P1.16-002 Management of Local Recurrence after Segmentectomy for Stage IA Lung Cancer

S2050 Background: The proportion of younger patients with lung cancer is smaller than the older. But, as with older patients, the number is on the rise and clinical features of younger patients might be different compared to older patients. So we investigated the characteristics of younger patients with resected lung cancer through reviewing medical records. Method: From January 2010 to December 2014, 424 patients underwent operation for lung cancer at Pusan national university hospital. Mean age was 63.4±9.8 years old. Of them, 135 were under 60 years old (younger group). Medical records including demographic factors, histological type, surgical factors and outcomes, disease free survival rate (DFS) and overall survival rate (OS) were reviewed retrospectively. Result: In younger group, mean age was 52.2±7.6 years old and proportion of female was significantly higher (p value¼0.00). Co-morbidity and other combined malignancies were smaller (respectively, p value ¼ 0.00 and 0.007) and proportion of adenocarcinoma were higher than older group (p value ¼ 0.03). Mean operative time was shorter than older group (4.57 versus 4.90 hours, p value¼ 0.03). There was no significant difference in other factors (postoperative complications, surgical approach, FEV1, hospitalization, and etc.). Mean follow up duration was 34.0±17.7 months, and 3 year DFS and 3 year OS of younger group in stage IA was 97.9% (versus 94.0% in older patients, p value ¼ 0.009) and 96.4% (versus 93.3% in older patients, p value ¼ 0.07). In other stage, there was no significant difference of DFS and OS. Conclusion: This study shows that there were significantly different characteristics between younger and older patients group including DFS in pathologic stage IA, sex, and proportion of histological type, and suggests that development and application of more adequate modalities for early diagnosis and treatment in younger patients is needed. Keywords: lung cancer, young patients, clinical characteristics

P1.16-002 Management of Local Recurrence after Segmentectomy for Stage IA Lung Cancer T. Mori, F. Kosuke, T. Yamada, H. Osumi, Y. Motooka, E. Matsubara, K. Shiraishi, K. Ikeda, M. Suzuki Thoracic Surgery, Kumamoto University Hospital, Kumamoto/JP Background: Segmentectomy is thought to be able to spare lung parenchyma compared with lobectomy. On the other hand it might cause more local recurrences. The management of local recurrence after segmentectomy is thought to be an important issue. The aim of this study is to evaluate the management of local recurrence after segmentectomy. Method: From June 2005 to March 2009 we performed segmentectomy for clinical stage IA lung cancer, 88 male and 91 female with mean age of 66 year-old (32-83). The histological types of 179 lung tumors according to WHO histological classification are as follows: atypical adenomatous hyperplasia (2), adenocarcinoma in situ (34), minimally invasive adenocarcinoma (27), invasive adenocarcinoma (96), Squamous cell carcinoma (2), adenosquamous carcinoma (4), and carcinoid (2), respectively. Median follow-up time was 2920 days. During follow up there were 15 recurrences. Of 15 cases with recurrence 6 cases had local recurrences without distant metastasis. Result: Mean time to local recurrence after segmentectomy was 1595 ± 1027 days (356－2965). Of 6 cases with local recurrence 5 cases had micropapillary component more than 5%. The initial treatments for local recurrence were as

Journal of Thoracic Oncology

Vol. 12 No. 11S2

follows: completion lobectomy (4), radiation (1), radiofrequency ablation (1), respectively. Three of 6 cases have been alive without evidence of disease since initial treatment for local recurrence of lung cancer. Conclusion: Management of local recurrence after segmentectomy is important. Local treatment, such as, completion lobectomy, radiation, or radio frequency ablation may effective for selected cases. Keywords: local recurrence, lung cancer, segmentectomy

P1.16-003 Learning Curve for Adoption of Robotic Lobectomy for Early Stage Non-Small Cell Lung Cancer by a Thoracic Surgeon Experienced in Open Lobectomy S. Gallagher,1 A. Abolhoda,2 V. Kirkpatrick,1 A. Saffarzadeh,1 M. Thein,2 S. Wilson2 1University of California, Irvine, Orange, CA/US, 2 Surgery, Long Beach Va Medical Center, Long Beach/US Background: Optimal minimally invasive approach in treatment of non-small cell lung cancer (NSCLC) is controversial. Our goals were: 1.To profile the learning curve of adoption of robotic lobectomy by an experienced open thoracic surgeon, novice with VATS-lobectomy techniques; 2. To compare the clinical outcomes of robotic lobectomy vs. historical open lobectomy by the same surgeon (AA). Method: We conducted a retrospective review of 157 consecutive patients undergoing lobectomy for clinical stage I and II NSCLC by one surgeon, previously novice in performing minimally invasive lobectomy, at a single facility between 2007 and 2014. Robotic platform was adopted in 2011. 57 patients underwent open thoracotomy (OT), 40 prior to 2011, and 100 patients underwent robotic lobectomy. Result: The preoperative characteristics and risk profile of the two groups were similar. Aside from longer operative time (a bimodal learning curve), the robotic group (including 13% of patients with open conversion) had significantly lower intraoperative blood loss and overall morbidity rate, significantly shorter chest tube duration and length of stay, and a statistical trend toward lower 90 day mortality and 30 day readmission rate (Table 1). Median number of lymph node stations dissected and percentage of pathologic nodal upstaging were equivalent between robotic and OT groups (5 vs. 4; 17% vs. 14%, respectively). The conversion rate for the latter half of the robotic group was significantly lower (6% vs. 20%, p<0.05). Conclusion: Adoption of robotic platform for lobectomy for NSCLC is safe and feasible without significant