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Jitsuo Usuda
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P04 - Early Stage/Localized Disease - Perioperative Therapy (Neoadjuvant Therapy, Surgery, Adjuvant Therapy) (ID 113)
- Event: WCLC 2020
- Type: Posters
- Track: Early Stage/Localized Disease
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P04.05 - Efficacy of Uniportal Video-Assisted Thoracic Surgery (U-VATS) Simple Segmentectomy for Early Lung Cancer (ID 3871)
00:00 - 00:00 | Author(s): Jitsuo Usuda
- Abstract
Introduction
Uniportal video-assisted thoracic surgery (U-VATS) has already spread over the world, especially in Asia. My purpose is to
assess the feasibility and safety of U-VATS simple segmentectomy using electrocautery and stapler for clinical stage I lung cancer.
Methods
U-VATS segmentectomy (42) was performed for stage I lung cancer between 2013 and 2020. In uniportal segmentectomy , an approximately 4-cm small incision was placed at the fourth or fifth intercostal space from the anterior to posterior axillary line. Segmentectomy using electrocautery (SE:n=18) or segmentectomy using stapler (SS:N=24) for early lung cancer was carried out. The evaluation items were general operative outcomes, pain stress using the numeric rating scale (NRS) on postoperative day 30. All segmentectomies were simple segmentectmies.
Results
SE showed similar perioperative outcomes (blood loss, operation time, drainage duration, postoperative hospital stay, the number of lymph node retrieval and frequency of postoperative complications compared to SS. The most frequent segment removed was the S6 (13 cases, 31%). The mean operation time(min.) in ES and SS was 165±19 and 148±18 , respectively. and also there was no significant difference between SE and SS in regard to blood loss, the number of lymph node retrieval, drainage duration, hospital stay, conversion to thoracotomy, and the frequency of air leakage more than 7 days. Additionally, the average NRS in SE was almost the same as that in SS on postoperative day 30 (SE:2.3 ± 0.5 vs. SS:2.4 ± 0.7, P=0.62). 5-years disease free survival rate was 94.4% in all cases.
Conclusion
U-VATS simple segmentectomy for early lung cancer was safe and feasible. Generally, U-VATS segmentectomy was performed using stapler, however U-VATS surgeons should also master the technique using electrocautery in view of surgical margin and residual lung function.
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P06 - Early Stage/Localized Disease - Multiple Primary Lung Cancer (ID 115)
- Event: WCLC 2020
- Type: Posters
- Track: Early Stage/Localized Disease
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P06.01 - Therapeutic Strategies for Metachronous Multiple Primary Lung Cancer (ID 3377)
00:00 - 00:00 | Presenting Author(s): Jitsuo Usuda
- Abstract
Introduction
It is not uncommon to encounter metachronous primary lung cancer after surgical treatment along with the increase in the elderly patients. In consideration of increasing number of such patients, it is necessary to take various treatment strategies.
Method: In order to establish a treatment strategy for multiple lung cancer, we retrospectively examined multiple lung cancer cases operated for primary lung cancer in our department from January 2013 to December 2018, and the future treatment strategy was examined.
Methods
In order to establish a treatment strategy for multiple lung cancer, we retrospectively examined multiple lung cancer cases operated for primary lung cancer in our department from January 2013 to December 2018, and the future treatment strategy was examined.
Results
Of 821 patients who underwent surgery for primary lung cancer, 60 were multiple lung cancers, 31 were synchronous multiple lung cancers, and 29 were metachronous multiple lung cancers. Among the cases of metachronous multiple lung cancer, 27 cases had undergone lobectomy or more in the first operation, 1 case of segmental resection, and 1 case of partial resection.
As for the treatment of secondary lung cancer lesions, 20 lesions were performed surgery (lobectomy; 1, segmental resection;5, partial resection; 14), 6 lesions of photodynamic therapy (PDT), and 3 lesions of SBRT. Among the surgical cases, there were 3 cases on the same side as the first cancer and 17 cases on the opposite side. The three cases underwent partial resection. Among 17 patients, postoperative home oxygen therapy was introduced in 2 patients. Regarding the prognosis, three patients who had surgical resection, died of recurrence of the first lesion. Two of the six PDT patients died of recurrence of the first lung cancer and one died of other disease. All three patients who underwent SBRT are alive without recurrence.
Conclusion
If early detection and early diagnosis are made as a treatment strategy for metachronous multiple lung cancer, it may be possible to preserve lung function by reducing surgery or SBRT, PDT, and to cure without damaging the quality of life.
