International Conference on Frontiers in Lung Cancer November 12-13, 2019 Tokyo, Japan

Biography:

Makarov Valery is affiliated from Almaty Oncology Center, Republic of Kazakhstan. 

Abstract:

Objective.  Analysis of the immediate  results of video-assisted thoracoscopic lobectomy and lung resection.

Materials and  methods. For the period from 2014 to 2018, 118 patients with peripheral lung formation were operated on in the surgical department of the Almaty Oncology Center. The ratio of men to women is 62 and 56, respectively.

Results.The following operations were performed: lobectomy in 92 cases (78%), of which: upper lobectomy - 44 (47.8%), average lobectomy - 13 (14.1%), lower lobectomy - 32 (35%), bilobectomy - 3 (3.3%), anatomical resections - 24 (20.32%). All patients underwent extensive lymphadenectomy on the side of the operation. In 22 patients, for various reasons, a preservation of thoracotomy was performed. As a result of our analysis: the absence of N₀ lymph node damage was observed in 82 patients (70%), the first-order lymph node damage N₁ - 13 (11%), N₂ - 13 (11%), N₃-5 (4%) , N_X– 5 (4%). Most patients are activated on the first day after surgery.There was no mortality. Summing up the analysis, we want to note that the complication rate is 12.2% (13 patients). Of these, bleeding - 6 cases, in 4 cases, conversion to a minithoracotomy was necessary in order to ensure adequate surgical hemostasis. The average postoperative bed of days is 5.8. 20% of patients were discharged on the 5-6th day after surgery. 5-year survival at stage I - 72%.
Conclusion. An analysis of the direct results of the study allows us to conclude that video-assisted thoracoscopic surgery is a highly effective, minimally invasive, safe method of treating peripheral lung cancer, which allows us to recommend it for wider use in oncological practice.

Key words:
lung cancer, epidemiology, treatment of lung cancer, videothoracoscopy, VATS technique.

Biography:

Anh Tran Thị Tuan has completed his Master of Medicine specialized in Cytology and Histopathology in 2018 at Hanoi Medical University in Vietnam. She is the pathologist in Pathology Department of Vietnam National Lung Hospital, a premier hospital of Tuberculosis and Lung disease in Vietnam. She has published more than 10 papers in medicine journals of Vietnam about Lung cancer, PD-L1, tumor of the lung.

Abstract:

Immunotherapy enhances natural immunity to fight cancer. Through PD-L1 check - points, this treatment activates patient's immune system to help identify cancer cells, select and skill them. This therapy is determined to be effective even in patients with PD-L1 expression, including weakness positive. This treatment brings opportunities for many people with cancer, especially lung cancer with non small cell carcinoma type, so the most subtyp is adenocarcinoma. The development in medicine science helps more and more patients having benefit and improving the quality of life with modern treatments. Currently there are many immunohistochemistry antibodies kít used for evaluating PD-L1 expression with each of the anti-PD1 or PD-L1 drugs. Ventana's SP263 kit is the most common in using to diagnose for widely responds to the patients’s demand in treatment

Our study has 102 patients with lung adenocarcinoma in the Department of Oncology – Vietnam National Lung Hospital, stain PD – L1 with Ventana's SP263 antibodies kit by automatic system BenchMark of VENTANA with OptiView DAB IHC Detection KIT, to increase the amplification expresion of PD-L1. Also, 44 patients were tested for EGFR mutations by COBAS z480 ver2 system.

The result for the rate of PD-L1 expression is 52%, the strong positive is 21.6%. In particular, the proportion of patient having PD-L1 expression with TPS from 1-10% is 9.8% and TPS> 10% is 42.2%. PD-L1 revealed the predominance in male, smoker, advanced stage, solid subtype, grade III, age group from 60 to 69 (p <0.05). The rate of EGFR mutations was 34.1%; the  most is EGFR del19 and then is L858R in exon 21; 4.5% patients had T790M mutation. However, the correlation between the expression of PDL1 and EGFR mutation has not been determined because the number of patient who tested EGFR mutations in the study was not enough for calculation.

