Author of

• 32292

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  EP1.17 - Treatment of Early Stage/Localized Disease (ID 207)

  • Event: WCLC 2019
  • Type: E-Poster Viewing in the Exhibit Hall
  • Track: Treatment of Early Stage/Localized Disease
  • Presentations: 2
  • Moderators:
  • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall

  • 32302

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    EP1.17-09 - Survival Analysis of 911 Patients with Surgically Resected Lung Cancers (ID 1887)

    08:00 - 18:00  |  Presenting Author(s): Jun Zhang
    • Abstract

    Background
    

    To summarize the treatment results of surgically resected lung cancers.

    Method
    

    Survival analysis was conducted in 911 cases of lung cancers surgically resected during the period of April 2000 to July 2010; 577 (63.3%) were male, 334 (36.7%) female; aged 16 to 85 years-old (middle 60); 455 (49.9%) were smokers.

    Result
    

    Lobectomy and lymph node dissection were undergone. The1, 3, 5, 10-years survival rate for this group of resected lung cancers was 81%, 62%, 53% and 43%, respectively; the middle survival time was 85.5 months. Univariate analysis revealed that gender, smoking status, histology and pathological stages (pTNM stages), tumor size (T factor), lymph nodes' metastasis (N factor), and postoperative adjuvant chemo-radiation therapy were important prognostic factors affecting the postoperative survival significantly (P<0.05). The1, 3, 5, 10-year survival rate for this group of resected stage I (336 cases) lung cancers was 94%, 79%, 75% and 62%, respectively, the middle survival time 132 months; stage II (234 cases): 78%, 60%, 48% and 32%, respectively, the middle survival time 64 months; stage III (242 cases): 69%, 45%, 33% and 24%, respectively, the middle survival time 33 months (P=0.000). The1, 3, 5, 10-years survival rate for resected adenocarcinoma (491 cases) was 85%, 65%, 53% and 39%, respectively, the middle survival time 84 months; squamous cell carcinoma (315 cases): 79%, 60%, 53% and 45%, respectively, the middle survival time 91 months; adenosuamous carcinoma (17 cases): 82%, 58%, 58%, and none, respectively, the middle survival time 78 months; small cell lung cancer (43 cases): 64%, 44%, 33% and none, respectively, the middle survival time 32 months (P=0.011). The1, 3, 5, 10-years survival rate for those who received adjuvant chemo or chemo-radiation therapy (319 cases) was 87%, 73%, 67% and 64%, respectively, the middle survival time 132 months; who did not receive adjuvant chemo or chemo-radiation therapy (592 cases): 78%, 57%, 46% and 36%, respectively, the middle survival time 57 months (P=0.000).

    Conclusion
    

    Pathological stages and postoperative chemo-radiation therapy are independent prognostic factors for surgically resected lung cancers. Surgically resected early stage lung cancers have much better prognosis; postoperative adjuvant chemo-radiation could improve prognosis of surgically resected lung cancers. (This study was partly supported by Science Foundation of Shenyang City, China, No. F16-206-9-05, 17-230-9-71)

  • 32312

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    EP1.17-16 - Ultra-Small Lung Cancer (≤0.5cm) Is Facing Dilemma Situation of Over-Resection (ID 2433)

    08:00 - 18:00  |  Presenting Author(s): Jun Zhang
    • Abstract

    Background
    

    Lung cancer is increasing rapidly in China. More and more ground-glass opacity (GGO) nodules, micro-small pulmonary nodules (micro-SPN, ≤1.0cm), and ultra-small pulmonary nodules (ultra-SPN, ≤0.5cm) are being detected, most are not malignant, some are atypical adenomatous hyperplasia (AAH), but some are indeed early stage lung cancer, either adenocarcinoma in situ (AIS) or minimally invasive adenocarcinoma (MIA). Limited resection is reasonable for these micro-small lung cancer (micro-SLC, ≤1.0cm), and ultra-small lung cancer (ultra-SLC, ≤0.5cm), but we always face the dilemma situation that the patients prefer to ask for lobectomy instead of limited resection, no matter what the postoperative pathology will be, a MIA, AIS or just an AAH. For some patients, especially those with family cancer history suffer more mental pressure than others. On the other hand, we face the dilemma situation that when surgery performed at early stage, ultra-SPN stage, the result will be ultra-SLC, AIS, or AAH; when follow-up finds GGO nodules growing up, emerging with malignant signs, it will enter into micro-SPN stage, we may need to cut more lung tissues, the result will become micro-SLC, MIA; when enter into SPN (≤2.0cm) stage, it may become SLC (≤2.0cm), invasive lung adenocarcinomas (ILA).

