Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
neither lymphatic vessels were detected: 3 of them had complete responses
after preoperative treatment. Conclusion: Application of NIR fluorescence
allows studying features of lymphatic vessels and SLN in NSCLC. Absence of
metastatic disease in the SLN directly correlates with final nodal status of the
lymphadenectomy specimen.
Keywords: sentinel lymph nodes, NSCLC, near-infrared fluorescence,
lymphatic flow
carcinoma (64%; squamous cell, 23%; other, 13%). Stage (TNM-7) distribution
was: I, 64.5%; II, 22%; III, 12.5%. Lobectomy was the preferred anatomical
resection and mean hospital stay was 8.3 days. Complication rate was 7.6%.
Recurrence free and overall survival will be presented at the conference. There
were no statistical differences between patients with LC/BC and LC with
regard to main clinical parameters and short term outcome. Conclusion: Due
to improvements in breast cancer therapy, a reasonably number of patients
developing subsequent lung cancer is observed. Short-term outcome of
patients with LC/BC is similar to those with LC.
Keywords: lung cancer, Breast cancer
POSTER SESSION 3 – P3.04: SURGERY
MISCELLANEOUS I –
WEDNESDAY, DECEMBER 7, 2016
P3.04-002 REDUCING THE AMOUNT OF RESECTION AFTER
INDUCTION PHOTODYNAMIC AND CHEMOTHERAPY IN
INOPERABLE NON-SMALL CELL LUNG CANCER
Andrey Akopov, Ivan Chistiakov, Margarita Urtenova, Anatoly Rusanov
Pavlov First State Medical University, Saint-Petersburg/Russian Federation
Background: Involvement of the main bronchus in non-small cell lung cancer
(NSCLC) often determines functional inoperability. Induction chemotherapy
and endobronchial photodynamic therapy (PDT) were done with the purpose
of performing lobectomy (bilobectomy) instead of pneumonectomy.
Methods: Prospective study included patients with central NSCLC with the
involvement of the main bronchus or trachea who were initially considered
as intolerant to pneumonectomy. After an induction from two to six courses
of chemotherapy and endobronchial PDT (chlorine E6 as a photosensitizer,
light wavelength of 662 nm) patients were re-examined and lobectomy was
offered to patients with positive response. Results: From 2008 to 2015 48
patients with NSCLC were considered as intolerant to pneumonectomy due
to low level of FEV1 (an average, 49±18% predicted, from 21% to 67%), data
of perfusion scintigraphy, level of DLCO, level of Vo 2
max and contralateral
side lobectomy performed earlier. After preoperative treatment 38 patients
(79%) underwent lobectomy instead of pneumonectomy. Initial tumor was
localized the right main bronchus in 13 patients (34%), left main bronchus
— in 18 (47%), tracheal bifurcation — in 7 patients (18%). Stages were: IIA – 2
patients, IIB – 2 patients, IIIA – 15 patients, IIIB – 19 patients. cN0 disease was
diagnosed in 12 patients (32%), cN1 – in 9 (24%), cN2 – in 17 patients (44%).
In all cases tumor disappeared from the main bronchus after preoperative
treatment. 11 conventional lobectomies, 15 wedge, 9 sleeve lobectomies and
3 bilobectomies were done. In all cases bronchial cutting was done in initially
affected zone. Pathological examination revealed 34 of 38 patients operated
completely (R0-89%), 4 – microscopically incompletely (positive bronchial
resection margin, R1-11%), рN+ was diagnosed in 12 patients (32%). No
postoperative mortality and major complications were noted. During followup
(from 6 to 72 months) one local recurrence was developed (3%); three
– and five-year survival rates were 88% and 55%. Conclusion: Preoperative
treatment including chemotherapy and PDT led to less extensive resections
(lobectomy instead of pneumonectomy) reducing surgical risks.
Keywords: lobectomy instead of pneumonectomy, NSCLC, Inoperable,
photodynamic therapy
POSTER SESSION 3 – P3.04: SURGERY
MISCELLANEOUS I –
WEDNESDAY, DECEMBER 7, 2016
P3.04-004 THE RISK FACTOR OF THE THROMBUS FORMATION IN
PULMONARY VEIN STUMP AFTER LEFT UPPER LOBECTOMY FOR
LUNG CANCER
Reiko Shimizu 1 , Shoko Hayashi 2 , Kiyomichi Mizuno 2 , Yoshiyuki Yasuura 2 ,
Hiroyuki Kayata 2 , Hideaki Kojima 2 , Shoji Takahashi 2 , Mitsuhiro Isaka 2 ,
Masahiro Endo 3 , Yasuhisa Ohde 1
1 Thoracic Surgery, Shizuoka Cancer Center, Shizuoka/Japan, 2 Division of Thoracic
Surgery, Shizuoka Cancer Center, Shizuoka/Japan, 3 Division of Diagnostic
Radiology, Shizuoka Cancer Center, Shizuoka/Japan
Background: It has been known that thrombosis in the pulmonary vein (PV)
stump after lobectomy could possibly be the cause of embolism of vital
organs including cerebral infarction. Several studies have proved that left
upper lobectomy is the risk factor of thrombus forming in the PV stump.
