Imanishi Naoko
   Department   University Hospital  General Thoracic Surgery, Clinical Departments
   Position  
Language English
Title P-271 COMPLETE RESECTION OF THE PRIMARY LESION FOR STAGE IV NONSMALL CELL LUNG CANCER
Conference 25th European Conference on General Thoracic Surgery
Conference Type International society and overseas society
Presentation Type Poster notice
Lecture Type Panelist at Symposium/Workshop (Applied)
Publisher and common publisherYasuhiro Chikaishi, M. Takenaka, K. Kuroda, N. Imanishi, F. Tanaka
Date 2017/05/30
Venue
(city and name of the country)
Congress Innsbruck, Innsbruck, Austria
Summary Objectives: The general treatment for stage IV Non-Small Cell Lung Cancer (NSCLC) is systemic chemotherapy. However, some patients, such as those with oligometastasis or M1a disease, are diagnosed after surgery. In this study, we retrospectively examined the outcomes following complete resection of the primary lesion for stage IV NSCLC at our institution. Methods: Thirty-eight patients underwent surgery at our department from June 2005 to May 2016 for stage IV NSCLC as the first-line treatment through complete resection of the primary lesion. We retrospectively examined the patient characteristics and prognoses. Results: The median follow-up duration for the 38 patients was 17.7 months (range, 1 to 82.3 months). The T factors were T1/T2/T3/T4 in 4/16/12/6 patients, respectively. The N factors were N0/ N1/N2/N3 in 16/8/12/2 patients, respectively. The M factors were M1a/M1b in 19/19 patients, respectively. Of the 19 M1b patients, 14 had oligomatastasis. We classified each case into R (-) and R (+) according to the degree of cure. R(-) is a patient who demonstrated no dissemination on the image among M1a and a patient in which all lesions have been locally controlled among M1b. R is a patient with dissemination observed on the image among M1a and a patient with a lesion that cannot be locally controlled among M1b The R factors were R(-)/R(+) in 21/17 patients, respectively. The histology was adenocarcinoma/squamous cell carcinoma/others in 30/5/3 patients, respectively. The 5-year overall survival rate was 29%, and the median survival time was 725 days. The prognosis of N (-) was better than N(+) (P=0.108). Squamous cell carcinoma and R(+) were significantly poor prognostic factors (p=0.002, 0.002 respectively). Conclusion: Even at stage IV, if it is other than N(-) or R(-), squamous cell carcinoma, it was thought to be the significance of surgical treatment of intervention