Impact of free tumor clusters on prognosis after resection of pulmonary adenocarcinoma Junichi Morimoto, MD, PhD, Takahiro Nakajima, MD, PhD, Hidemi.

Slides:

Advertisements

Similar presentations

Advantage of Induction Chemoradiotherapy for Lung Cancer in Securing Cancer-Free Bronchial Margin Hiroki Sato, MD, Shinichi Toyooka, MD, PhD, Junichi.

Advertisements

Improved survival with pulmonary metastasectomy: An analysis of 1720 patients with pulmonary metastatic melanoma Rebecca P. Petersen, MD, MSc, Steven.

Prognostic impacts of EGFR mutation status and subtype in patients with surgically resected lung adenocarcinoma Kazuya Takamochi, MD, Shiaki Oh, MD,

Max B. Mitchell, MD The Journal of Thoracic and Cardiovascular Surgery

Stephen R. Broderick, MD, MPHS

Is lung cancer resection indicated in patients with idiopathic pulmonary fibrosis? Atsushi Watanabe, MD, PhD, Tetsuya Higami, MD, PhD, Syunsuke Ohori,

Effect of tumor size on prognosis in patients with non–small cell lung cancer: The role of segmentectomy as a type of lesser resection Morihito Okada,

Surgical–pathologic factors affect long-term outcomes in stage IB (pT2 N0 M0) non– small cell lung cancer: A heterogeneous disease Chung-Ping Hsu, MD,

Prediction of Prognosis and Surgical Indications for Pulmonary Metastasectomy From Colorectal Cancer Toshihiko Iizasa, MD, Makoto Suzuki, MD, Shigetoshi.

Impact of tumor size on outcomes after anatomic lung resection for stage 1A non–small cell lung cancer based on the current staging system Shamus R.

The impact on survival of positive intraoperative pleural lavage cytology in patients with non–small-cell lung cancer Keiju Aokage, MD, Junji Yoshida,

Surgical treatment is decisive for outcome in chondrosarcoma of the chest wall: A population-based Scandinavian Sarcoma Group study of 106 patients Björn.

Effect of Perioperative Pirfenidone Treatment in Lung Cancer Patients With Idiopathic Pulmonary Fibrosis Takekazu Iwata, MD, PhD, Shigetoshi Yoshida,

Radical sublobar resection for small-sized non–small cell lung cancer: A multicenter study Morihito Okada, MD, PhD, Teruaki Koike, MD, PhD, Masahiko.

Pleomorphic carcinoma of the lung: A surgical outcome

Prognostic Impact of Margin Distance and Tumor Spread Through Air Spaces in Limited Resection for Primary Lung Cancer Kyohei Masai, MD, Hiroyuki Sakurai,

Outcomes of unexpected pathologic N1 and N2 disease after video-assisted thoracic surgery lobectomy for clinical stage I non–small cell lung cancer Hong.

Role of lymphatic invasion in the prognosis of patients with clinical node-negative and pathologic node-positive lung adenocarcinoma Takahiro Mimae,

Mauro Lo Rito, MD, Tamadhir Gazzaz, MD, Travis J. Wilder, MD, Rachel D

Pulmonary hypertension in valve disease: A beast of the past?

Tumor Spread through Air Spaces is an Important Pattern of Invasion and Impacts the Frequency and Location of Recurrences after Limited Resection for.

Interstitial tumor-associated macrophages combined with tumor-derived colony- stimulating factor-1 and interleukin-6, a novel prognostic biomarker in non–small.

Lung adenocarcinoma with intraoperatively diagnosed pleural seeding: Is main tumor resection beneficial for prognosis? Chi Li, MD, Shuenn-Wen Kuo, MD,

Timing of surgery for pulmonary embolism: An evolving paradigm

The prognostic role of pathologic invasive component size, excluding lepidic growth, in stage I lung adenocarcinoma Yasuhiro Tsutani, MD, PhD, Yoshihiro.

The lord of the rings Antonio Miceli, MD, PhD

Impact of prior hospital mortality versus surgical volume on mortality following surgery for congenital heart disease Matthew E. Oster, MD, Matthew J.

Esophagectomy versus endoscopic resection for patients with early-stage adenocarcinoma: Mercedes versus Tesla Toni Lerut, MD The Journal of Thoracic.

Certification in cardiothoracic surgical critical care: A distinction for some or for all? Nicholas D. Andersen, MD The Journal of Thoracic and Cardiovascular.

