving trimodality therapy.