Biography:

Laksmi Wulandari, MD, PhD, FCCP. is a Pulmonologist, Consultant ) at Pulmonology Department, Faculty of Medicine, Airlangga University, Surabaya-Indonesia.

Abstract:

Introduction: ctDNA plasma testing is one of methods to examine biomarkers for lung adenocarcinoma tumor in order to detect mutation of epidermal growth factor receptor (EGFR). The advantages of ctDNA testing over tissue biopsy and lung tumor cytology include less invasive, faster, cheaper, and minimum complication risk for patient.

Aim: Analyzing comparison of detection of EFGR mutation in peripheral blood plasma (liquid biopsy) with cytological specimens of patient with lung adenocarcinoma.

Methods: ctDNA plasma testing was conducted in 124 patients with lung adenocarcinoma. This study was performed from January to December 2018. The results of ctDNA testing were compared with the results of EGFR cytological specimens measurement from the previous examination. 

Results: The characteristics of most patients included ages 55-59 years, males, non-smokers, stage 4A lung adenocarcinoma, with most metastasis found in pleura. We found a correlation of EGFR prevalence with non-smoking status and age. The results of ctDNA plasma testing showed 27.4% EGFR common mutation and 72.6% EGFR wild type mutation. The results of EGFR mutation cytological specimens testing were 47.6%, and 52.4% wild type. ctDNA sensitivity towards cytological was 48.3%, 90.9% specificity, 82.35% PPV, 66.7% NPV and 70.97% concordance rate.

Conclusion: EGFR mutation with cytological specimens examination was more accurate than ctDNA.

Keywords: concordance rate, ctDNA plasma, EGFR mutation, lung adenocarcinoma

Biography:

Abstract:

Trousseau’s syndrome (TS) is a hypercoagulability manifestation of the paraneoplastic syndrome (PNS), known as a variant of cancer-associated thrombosis and defined as a migratory thrombophlebitis found typically in patients with an underlying malignancy. TS commonly occurs in pancreatic cancer (24%), lung cancer (20%), prostate cancer (13%), stomach cancer (12%) then breast and colon cancer.

Case presentation:

Here, we describe the case of 50 years old male patient, nonsmoker, he was doing checkup for his job, found to have mantoux test (TBT) highly positive so ordered for him chest x-ray. He has a previous chronic history of burning sensation of both feet, respond to analgesic drugs. No history of shortness of breath or cough. No history of fever, night sweating, weight loss, loss of appetite and fatigue. Auscultation of Chest x-ray revealed a mass in left upper lobe of lung. Computed Tomography chest showed left lingual superior segment lobulated mass 5.5 x 4.3 cm with left hilar and mediastinal lymph node enlargement. Also in the CT reported bone metastasis in vertebra that confirmed with bone sacn.  Tumor markers were negative. CT guided biopsy for this lesion in the left upper chest done and the histopathology result showed poorly differentiated adenocarcinoma, molecular studies: EGFR, ALK, ROS, PD-1 were negative. Patient referred to the oncology center as case of lung adenocarcinoma with distant metastasis, stage T4bN2bM1 and started in chemotherapy Cisaplatin and Alimta. Spirat CT revealed incidental finding of multiple filling defect indicate segmental pulmonary embolism, because of legs pain done also Doppler of lower limb and showed deep venous thrombosis in the left limb. Started with Enoxaparin full dose. This case report indicate a Trousseau’s syndrome (TS) Cancer- associated thrombosis.

The patient after receiving first cycle chemotherapy, was discharged on Enoxaparin and was stable and return to his job.

Conclusions:

TS is a paraneoplastic manifestation must consider in patients with advanced stages of cancer regardless of the primary site of the cancer. In lung cancer, the paraneoplastic syndrome presented more frequently with small cell carcinoma in 10% but regarding TS in the literature, previous cases reported adenocarcinoma was the most prevalent histology associated thrombosis. Keywords: Trousseau syndrome, adenocarcinoma, Cancer-associated thrombosis