Karen M. Harrison–Phipps, MD, Francis C. Nichols, MD, Cathy D

Thymic carcinoma outcomes and prognosis: Results of an international analysis Usman Ahmad, MD, Xiaopan Yao, PhD, Frank Detterbeck, MD, James Huang, MD,

Loss of CRNN expression is associated with advanced tumor stage and poor survival in patients with esophageal squamous cell carcinoma Po-Kuei Hsu, MD,

Main stem bronchus surgery with pulmonary preservation

Smoking Status as a Prognostic Factor in Patients with Stage I Pulmonary Adenocarcinoma Ichiro Yoshino, MD, PhD, Daigo Kawano, MD, Taro Oba, MD, Koji.

Postinduction positron emission tomography assessment of N2 nodes is not associated with ypN2 disease or overall survival in stage IIIA non–small cell.

Impact of positive pleural lavage cytology on survival in patients having lung resection for non–small-cell lung cancer: An international individual patient.

The assessment of cost effectiveness and the effectiveness of cost assessment in cardiothoracic surgery Vinay Badhwar, MD The Journal of Thoracic and.

Results of surgical intervention for p-stage IIIA (N2) non–small cell lung cancer: Acceptable prognosis predicted by complete resection in patients with.

Prognostic Impact of Node Involvement Pattern in Pulmonary pN1 Squamous Cell Carcinoma Patients Masayuki Nakao, MD, Junji Yoshida, MD, PhD, Genichiro.

Stephen R. Broderick, MD, MPHS

Surgery for aortic and mitral valve disease in the United States: A trend of change in surgical practice between 1998 and 2005 Scott D. Barnett, PhD,

Pattern of Metastasis Outside Tumor-Bearing Segments in Primary Lung Cancer: Rationale for Segmentectomy Yuichi Sakairi, MD, PhD, Ichiro Yoshino, MD,

Chronic obstructive pulmonary disease severity influences outcomes after off-pump coronary artery bypass Benjamin Medalion, MD, Michael G. Katz, MD,

Are discordant positron emission tomography and pathological assessments of the mediastinum in non–small cell lung cancer significant? Daniel J. Tandberg,

Clinicopathologic Features and Computed Tomographic Findings of 52 Surgically Resected Adenosquamous Carcinomas of the Lung Yukio Watanabe, MD, Koji.

Left ventricular vegetations: A rare manifestation of Libman-Sacks endocarditis Naritomo Nishioka, MD, Naoto Morimoto, MD, PhD, Masato Yoshida, MD, PhD,

Niv Ad, MD, Lawrence M. Wei, MD

Pulmonary Resection for Metastases from Colorectal Cancer

The Annals of Thoracic Surgery

Phase II trial of postoperative adjuvant cisplatin and etoposide in patients with completely resected stage I-IIIa small cell lung cancer: The Japan Clinical.

Passing the torch The Journal of Thoracic and Cardiovascular Surgery

Functional tricuspid pathology: To treat or not to treat

Lymph Node Staging by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Patients With Small Cell Lung Cancer Hironobu Wada, MD, Takahiro.

Effect of virtual-assisted lung mapping in acquisition of surgical margins in sublobar lung resection Masaaki Sato, MD, PhD, Masashi Kobayashi, MD, PhD,

Improved survival with pulmonary metastasectomy: An analysis of 1720 patients with pulmonary metastatic melanoma Rebecca P. Petersen, MD, MSc, Steven.

Off-pump bilateral skeletonized internal thoracic artery grafting in patients with chronic kidney disease Takeshi Kinoshita, MD, PhD, Tohru Asai, MD,

The Journal of Thoracic and Cardiovascular Surgery

Discussion The Journal of Thoracic and Cardiovascular Surgery

The Clinical Impact of Solid and Micropapillary Patterns in Resected Lung Adenocarcinoma Naoki Yanagawa, MD, PhD, Satoshi Shiono, MD, PhD, Masami Abiko,

The future of cardiac surgery training: A survival guide

Junaid Haroon, MD, Subroto Paul, MD, MPH

Respect the aorta The Journal of Thoracic and Cardiovascular Surgery

Disease-Free Interval Length Correlates to Prognosis of Patients Who Underwent Metastasectomy for Esophageal Lung Metastases Satoshi Shiono, MD, Masafumi.

Salvage surgery for advanced non–small cell lung cancer after response to gefitinib Tomoyuki Hishida, MD, Kanji Nagai, MD, Tetsuya Mitsudomi, MD, Kohei.

Preoperative PFTs: The answer is blowing in the wind

Who should decide margin length in pulmonary excision of lung cancer?

