Thoracic Oncology and Surgery

Introduction

In November 2003, the Division initiated a new limited resection trial for small pulmonary ground-glass opacity (GGO) lesions. Patient selection is based solely on high-resolution CT (HRCT) findings: a pure or mixed GGO lesion 2 cm or smaller in the lung periphery with a tumor disappearance ratio (TDR) of 0.5 or higher on HRCT. TDR is defined as 1−DM/DL, where DM is the maximum tumor diameter on mediastinal setting and DL on lung setting. In November 2006, the Department of Thoracic Oncology, Kanagawa Cancer Center Hospital, Yokohama, Kanagawa, Japan, joined the trial. The enrollment pace has now more than doubled, and we anticipate that we will reach our 100 patient target within a year. The Division is also developing a new GGO lesion treatment trial protocol employing non-surgical modalities such as stereotactic radiation in collaboration with institutes that have the necessary equipment.
The Division is also performing a new negative resection margin technique trial using lavage cytology examination for primary and metastatic lung cancer patients treated by limited resection. This method involves washing the used stapler cartridges followed by intraoperative cytological evaluation of the washed saline sediment.

Ongoing Clinical Trials
  1. Surgical margin lavage cytology examination in limited resection for primary and metastatic lung cancer patients [observational].
  2. Limited resection trial for small ground-glass opacity (GGO) lung tumors [phase II].
  3. Member of an organized trial of combined chemotherapy with cisplatin and irinotecan for large cell neuroendocrine carcinoma [phase II].
  4. Member of an organized trial of TS-1 vs. UFT adjuvant chemotherapy for completely resected pathologic stage I (> 2 cm) non-small cell lung cancer [phase III].

● J. Yoshida, K. Nagai ●

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