Thoracic Oncology

Introduction

The Thoracic Oncology Division imparts care to patients with primary and metastatic lung cancers, mediastinal tumors, and pleural tumors. In order to help such patients by providing multidisciplinary care, the Division works closely with co-physicians, thoracic surgeons, radiation oncologists, and psychiatrists with expertise in their respective fields. We also conduct clinical research to gain a better understanding of these malignant tumors and to develop new and more effective diagnostic modalities and treatments. Residents and trainees from domestic and international institutions have joined the Thoracic Oncology Program.

Routine Activities

The outpatient clinic of this Division, conducted by the staff members, is open from Monday to Friday and is concerned with the examination of all new patients who are referred to the Thoracic Oncology Division and of the returning patients. Patients who are candidates for surgical resection are also examined. The staff at the Thoracic Oncology Division are responsible for reading chest radiographs and chest CTs at the hospital. Bronchoscopy for diagnosis and treatment is carried out in the afternoons from Monday to Thursday. Fluoroscopic CT-guided needle lung biopsies and fluoroscopy-guided needle biopsies are performed on the same day as bronchoscopy. For management of patients, the Division uses approximately 90 beds in conjunction with the Thoracic Surgery Division.
Case conferences on thoracic surgery, medical oncology, and for the nursing staff are scheduled on Tuesday evenings, Wednesday evenings, and Friday afternoons, respectively. The staff members and residents attend a journal club on Wednesday mornings along with the Thoracic Surgery staff. At monthly meetings with physicians involved in private practice, the staff presents case reports and research results for subspecialty education of these physicians.

● K. Kubota ●

Year    1995       1996       1997       1998       1999       2000       2001       2002       2003       2004       2005       2006       2007

Number of patients 303 362 407 382 423 445 525 518 553 580 568 589 593

Stage of disease

    IA 57 85 81 83 90 107 140 128 153 147 123 157 164

    IB 47 48 51 58 60 80 66 67 56 84 89 81 81

    IIA 4 2 2 3 8 4 1 7 7 9 0 6 7

    IIB 18 19 32 22 31 18 27 27 34 36 29 35 31

    IIIA 38 39 28 21 29 39 41 50 46 35 52 60 42

    IIIB 46 73 78 64 63 77 113 105 89 107 119 97 111

    IV 93 96 135 131 142 120 137 134 168 162 156 153 157

Histology

    Adenocarcinoma 172 218 241 230 274 270 307 283 329 352 328 328 321

    Squamous cell ca. 75 87 93 95 86 96 118 116 121 117 111 120 107

    Small cell ca. 39 36 50 46 37 42 58 68 48 58 58 71 67

    Large cell ca. 2 1 6 1 6 10 6 12 11 15 12 18 20

    NSCLC 5 10 12 2 11 20 27 31 32 30 48 40 61

    Others 8 10 5 6 7 7 9 7 12 8 11 12 17

Treatment

    Chemo -> surgery 2 7 2 1 1 2 4 7 6 2 4 7 4

    Surgery 134 147 159 164 184 197 226 223 240 265 230 225 257

    Chemotherapy (CT) 89 111 120 126 136 135 184 202 208 214 218 200 214

    CT+RT 21 16 31 23 29 50 68 58 67 66 72 91 63

    surgery -> Chemo 1 0 1 0 0 0 0 0 1 3 16 35 24

    Radiotherapy (RT) 25 29 27 18 24 27 18 13 10 8 12 14 10

    Laser therapy 0 3 1 0 1 1 2 0 2 3 1 0 0

    Palliative care 31 49 66 50 48 33 23 15 19 19 15 17 21

Table of Contents

Year	1995	1996	1997	1998	1999	2000	2001	2002	2003	2004	2005	2006	2007
Number of patients	303	362	407	382	423	445	525	518	553	580	568	589	593
Stage of disease
IA	57	85	81	83	90	107	140	128	153	147	123	157	164
IB	47	48	51	58	60	80	66	67	56	84	89	81	81
IIA	4	2	2	3	8	4	1	7	7	9	0	6	7
IIB	18	19	32	22	31	18	27	27	34	36	29	35	31
IIIA	38	39	28	21	29	39	41	50	46	35	52	60	42
IIIB	46	73	78	64	63	77	113	105	89	107	119	97	111
IV	93	96	135	131	142	120	137	134	168	162	156	153	157
Histology
Adenocarcinoma	172	218	241	230	274	270	307	283	329	352	328	328	321
Squamous cell ca.	75	87	93	95	86	96	118	116	121	117	111	120	107
Small cell ca.	39	36	50	46	37	42	58	68	48	58	58	71	67
Large cell ca.	2	1	6	1	6	10	6	12	11	15	12	18	20
NSCLC	5	10	12	2	11	20	27	31	32	30	48	40	61
Others	8	10	5	6	7	7	9	7	12	8	11	12	17
Treatment
Chemo -> surgery	2	7	2	1	1	2	4	7	6	2	4	7	4
Surgery	134	147	159	164	184	197	226	223	240	265	230	225	257
Chemotherapy (CT)	89	111	120	126	136	135	184	202	208	214	218	200	214
CT+RT	21	16	31	23	29	50	68	58	67	66	72	91	63
surgery -> Chemo	1	0	1	0	0	0	0	0	1	3	16	35	24
Radiotherapy (RT)	25	29	27	18	24	27	18	13	10	8	12	14	10
Laser therapy	0	3	1	0	1	1	2	0	2	3	1	0	0
Palliative care	31	49	66	50	48	33	23	15	19	19	15	17	21