Pneumonectomy for Locally Advanced Lung Cancer after Neoadjuvant Concurrent Chemo-radiation Therapy K. Okabe, H. Tao, T. Tanaka, T. Hayashi, K. Yoshiyama,

Slides:

Advertisements

Similar presentations

Advertisements

IN THE NAME OF GOD. Outcomes after resection of locally advanced or borderline resectable pancreatic cancer after neoadjuvant therapy The American Journal.

Post-operative Radiotherapy for Esophageal Cancer Parag Sanghvi, M.D., M.S.P.H. Department of Radiation Medicine Esophageal Care Conference 3/26/2007.

I I. B.- T R E A T M E N T P L A N: DOCETAXEL 75 mg/m2 40 mg/m2 THORACIC RT (66 Gys: 180 cGy/d) CISPLATIN 40 mg/m2 Days E V A L U A.

Rectal Cancer: A Complete Clinical Response…Now what?

« A Clear cell sarcoma » FN. 25 year-old male January cm mass on the medial side of the right heel Early August cm clinical right.

NSCLC Pancoast tumor Swiss tumor board Bern – Dr. Christian Monnerat Département Pluridisciplaire d’Oncologie – Hôpital Neuchâtelois Service.

H. AlHussain, I. Busca, L. Eapen,, S. El-Sayed The Ottawa Hospital Cancer Center, University of Ottawa Department of Radiation Oncology.

Controversies in Adjuvant Therapy for Pancreatic Cancer Parag Sanghvi M.D. Tasha McDonald M.D. Department of Radiation Medicine OHSU.

62 years old man Main complaint: Back pain at night but not during the day Loss of appettite Weight loss.

Abstract Neoadjuvant Chemotherapy First, Followed by Chemoradiation and Then Surgery, in the Management of Locally Advanced Rectal Cancer A. Cercek, K.

Neoadjuvant Adjuvant Curative Palliative Neoadjuvant Radiation therapy the results of a phase III study from Beijing demonstrated a survival benefit.

A Propensity-matched Study of Lobectomy Versus Segmentectomy for Radiologically Pure Solid Small-sized Non-small Cell Lung Cancer Terumoto Koike 1, Seijiro.

Prof Ramesh S Bilimagga President AROI Group Medical Director - HCG.

AATS Postgraduate Course April 26, 2015 N2 - Current Evidence: Is There Role for Surgery? Is There a Role for Postop Radiation for Surprise N2? Linda W.

Prospective Phase II Study of Preoperative Radiotherapy and Oral Capecitabine followed by Total Mesorectal Exicision (TME) in Locally Advanced Rectal Cancer.

Who Should be Responsible for the Initial Diagnosis and Staging of Lung Cancer? Surgeons vs. Non-Surgeons: Competition or Collaboration Moishe Liberman.

Experience and Outcomes with Hypofractionated Concurrent Chemoradiation for Stage III NSCLC at NCCC Gregory Webb Medical Student.

A phase I study on the combination of neoadjuvant radiotherapy plus pazopanib in patients with locally advanced soft tissue sarcoma of the extremities.

Clinical features and outcome in ovarian sarcomas: Analysis of a single-institution experience A López Pousa, X Gonzàlez Farré, MJ. Quintana, S Bagué,

Thoracic Surgery By Mike Poullis.

In the name of God Isfahan medical school Shahnaz Aram MD.

LUNG CANCER Dr.Mohammadzadeh. Lung cancer is the leading cancer killer in the United States. Every year, it accounts for 30% of all cancer deaths— more.

1 Phase II trial of sequential gemcitabine and carboplatin followed by paclitaxel as first-line treatment of advanced urothelial carcinoma Presented by.

Phase II Trial of Continuous Course Re- irradiation Concurrent with Weekly Cisplatinum and Cetuximab for Recurrent Squamous Cell Carcinoma of The Head.

Definitive chemo-radiotherapy for esophageal cancer; failure pattern and salvage treatments Ryuta Koike, Y. Nishimura, K. Nakamatsu, S. Kanamori, M. Okubo,

A phase I dose escalation study of Nimotuzumab in combination with concurrent chemoradiation for patients with locally advanced squamous cell carcinoma.

SYNCHRONOUS COLORECTAL AND LIVER RESECTION J Peter A Lodge MD FRCS HPB and Transplant Unit St James’s University Hospital Leeds LS9 7TF 2006 Association.

CASE 1 65-year-old man No other diseases or previous surgeries July 2005: PSA 11.5 ng/ml; F/T: 9% After prostate biopsy revealing adenocarcinoma: RETROPUBIC.

Anal Cancer - Case 1  62 years old woman with 6 months history of anal pain  Clinically T 3 squamous cell carcinoma growing anteriorly  Which staging.

Phase Ⅱ Trial of Docetaxel and Cisplatin Neoadjuvant Chemotherapy Followed by Intensity-modulated Radiotherapy with Concurrent Cisplatin in Locally Advanced.