    Method
    

    Video-assisted thoracoscopic surgery (VATS) and minimally invasive small incision, muscle- and rib-sparing thoracotomy (miMRST) were performed. Case 1: male, aged 60 in 2015, a peripheral ultra-SPN, GGO nodule, 0.3X0.3cm in right upper lobe; it became 0.5X0.3cm in Jan 2018, VATS wedge resection was performed. Case 2: female, aged 59 in 2013, an ultra-SPN, GGO nodules, 0.5X0.3cm in right middle lobe; the patient omitted it until it became 0.8X0.6cm in Nov 2016, VATS wedge resection was performed. Case 3: male, aged 55 in 2016, an ultra-SPN, GGO nodules, 0.5X0.4cm in lingular segment, segmentomy was advised; the patient refused; it became 1.0X0.8cm in Jan 2019, lingular segmentomy with lymph node sampling was advised, but the patient insisted on asking for lobectomy, instead of limited resection (both his brothers suffered from lung cancer). miMRST was performed for case 3.

    Result
    

    The patients recovered quickly from mini-invasive surgery. The final pathology was AIS, or MIA. Case 1: the frozen pathology was AAH; the postoperative pathology was AIS. Case 2: the frozen pathology was AAH; the postoperative pathology was MIA. Case 3: the frozen pathology was AAH; the postoperative pathology was MIA. No adjuvant treatment needed. Follow-up shows no recurrence and metastasis.

    Conclusion
    

    Certain GGO nodules progress rapidly, surgery should be performed at much earlier stage, ultra-SPN stage, ultra-SLC stage might be of first choice. For Case 1: if the surgery was done earlier, the final result might be AAH, instead of AIS. For Case 2, 3: if the surgery was done earlier, especially at ultra-SPN stage, the postoperative pathology should be AAH, AIS, instead of MIA. To perform surgery at much earlier stage could help save much more lung tissues, to achieve a much better prognosis for micro-SLC and ultra-SLC patients. (This study was partly supported by Science Foundation of Shenyang City, China, No. F16-206-9-05, 17-230-9-71 ).

• 31609

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  P2.15 - Thymoma/Other Thoracic Malignancies (ID 185)

  • Event: WCLC 2019
  • Type: Poster Viewing in the Exhibit Hall
  • Track: Thymoma/Other Thoracic Malignancies
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall

  • 31610

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    P2.15-01 - Surgical Resection of 61 Cases of Inflammatory Myofibroblastic Tumor of the Lung (ID 1905)

    10:15 - 18:15  |  Presenting Author(s): Jun Zhang
    • Abstract

    Background
    

    Inflammatory myofibroblastic tumor (IMT) of the lung is rare soft tissue tumor, with low malignant potential. Here we report 61 cases of surgically resected IMT of the lung.

    Method
    

    Surgically resected IMT of the lung, during the period of September 2004 to July 2010 were retrospectively studied. Of the 61 patients, 40 were male (65.6%), 21 female (34.4%); aged 34 to 77 years old (middle age 55). The symptoms included cough in 32 cases (52.5%), bloody sputum 19 (31.1%), sputum 14 (23.0%), fever 13 (21.3%), chest pain 10 (16.4%), hemoptysis 8 (13.1%), shortness of breath 6 (9.8%), shoulder pain 2 (3.2%), sore throat 1 (1.6%), and asymptomatic 9 (14.8%). Chest CT showed 50 cases (81.2%) were round-ball-like pulmonary nodules, most with smooth and clear borders, while speculated 18 (29.5%), lobulated 13 (21.3%), cavity or vacuole sign 12 (19.7%), calcification 7 (11.5%), pleural indentation 6 (9.8%), and vessel convergence 1 (1.6%). Fibrobronchonscopy was performed in 13 cases but no malignant evidence obtained. CT guided fine-needle biopsy was refused by the patients, and surgical resection was requested.

    Result
    

    Wedge resection was performed in 29 cases (47.5%), and lobectomy in 27 cases (44.3%) (lymph node dissection was performed in 6 suspected cases), segmentomy 5 cases (8.2%). Frozen pathological diagnosis were performed in 59 cases (96.7%), IMT was diagnosed in 38 cases (64.4%) (with alveolar epithelial dysplasia in 14 cases), inflammation or benign disease in 18 cases (30.5%), granulomatous inflammation in 2 cases (3.4%), and malignant in 1 case (1.7%). All patients recovered smoothly except one case received second thoracotomy on the day of surgery due to postoperative hemothorax; no other serious complications happened; all cases were discharged on about the 10^th day postoperatively as usual. IMT was confirmed in all these 61 surgical resected cases by the postoperative pathological diagnosis. Follow-up showed all patients recovered well, and no recurrence and metastasis found.

    Conclusion
    

    IMT of the lung has no specific symptoms, lacks specific CT imaging characteristic to distinguish from lung cancer. Surgical resection is of first choice for treatment of IMT of the lung, with no recurrence and metastasis found; wedge resection is recommended; lobectomy and lymph node dissection may be reasonable and necessary for certain suspected cases. Surgical resected IMT of the lung has a good prognosis according to our limited cases and short-time observations. (This study was partly supported by Science Foundation of Shenyang City, China, No. F16-206-9-05, 17-230-9-71)