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Takeshi Mori
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P1.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 186)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.16-25 - Impact of Pirfenidone on the Risk Scoring System of Postoperative Acute Exacerbation of Interstitial Pneumonia in Lung Cancer (ID 2407)
09:45 - 18:00 | Author(s): Takeshi Mori
- Abstract
Background
Acute exacerbation (AE) of idiopathic interstitial pneumonia (IIP) is a life-threatening complication of lung cancer resection. There has been an increasing number of studies about postoperative AE of IIP in recent years. A few of these have reported that perioperative oral administration of pirfenidone reduces the occurrence of AE in patients with IIP. Furthermore, a large cohort study conducted by the Japanese Association for Chest Surgeons (JACS) proposed risk factors for postoperative AE in IIP patients which can predict the incidence of AE following an operation. JACS risk score included seven factors (sex, history of AE, surgical procedure, usual interstitial pneumonia pattern, steroid use, KL-6, %VC) and classified patients into three groups: low risk (risk score: 0-10), intermediate risk (risk score: 11-14) and high risk (risk score: 15-22). The objective of present study is to investigate the validity of those risk factors for patients with IIP who are taking pirfenidone.
Method
We retrospectively analyzed 1626 consecutive lung cancer patients who had undergone lung resection at our institution from January 2010 to December 2018. The patients who underwent lung resection since 2016 onward were administered pirfenidone from 4 weeks before operation to 4 weeks after operation.
Result
Out of 1626 patients, 125 patients (7.7%) had IIP. Twenty patients (16%) took pirfenidone and 105 patients (84%) did not take pirfenidone. Of the patients taking pirfenidone, three patients (15%) contracted AE of IIP after lung resection within 30 postoperative days. No significant difference was identified in JACS risk score between AE (+) group taking pirfenidone and AE (-) group taking pirfenidone (10.7 ± 3.2 versus 8.6 ± 2.6, p = 0.74). In the AE (+) group taking pirfenidone, there were significant higher rates of patients having increased serum levels of KL-6 or having reached pathological stageⅡ-Ⅳ (UICC 8th) (p = 0.01 , p = 0.04, respectively). Of the patients not taking pirfenidone, seven patients (6.7%) contracted AE of IIP. No significant difference was identified in incidence of postoperative AE between the group of patients taking pirfenidone and the group not taking pirfenidone (p = 0.21).
Conclusion
In the patients taking pirfenidone, there was no significant difference in the risk score between AE (+) group and AE (-) group.
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P2.05 - Interventional Diagnostic/Pulmonology (ID 168)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Interventional Diagnostics/Pulmonology
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.05-11 - 3D CT Is Useful for Segmentectomy but Is Not Always True (Now Available) (ID 235)
10:15 - 18:15 | Presenting Author(s): Takeshi Mori
- Abstract
Background
Pulmonary vessels and bronchus have a lot of variations. 3D CT is a good guide for segmentectomy, but sometimes shows images different from real anatomy of the lung structures. The aim of this study is to evaluate effectiveness and problems to apply 3D CT for segmentectomy.
Method
From July 2018 to December 2018, 78 cases underwent chest surgery in our hospital. Using contrast enhanced volume dataset of 64-row CT, pulmonary artery (PA) was separated form pulmonary vein (PV) based on the difference of CT number between them. Image interpretations for surgery were performed by one experienced thoracic surgeon (TM) using axial, sagittal, coronal images, and 3D image containing PA, PV, bronchus, and lobar fissure in this study.
Result
Of 29 case underwent lobectomy or segmentectomy, 23 cases were performed 3D CT. Failure to discriminate among PA, PV, and other structures were observed in 9 cases: Ascending A2 → branch of V2 in 2 cases; V2t → Ascending A2 in 4 cases; A3a → branch of V3 in 1 case; V3b → branch of A3 in 1 case; V1a → A1 in 1 case; V1 runs dorsal side of A1,3 → part of A1,3 in 1 case; #12l →lower lobe PA in 1 case.
Case 7 underwent right S1 segmentectomy. 3D CT showed recurrent A2 runs ventral side of B1, but did not show V1 runs dorsal side of A1,3 which was found during surgery.
Conclusion
3D CT is useful for segmentectomy to understand the lung anatomy, but does not always give us true anatomy. Surgery should be performed keeping the fact in mind.