The aim of this study was to clarify the risk factors of thrombus forming in
the PV stump after left upper lobectomy for lung cancer. Methods: At our
institute, 342 patients underwent left upper lobectomy for lung cancer from
September 2002 to December 2013. Among them, 296 patients who received
follow-up enhanced CT after surgery were retrospectively analyzed to see
whether the thrombus in the left superior pulmonary vein (LSPV) stump
would be detected. We analyzed the risk factors for thrombosis formation
by uni-, and multivariate analysis. Results: Thrombus in the LSPV stump was
formed in 21 patients (7.1%). Body Mass Index (BMI) of the thrombus forming
group (median, 23.64; range 20.03 to 28.99) was significantly higher than the
no-thrombus-forming group (median, 22.06; range 13.37 to 30.57; p=0.022).
Univariate analysis revealed that significant risk factors include high BMI
(p=0.022), no history of malignant disease (p=0.045), history of ischemic heart
disease (p=0.049), cut LSPV at peripheral branch (p=0.029), pN2 (p=0.005),
pStage III or higher (p=0.007), and adjuvant chemotherapy (p=0.005). In
multivariate analysis, only pStage III was the significant risk factor.
Odds Ratio
95% Confidence
Interval
p Value
BMI 1.170 0.992 - 1.379 0.061
History of malignant
disease
0.288 0.037 - 2.273 0.238
POSTER SESSION 3 – P3.04: SURGERY
MISCELLANEOUS I –
WEDNESDAY, DECEMBER 7, 2016
History of ischemic
heart disease
Cut LSPV at
peripheral branch
3.485 0.952 - 12.756 0.059
3.611 0.801 - 16.272 0.095
P3.04-003 INCIDENCE AND OUTCOME OF FEMALE PATIENTS WITH
PREVIOUS BREAST CANCER UNDERGOING CURATIVE RESECTION
FOR LUNG CANCER
Sabrina Tahon, Ariane Steindl, Mai Nguyen, Balazs Dome, Viktoria Laszlo,
Walter Klepetko, Thomas Klikovits, Mir Hoda
Division of Thoracic Surgery, Medical University Vienna, Vienna/Austria
Background: Due to recent improvements in breast cancer (BC) therapy
and outcome, female patients with BC may be at higher risk of developing
secondary malignancies such as lung cancer (LC). The aim of this study is to
evaluate the incidence and outcome of previous BC in female patients with
resectable lung cancer. Methods: A retrospective non-interventional singecenter
cohort study was conducted, assessing all female patients undergoing
curative resection for LC between 2006 and 2013 at our institution by
reviewing medical charts. Follow-up will be completed in September 2016.
Incidence of previous BC among these patients was the primary endpoint.
Subsequent secondary correlation of clinical parameters was performed using
uni- and multivariate logistic and cox regression models. Results: Allover,
463 female patients with LC were identified. The incidence of previous BC
was 8.6% (40/463). Mean age was 64.1 years (SD ± 11.5) and was not different
between patients with LC and LC/BC. Main histological LC subtype was adeno-
pStage III or IV 3.830 1.394 - 10.524 0.009
Table1. Multivariate Analysis of Clinicopathologic Factors Conclusion:
Thromboses were formed frequently after left upper lobectomy for advanced
lung cancer.
Keywords: risk factor, lobectomy, complication, pulmonary vein stump
thromboses
POSTER SESSION 3 – P3.04: SURGERY
MISCELLANEOUS I –
WEDNESDAY, DECEMBER 7, 2016
P3.04-005 EVALUATION OF NONINVASIVE LUNG
ADENOCARCINOMA USING 3D-CT IMAGING
Katsuyuki Suzuki 1 , Satoshi Shiono 2 , Kei Yarimizu 2
1 Department of Thoracic Surgery, Yamagata Prefectural Central Hospital,
Yamagata/Japan, 2 Thoracic Surgery, Yamagata Prefectural Central Hospital,
S728 Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017