Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
cancer. However, the patients who have poor lung function or small size
lung nodule underwent sublobar resection. We retrospective reviewed the
oncologic outcome after sublobar resection lobectomy in stage I and II nonsmall
cell lung cancer. Methods: 1019 consecutive patients who underwent
lung resection surgery due to non-small cell lung cancer between January
2000 and December 2009 were evaluated through retrospective chart
review. We used the Kaplan-Meier method to exam survival and recurrence,
Cox proportional hazard model to identify variables affection survival and
recurrence. Results: We performed lobectomy in 928 patients, while sublobar
resection in 90 patients. 5-year survival and 10-year survival were not shown
statistically significant between sublobar resection and lobectomy (77.0% vs.
80.7%, 58.5% vs. 62.1%, p=0.566). 5-year and 10-year disease free survival were
not also shown the difference between sublobar resection and lobectomy
(68.9% vs. 63.8%, 67.8% vs. 58.7%, p=0.246). Univariate analysis using the Cox
proportional hazards regression model identified sublobar resection is not
predicting factor for recurrence (p=0.246). Conclusion: Our results suggest
that the oncologic outcome of sublobar resection versus lobecotomy is not
significant difference in stage I and II non-small cell lung cancer patients.
These results will be validated by prospective randomized trial.
Keywords: lobectomy, non-small cell lung cancer, sublobar resection
POSTER SESSION 3 – P3.04: SURGERY
MISCELLANEOUS I –
WEDNESDAY, DECEMBER 7, 2016
P3.04-025 REPEATED LUNG RESECTION OF IPSILATERAL LUNG
CANCER THAT IS DETECTED AFTER SEGMENTECTOMY FOR
PRIMARY LUNG CANCER
Masanori Tsuchida 1 , Tatsuya Goto 2 , Akihiko Kitahara 1 , Seijiro Sato 1 , Terumoto
Koike 1
1 Thoracic and Cardiovascular Surgery, Niigata University Graduate School of
Medical and Dental Sciences, Niigata/Japan, 2 Niigata University, Niigata/Japan
Background: Small peripheral lung cancer has increasingly been treated by
segmentectomy as a limited resection for both curative and compromised
intent. Few reports have described repeated resection of a new lesion
originating in the lung of same side during postoperative follow-up. Methods:
We experienced five cases of repeated ipsilateral lung resection after
segmentectomy. Clinicopathological data and operative procedure were
analyzed retrospectively. Results:
The reason of limited resection for the first lung cancer was compromised
intent in three cases and curative intent in two cases. Median time to
second operation after initial resection was 63 months (20 to 106 months).
Preoperative pulmonary function test before repeated operation was normal
in all cases. In four cases, location of second cancer was in the same lobe of
the first cancer. Procedure of repeated resection was partial resection in
one, segmentectomy in two, completion lobectomy in one and completion
pneumonectomy in one. All tumor were resected completely. There was no
morbidity nor mortality. Histological diagnosis of second cancer was surgicalmargin
recurrence in two, second primary cancer in three. All cases except
partial resection required intrapericardial vascular exposure due to severe
adhesion around pulmonary artery and vein. Among five cases, completion
lobectomy of the left upper lobe was the most difficult surgery due to
adhesion between pulmonary artery and bronchus. Conclusion: Repeated
resection of ipsilateral lung cancer detected after segmentectomy was
undergone safely. The difficulty of the procedure depends on the location of
the tumor and the type of procedures.
Keywords: segmentectomy, repeated lung resection, primary lung cancer
POSTER SESSION 3 – P3.04: SURGERY
MISCELLANEOUS I –
WEDNESDAY, DECEMBER 7, 2016
P3.04-026 A SIMULTANEOUS SURGICAL STRATEGY FOR PATIENTS
WITH LUNG CANCER AND SEVERE CARDIAC DISEASES REQUIRING
SURGICAL TREATMENT
Jae Jun Jung 1 , Jong Ho Cho 2 , Jhingook Kim 2 , Young Mog Shim 2 , Young Tak Lee 1
1 Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of
Medicine, Samsung Medical Center, Seoul/Korea, Republic of, 2 Department
Thoracic & Cardiovascular Surgery, Sungkyunkwan University School of Medicine,
Samsung Medical Center, Seoul/Korea, Republic of
Background: The simultaneous surgical treatment of lung carcinoma and
cardiac disease is rare.The aim of the study was to analyze the early and midterm
results of simultaneous surgical treatment for concomitant lung cancer
and cardiac diseases which both needs surgical treatment. Methods: We
performed a retrospective review of 12 patients who underwent pulmonary
and cardiac surgery, from 2002 to 2015, in a single institution. We focused
on early postoperative morbidity and mortality. Results: Total 12 patients
were recruited from 2002 to 2015 in the department of cardiothoracic surgery
at the Samsung Medical Center in Korea. Nine patients were the diagnosed
as concomitant non-small cell lung cancer and coronary artery disease, one
patient was diagnosed as concomitant non-small lung cancer and aortic arch
aneurysm, one patient was diagnosed as concomitant non-small lung cancer
and mitral stenosis with tricuspid regurgitation, one patient was diagnosed as
concomitant BALtoma and ASD with pulmonary hypertension. Various cardiac
surgeries were performed simultaneously with the pulmonary resection.