NSCLC stage IIIA type of chemotherapy ? Swiss tumor board Bern – Dr. Christian Monnerat Département Pluridisciplaire d’Oncologie – Hôpital Neuchâtelois.

Gene Expression Signatures for Prognosis in NSCLC, Coupled with Signatures of Oncogenic Pathway Deregulation, Provide a Novel Approach for Selection of.

The treatment of metastatic squamous cell carcinoma (SCCA) of the anal canal: A single institution experience P. Pathak, B. King, A. Ohinata, P. Das, C.H.

Effect of preoperative concurrent chemoradiotherapy on survival of patients with resectable esophageal or esophagogastric junction cancer: Results from.

Accelerated hemithoracic radiation followed by extrapleural pneumonectomy for malignant pleural mesothelioma Marc de Perrot, Ronald Feld, Natasha B Leighl,

LCC REC-1 Φ π π π Φ Φ See Primary and Adjuvant Treatment (LCC REC-3) Observe or See Primary Treatment (LCC REC-3) Rectal Cancer.

Management of the primary in Stage IV colorectal cancer Erin Kennedy, MD, PhD, FRCSC Colorectal Surgery Mount Sinai Hospital University of Toronto.

Jens Jakob 1 ; Anna Simeonova 2 ; Bernd Kasper 3 ; Ulrich Ronellenfitsch 1 ; Frederik Wenz 2 ; Peter Hohenberger 1 1 Department of Surgery, 2 Department.

Background Carcinoma of the anal canal accounts for 1.5% of all digestive system malignancies in the United States. 1 The annual incidence continues to.

. Background Paclitaxel and Irinotecan in Platinum Refractory or Resistant Small Cell Lung Cancer: a Galician Lung Cancer.

Taipei VGH Practice Guidelines: Oncology Guidelines Index Cancer of Lung Version Table of Content StagingStaging, ManuscriptManuscript Taipei Veterans.

Journal Club Dr. Eyad Al-Saeed Radiation Oncology 12 January, 2008.

LCC COL-1 See Pathologic Stage, Adjuvant Therapy, and Surveillance (LCC COL-3) Φ Φ Φ π π π Colon Cancer.

What Factors Predict Outcome At Relapse After Previous Esophagectomy And Adjuvant Therapy in High-Risk Esophageal Cancer? Edward Yu 1, Patricia Tai 5,

Adjuvant and Neoadjuvant Therapy in Non- Small Cell Lung Cancer Seminars in Oncology 2oo5;32 (suppl 2):S9-S15 Kyung Hee Medical Center Department of Thoracic.

Complete pathologic responses in the primary of rectal or colon cancer treated with FOLFOX without radiation A. Cercek, M. R. Weiser, K. A. Goodman, D.

Adjuvant Chemotherapy for Non–Small-Cell Lung Cancer in the Elderly: A Population-Based Study in Ontario, Canada JOURNAL OF CLINICAL ONCOLOGY, VOLUME 30.

Lung cancer Gene Kukuy, MD Cardiothoracic Surgery.

Adjuvant or neoadjuvant chemotherapy in minimal N2 stage IIIA nonsmall cell lung cancer Sofie De Craenea, Veerle Surmonta,b and Jan P. van Meerbeeck Current.

Neoadjuvant chemotherapy in the treatment of NSCLC Department of Thoracic Oncology, University Hospital Ghent, Belgium Current Opinion in Oncology 2007,

Multi-station N2 Ca Lung

Brain imaging prior to lung cancer resection

Results of Definitive Radiotherapy in Anal Canal Carcinoma

Basile Pache, Antonia Digklia*, Nicolas Demartines, Maurice Matter.

Brain imaging prior to lung cancer resection

Surgical treatment of hepatic and pulmonary metastases from colon cancer James R Headrick, MD, Daniel L Miller, MD, David M Nagorney, MD, Mark S Allen,

Outcomes of patients in the North Trent region with advanced non-small-cell lung cancer treated with maintenance pemetrexed following induction with platinum.

Treatment With Continuous, Hyperfractionated, Accelerated Radiotherapy (CHART) For Non-Small Cell Lung Cancer (NSCLC): The Weston Park Hospital Experience.

Concurrent chemotherapy and hyperthermia in patients with recurrent cervical cancer after chemoradiation: outcome and survival S.T. Heijkoop1,2; H.C. van.

Prognosis of younger patients in non-small cell lung cancer

Relationship between the site of esophageal carcinoma and survival of patients with locally advanced disease Authors: Andrea Masarykova, Ingrid Zavacka,

Improved survival outcomes after resection of ductal adenocarcinoma in the body and tail of the pancreas: A single center 10 years’ experience Seong.