Designing valves: An art or science?

A propensity-matched analysis comparing survival after primary minimally invasive esophagectomy followed by adjuvant therapy to neoadjuvant therapy for.

Prognostic impact of large cell neuroendocrine histology in patients with pathologic stage Ia pulmonary non–small cell carcinoma Akira Iyoda, MD, Kenzo.

Akiko Tanaka, MD, PhD, Takeyoshi Ota, MD, PhD

Presentation transcript:

Impact of free tumor clusters on prognosis after resection of pulmonary adenocarcinoma Junichi Morimoto, MD, PhD, Takahiro Nakajima, MD, PhD, Hidemi Suzuki, MD, PhD, Kaoru Nagato, MD, PhD, Takekazu Iwata, MD, PhD, Shigetoshi Yoshida, MD, PhD, Masaki Fukuyo, PhD, Satoshi Ota, MD, PhD, Yukio Nakatani, MD, PhD, Ichiro Yoshino, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 152, Issue 1, Pages 64-72.e1 (July 2016) DOI: 10.1016/j.jtcvs.2016.03.088 Copyright © 2016 Terms and Conditions

Figure 1 Pathologic findings of free tumor clusters in adenocarcinoma with micropapillary components. A, Representative pathologic findings of a micropapillary component (MPC)–positive pulmonary adenocarcinoma (low-power view). B, Individual clusters comprise 5 to 20 tumor cells with micropapillary features such as eccentric nuclei and absence of a central fibrovascular core (high-power view). The Journal of Thoracic and Cardiovascular Surgery 2016 152, 64-72.e1DOI: (10.1016/j.jtcvs.2016.03.088) Copyright © 2016 Terms and Conditions

Figure 2 A discrepancy in the sizes of tumor cells existing in the area between the macroscopic and microscopic views. A, The gross section of the tumor measured 24 mm (dotted line) and showed a 15-mm tumor with a sufficient surgical margin. B, Several nonintegrated free tumor clusters were observed floating in the alveolar spaces (circle). In this case, the cluster was found only 3 mm away from the surgical margin. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 64-72.e1DOI: (10.1016/j.jtcvs.2016.03.088) Copyright © 2016 Terms and Conditions

Figure 3 Relationship between the diameters of main tumors and the distances of nonintegrated free tumor clusters (FTCs) from the tumor margin. A, Relationship between the diameters of main tumors and the distances of nonintegrated free tumor clusters (FTCs) from the tumor margin. The vertical axis indicates the distance from the tumor edge to the furthest FTC, and the horizontal axis indicates the tumor diameter. B, The vertical axis indicates the ratio of the distance from the tumor edge to the furthest FTC divided by tumor diameter. The horizontal axis shows each patient in the FTC-positive group. All of the ratios were <1.0. Therefore, FTCs were observed only within the diameters of the main tumors. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 64-72.e1DOI: (10.1016/j.jtcvs.2016.03.088) Copyright © 2016 Terms and Conditions

Figure 4 Recurrence-free survival curves for each subgroup. A, Patients with MPCs (yellow group) experienced significantly poorer recurrence-free survival compared with patients without MPCs (gray group). B, Both MPC-positive patients without FTCs (green group) and those with FTCs (red group) experienced poorer survival than did patients without MPCs. Patients with FTCs experienced the worst survival among these 3 groups (P < .001). C, Recurrence-free survival curves of patients without MPCs by pT (pathologic assessment of the primary tumor) category. The curve of T2-MPC-negative patients (gray group) was equivalent to that of MPC-positive/FTC-negative patients (green group). D, The curve of T3-MPC-negative patients (gray group) was equivalent to that of MPC-positive/FTC-positive patients (red group). MPC, Micropapillary component; FTC, nonintegrated free tumor cluster. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 64-72.e1DOI: (10.1016/j.jtcvs.2016.03.088) Copyright © 2016 Terms and Conditions

Figure E1 Overall survival curves of the patients. A, Patients with micropapillary components (MPCs) experienced significantly poorer overall survival compared with patients without MPCs. B, MPC-positive patients with free tumor clusters experienced poorer survival than those without free tumor clusters. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 64-72.e1DOI: (10.1016/j.jtcvs.2016.03.088) Copyright © 2016 Terms and Conditions

FTC-positive patients had equivalent disease-free survival to p-T3 MPC-negative patients. The Journal of Thoracic and Cardiovascular Surgery 2016 152, 64-72.e1DOI: (10.1016/j.jtcvs.2016.03.088) Copyright © 2016 Terms and Conditions