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P1.08-073 Experience of Third Primary Lung Tumors after Treatment of First and Second Primary Lung Cancer
S776
Journal of Thoracic Oncology
Conclusion: Completion pneumonectomy has been considered as a complex and high risk surgical procedure, however, due to the recent progresses made in the surgical techniques and post-operative management, the CP in the setting of locally recurrent NSCLC became safe and favorable treatment option. More importantly, tumor specimen obtained by the CP can be used for selecting the updated molecular target drugs which might be helpful for patient’s long term survival. Keywords: Surgery, completion recurrence, lung cancer
pneumonectomy,
P1.08-073 Experience of Third Primary Lung Tumors after Treatment of First and Second Primary Lung Cancer Topic: Surgery for Locally Advanced and Advanced NSCLC Takehiro Watanabe, Takahisa Koizumi, Tatsuhiko Hirono Thoracic Surgery, Nishi-Niigata Chuo National Hospital, Niigata/Japan Background: Widespread adoption of lung cancer screening and development of high-resolution computed tomography (HRCT) have led to a marked increase in the detection of early lung cancer in Japan. After curative resection for early lung cancer, second primary lung cancers develop in a significant proportion. The majority of these cancers are detected at an early stage because of careful follow-up using HRCT. In our experience, more than 80% of these patients were treated with surgery or radiation therapy, and some of them have acquired with long-term survival. Recently we have experienced with third primary lung tumors in long-term survivors. In this paper, we reviewed the incidence, management, and outcome of third primary lung tumors. Methods: Between April 1996 and March 2016, 1194 patients underwent complete resection for primary lung cancer in our institution. Of these individuals, patients who developed a third primary lung tumor were selected for this study. Results: Of 1194 consecutive patient, 105 patients (8.8%) developed second primary lung cancers, and 11 patients (1%) of them developed third primary lung tumors. The patients included 10 men and one woman. The initial resection for primary lung cancer was lobectomy in 9 patients and segmentectomy in 2.
Vol. 12 No. 1S
Surgical resection for second primary lung cancer was performed in 8 patients, and radiation therapy was performed in 3. Four of the 11 patients underwent resection for third primary lung tumors. One patient had completion pneumonectomy, 1 had segmentectomy, and 2 had wedge resections. Five patients were treated by radiation therapy. The two remaining patients received best supportive care. Survival after resection of first primary lung cancer ranged from 50 months to 185 months, with a median survival of 138 months and an average survival of 137 months. Currently, 4 patients are alive without evidence of recurrence. Among them, three patients were treated by their third pulmonary resection, and one patient was treated by radiation therapy. Conclusion: During 20 years, third primary lung tumors were diagnosed in only 11 patients (1%). But long-term survivors after resection of lung cancer are increasing. Careful follow-up and early detection of second primary lung cancers using HRCT will induce the increase of experience for treatment of third primary lung tumors. In our little experience, aggressive surgery for third primary lung tumors may improve survival. Keywords: third primary lung tumor, radiation therapy, lung cancer, Surgery
P1.08-074 Effect of Intrapleural Perfusion Hyperthermic Chemotherapy in NonSmall Cell Lung Cancer with Pleural Seeding Topic: Surgery for Locally Advanced and Advanced NSCLC Hyo-Jun Jang,1 Kyung Wook Shin,1 Sukki Cho,1 Sook Whan Sung,2 Kwhanmien Kim,1 Sanghoon Jheon1 1Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam/Korea, Republic of, 2Seoul St.Mary’s Hospital, Seoul/Korea, Republic of Background: Pleural seeding is generally associated with poor prognosis in advanced non-small cell lung cancer (NSCLC). Although palliative chemotherapy is the mainstay modality for these patients, intrapleural perfusion hyperthermic chemotherapy (IPHC) may be a good alternative. The aim of this study was to evaluate the efficacy of IPHC and predictive factors for longer survival in NSCLC with pleural seeding.
Journal of Thoracic Oncology
Conclusion: Completion pneumonectomy has been considered as a complex and high risk surgical procedure, however, due to the recent progresses made in the surgical techniques and post-operative management, the CP in the setting of locally recurrent NSCLC became safe and favorable treatment option. More importantly, tumor specimen obtained by the CP can be used for selecting the updated molecular target drugs which might be helpful for patient’s long term survival. Keywords: Surgery, completion recurrence, lung cancer
pneumonectomy,
P1.08-073 Experience of Third Primary Lung Tumors after Treatment of First and Second Primary Lung Cancer Topic: Surgery for Locally Advanced and Advanced NSCLC Takehiro Watanabe, Takahisa Koizumi, Tatsuhiko Hirono Thoracic Surgery, Nishi-Niigata Chuo National Hospital, Niigata/Japan Background: Widespread adoption of lung cancer screening and development of high-resolution computed tomography (HRCT) have led to a marked increase in the detection of early lung cancer in Japan. After curative resection for early lung cancer, second primary lung cancers develop in a significant proportion. The majority of these cancers are detected at an early stage because of careful follow-up using HRCT. In our experience, more than 80% of these patients were treated with surgery or radiation therapy, and some of them have acquired with long-term survival. Recently we have experienced with third primary lung tumors in long-term survivors. In this paper, we reviewed the incidence, management, and outcome of third primary lung tumors. Methods: Between April 1996 and March 2016, 1194 patients underwent complete resection for primary lung cancer in our institution. Of these individuals, patients who developed a third primary lung tumor were selected for this study. Results: Of 1194 consecutive patient, 105 patients (8.8%) developed second primary lung cancers, and 11 patients (1%) of them developed third primary lung tumors. The patients included 10 men and one woman. The initial resection for primary lung cancer was lobectomy in 9 patients and segmentectomy in 2.
Vol. 12 No. 1S
Surgical resection for second primary lung cancer was performed in 8 patients, and radiation therapy was performed in 3. Four of the 11 patients underwent resection for third primary lung tumors. One patient had completion pneumonectomy, 1 had segmentectomy, and 2 had wedge resections. Five patients were treated by radiation therapy. The two remaining patients received best supportive care. Survival after resection of first primary lung cancer ranged from 50 months to 185 months, with a median survival of 138 months and an average survival of 137 months. Currently, 4 patients are alive without evidence of recurrence. Among them, three patients were treated by their third pulmonary resection, and one patient was treated by radiation therapy. Conclusion: During 20 years, third primary lung tumors were diagnosed in only 11 patients (1%). But long-term survivors after resection of lung cancer are increasing. Careful follow-up and early detection of second primary lung cancers using HRCT will induce the increase of experience for treatment of third primary lung tumors. In our little experience, aggressive surgery for third primary lung tumors may improve survival. Keywords: third primary lung tumor, radiation therapy, lung cancer, Surgery
P1.08-074 Effect of Intrapleural Perfusion Hyperthermic Chemotherapy in NonSmall Cell Lung Cancer with Pleural Seeding Topic: Surgery for Locally Advanced and Advanced NSCLC Hyo-Jun Jang,1 Kyung Wook Shin,1 Sukki Cho,1 Sook Whan Sung,2 Kwhanmien Kim,1 Sanghoon Jheon1 1Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam/Korea, Republic of, 2Seoul St.Mary’s Hospital, Seoul/Korea, Republic of Background: Pleural seeding is generally associated with poor prognosis in advanced non-small cell lung cancer (NSCLC). Although palliative chemotherapy is the mainstay modality for these patients, intrapleural perfusion hyperthermic chemotherapy (IPHC) may be a good alternative. The aim of this study was to evaluate the efficacy of IPHC and predictive factors for longer survival in NSCLC with pleural seeding.