Ten patients were performed via median sternotomy, and 2 patients were
performed via anterior thoracotomy. The mean age of the patients was 62.7
years old. Follow-up ranging from 6 months to 12 years is available for these
patients. The lobectomy by median sternotomy rate was 41.6 % (5 patients),
the lobectomy by anterior thoracotomy rate was 16.7 % (2 patients), and the
wedge resection by median sternotomy rate was 41.6 % (5 patients). There
were no mortality or major morbidity, apart from 8 minor complications in
four patients (33.3%) (air leak, atrial fibrillation, atelectasis, pneumonia,
delirium). Conclusion: Simultaneous cardiac surgery and lung resection in this
small number of patients were safely performed without life-threatening
morbidity and no in-hospital mortality.
Keywords: simutaneous surgery, lung cancer, cardiac disease
POSTER SESSION 3 – P3.04: SURGERY
MISCELLANEOUS I –
WEDNESDAY, DECEMBER 7, 2016
P3.04-027 FEASIBILITY OF LUNG CANCER SURGERY FOR THE
PATIENT WITH PREVIOUS HISTORY OF CORONARY ARTERY BYPASS
GRAFTING
Yutaro Koike 1 , Aritoshi Hattori 2 , Takeshi Matsunaga 1 , Kazuya Takamochi 1 ,
Shiaki Oh 1 , Kenji Suzuki 2
1 Juntendo University Hospital, Tokyo/Japan, 2 General Thoracic Surgery, Juntendo
University Hospital, Tokyo/Japan
Background: Owning to the aging society all over the world, high-risk lung
cancer patients with severe cardio-pulmonary complications is more common.
Among them, thea likelihood to encounter lung cancer patient with a previous
history of coronary artery bypass grafting (CABG) has been increasing in our
daily practice. However, pulmonary resections after CABG are technically
challenging due to the critical adhesions around the CABG field, which need
meticulous surgery. Methods: Owning to the aging society all over the world,
high-risk lung cancer patients with severe cardio-pulmonary complications is
more common. Among them, thea likelihood to encounter lung cancer patient
with a previous history of coronary artery bypass grafting (CABG) has been
increasing in our daily practice. However, pulmonary resections after CABG
are technically challenging due to the critical adhesions around the CABG
field, which need meticulous surgery. Results: Overall patients with previous
CABG were comprised of 35 (88%) male with an average age of 70 years and
high-smoking rate (40 pack-year smoking). Location of the lung cancer was
26(65%) in right side, while 27(68%) were in upper or middle lobe and 11(28%)
in lower lobe.[a1] [y2] Clinical-stage of lung cancers were 22(55%) in IA,
6(15%) in IB and 12(30%)in II or more. Coronary CT was performed before the
operation in 13(35%). Lobectomy was performed in 27(68%), segmentectomy
in 6(15%), wedge resection in 7(18%), and mediastinal node dissection in
12(30%), respectively. Regarding CABG surgery, harvest of left / right internal
thoracic artery was performed in 20(50%) / 21(53%). Adhesions around CABG
fields were observed in 7(58%) / 5(23%), including 9(75%) upper or middle lobe
lung cancer needing perivascular exfoliation without any intraoperative graft
damage. Postoperative complications were shown in 13(33%), but the 30days
mortality was 0%. The 3-year survival rate was 71.6 %, 3-year lung cancer
specific survival rate was 76.1%. Conclusion: Results Owning to the aging
society all over the world, high-risk lung cancer patients with severe cardiopulmonary
complications is more common. Among them, thea likelihood
to encounter lung cancer patient with a previous history of coronary artery
bypass grafting (CABG) has been increasing in our daily practice. However,
pulmonary resections after CABG are technically challenging due to the
Copyright © 2016 by the International Association for the Study of Lung Cancer
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