Evaluate the results of concomitance chemoradiotherapy postoperative treatment for rectal cancer in stage II-III At K Hospital from 2012 to 2016 Speaker:

Effect of Neoadjuvant Concurrent Chemoradiotherapy on Locally Advanced Middle and Low Rectal Cancer— A Propensity Score Matching Study 官泰全,林春吉,楊純豪,姜正愷,林宏鑫,藍苑慈,

EVALUATE EFFECTIVENESS OF GEFIITINIB IN FIRST LINE TREATIMENT AVANCED NSCLC PATIENTS WITH EGFR MUTATION BS TRẦN THỊ CHUNG, Ths. NGUYỄN THỊ OANH Oncology.

Surgical treatment of hepatic and pulmonary metastases from colon cancer James R Headrick, MD, Daniel L Miller, MD, David M Nagorney, MD, Mark S Allen,

Cystic Neoplasm of the Pancreas Clinical Review of 60 Cases and Treatment Strategy D.K.Kim, S.I.Noh, J.S.Heo, J.H.Noh, T.S.Sohn, S.J.Kim, S.H.Choi, J.W.Joh,

Neoadjuvant Adjuvant Curative Palliative

Eung Chang Lee, Sung-Sik Han, Hyeong Min Park,

Presentation transcript:

Pneumonectomy for Locally Advanced Lung Cancer after Neoadjuvant Concurrent Chemo-radiation Therapy K. Okabe, H. Tao, T. Tanaka, T. Hayashi, K. Yoshiyama, M. Furukawa, K. Yoshida Division of Thoracic Surgery National Hospital Organization Yamaguchi Ube Medical Center, Japan

Disclosure none

Purpose To evaluate pneumonectomy for locally advanced non-small-cell lung cancer (NSCLC) after neoadjuvant concurrent chemotherapy and radiotherapy

Materials and Methods 16 consecutive patients with locally advanced NSCLC treated by pneumonectomy after neoadjuvant concurrent chemo-radiation therapy from Jan to present Prognosis data updated in March 2015 One institutional retrospective study

CDDP 40 mg/m 2 + TXT 40 mg/m 2 (Day 1, 8, 29, 36) Radiation 46 Gy (2 Gy x 23) tumor, hilum, and mediastinum Surgery 4 to 6 weeks after the end of radiotherapy No adjuvant treatment for R0 resection Pneumonectomy after neoadjuvant concurrent chemo-radiation therapy

Results Mean age at peumonectomy: 59 ( ) Sex: female 3, male 13 Side: right 3, left 13 Intrapericardial pneumonectomy: 7

Pathological diagnosis adenocarcinoma 7 squamous cell carcinoma 6 adenosquamous cell carcinoma 1 large cell neuroendocrine carcinoma 1 atypical carcinoid (preoperative diagnosis: squamous) 1

c-Stage before chemo-radiation IIIB: 6, IIIA: 8, IIA: 1, IB: 1 T4: 9, T3: 3, T2: 3, T1: 1 N2: 9, N1: 5, N0: 2 c-N2: 9 patients radiological (CT, PET) N2: 5 patients pathological (EBUS, c-MED) N2: 4 patients

Abnormal blood tumor marker CEA 337, 105, 33 ng/ml [normal range < 5.0 ] CYFRA 20, 11 ng/ml [normal range < 2.0] SCC 10, 8.5 ng/ml [normal range < 1.5] All abnormal blood tumor markers: down to normal

Grade 3 toxicity of neoadjuvant chemo-radiation Neutropenia 10 (63%) Anorexia 3 Diarrhea 1 Liver damage 1 Grade 4 toxicity: none

Bronchial stump buttress the first right patient (2008) by the omentum other 15 patients by the intercostal muscle flap Median operation time: 4 h 35 m (2 h 35 m – 7 h 30 m) Median bleeding amount: 175 g (60 g – 560 g)

R0 resection: all 16 patients Serious operative complication: none p-Stage after pneumonectomy CR (complete response) 6 (38%) IIIB 1 IIIA 2 IIA 3 IB 1 IA 3

Prognosis All 16 patients are alive without oxygen therapy. Median follow up after pneumonectomy 3 years 9 months (1 y 4 m – 8 y 2 m) PS 0: 15 patients, PS 1: 1 patient c-Stage of five 5-year-survivors: IIIB 4, IIIA 1 14 patients have NO recurrent or metastatic cancer.

Two patients have developed metastatic lesions. Contralateral lung metastasis was resected in 1 patient. Sep. 2009: lt pneumonectomy Jul. 2013: contralateral lung metastasis resection March 2015: alive without cancer The other patient is alive with metastatic lesions. Sep. 2012: lt pneumonectomy Sep. 2014: liver, abdominal LN, retro-peritoneum March 2015: alive

Conclusions 16 patients who underwent pneumonectomy for locally advanced NSCLC after neoadjuvant concurrent chemo-radiation therapy are all alive. This treatment strategy seems to be feasible and effective.

Thank you for your attention! K. Okabe Chief, Division of Thoracic Surgery National Hospital Organization Yamaguchi Ube Medical Center, Japan