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Volume 56, Issue 1
Displaying 1-12 of 12 articles from this issue
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Original Article
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Bumpei Kimura, Takuya Nakajima, Kenji Kusajima, Kayoko Tsuchiya, Noriy ...2016 Volume 56 Issue 1 Pages 2-11
Published: February 20, 2016
Released on J-STAGE: March 30, 2016
JOURNAL OPEN ACCESSPurpose. The aim of this study was to report the present status of the diagnosis and therapy of primary lung cancer in local community medical organizations. Objects and Methods. A total of 2039 hospitalized patients with primary lung cancer in local community hospitals in Tokyo from 1991 to 2012 were divided into 2 groups, 1135 patients in the first half period (1991-2000) (first group) and 904 patients in the second half period (2001-2012) (second group), and a comparison between the 2 groups was performed regarding reasons for diagnosis, histological patterns, disease stage, therapeutic methods, performance status (PS) and the 5-year survival. Results. When comparing the reasons for diagnosis between the 2 groups, the ratios of a symptom: mass survey: other diseases were 54.8%: 18.2%: 26.9% in the first group and 46.2%: 22.7%: 30.9% in the second group. Furthermore, concerning the histological patterns in the 2 groups, the frequency of adenocarcinoma vs. squamous cell carcinoma were 48.5%: 30.7% and 54.1%: 22.9%, respectively. Regarding disease stage, stage I vs. stage IV was 24.1%: 36.6% and 31.2%: 39.7%, respectively. Regarding therapeutic methods, the ratios of surgical operation: chemotherapy and/or radiation therapy: palliative care were 36.7%: 26.6%: 34.5% and 36.3%: 33.0%: 27.4%, respectively. Taken together, the second group had higher frequencies of lung cancer discovered due to reasons other than a symptom, adenocarcinoma, stage I and IV, and chemotherapy and/or radiation therapy. Additionally, the ratios of PS 0 and 4 were increased in the latter group. Regarding the 5-year survival rate, it was increased in the second group (24.1% vs. 32.5%, respectively). Conclusion. The survival rate of patients with primary lung cancer can be increased when diagnosed at stage I of lung cancer during mass survey and with the treatment of other diseases.View full abstractDownload PDF (436K)
Case Reports
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Yoshimasa Tokunaga, Tatsuo Nakagawa, Masao Saitoh, Takeshi Kondo2016 Volume 56 Issue 1 Pages 12-16
Published: February 20, 2016
Released on J-STAGE: March 30, 2016
JOURNAL OPEN ACCESSBackground. Glomus tumor of the trachea is a rare disease. Case. We herein describe a 56-year-old man with an asymptomatic glomus tumor of the trachea who underwent tracheal resection and reconstruction. Thirty months after surgery, bronchoscopy and imaging studies revealed no evidence of recurrence. Conclusion. The clinicopathological features are discussed in this case report.View full abstractDownload PDF (679K) -
Hitoshi Suzuki, Shin Shomura, Kentaro Inoue, Masaki Yada, Akira Shimam ...2016 Volume 56 Issue 1 Pages 17-21
Published: February 20, 2016
Released on J-STAGE: March 30, 2016
JOURNAL OPEN ACCESSBackground. A rapidly enlarging cavitary lesion associated with infection is not uncommon in the clinical setting; however, it is rare for it to develop soon after a transbronchial biopsy. We herein report a case of metastatic lung tumor with an infection-associated rapidly enlarging cavitary lesion following a transbronchial biopsy. Case. During a routine examination, a chest X-ray revealed an abnormal shadow in the left lower lung field of a 63-year-old man with a history of rectal cancer. A transbronchial biopsy confirmed distal metastasis to the lungs. Two days following the biopsy, the patient developed a severe fever and was hospitalized on an emergency basis. Chest CT revealed the rapid enlargement of a cavernous lesion and abscess formation. Antibiotics failed to reduce the fever and the patient subsequently fell into septic shock. Emergent left lower lobectomy was performed in an attempt to save the patient. Conclusion. The presentation of lung tumor together with an infected cavitary lesion may prove to be intractable. It is therefore necessary to be aware of such dangers and to be prepared to perform prompt surgery following a transbronchial biopsy, if indicated.View full abstractDownload PDF (782K) -
Manabu Ueno, Takahiro Abe, Mari Sato, Naoyuki Harada, Yuji Shimizu, Mi ...2016 Volume 56 Issue 1 Pages 22-26
Published: February 20, 2016
Released on J-STAGE: March 30, 2016
JOURNAL OPEN ACCESSBackground. Myocardial metastasis from squamous cell lung cancer in a never smoker female is very rare. Case. A 73-year-old woman was admitted to a local hospital due to back pain in April 2014. Because she developed myocardial infarction just after hospitalization, percutaneous cardiac intervention was performed. Chest CT showed a tumor in the left lower lobe. Therefore, she was referred to our hospital due to a lung tumor in May 2014. CT and MRI findings showed metastatic lesions in the myocardium, brain, kidney, bone and lymph nodes. The lesion of the cardiac metastases was associated with the myocardial infarction area. The patient eventually died due to consciousness disorder and circulatory failure in July 2014. Autopsy findings demonstrated squamous cell carcinoma in the left lower lung. Conclusion. The cause of myocardial infarction was considered to be the invasion of cardiac metastases of squamous cell lung cancer in a never smoker female.View full abstractDownload PDF (838K) -
Fumihiro Ishibashi, Yuuki Shiina, Yukiko Matsui, Yasumitsu Moriya, Tos ...2016 Volume 56 Issue 1 Pages 27-32
Published: February 20, 2016
Released on J-STAGE: March 30, 2016
JOURNAL OPEN ACCESSBackground. Primary germ cell tumors of the mediastinum are rare. Case. A 68-year-old man presented to our department with a chest CT revealing an anterior mediastinal mass and tumor of the left 6th rib. Although we suspected a rib metastasis from a thymoma or thymic cancer, a biopsy of the 6th rib tumor was non-diagnostic and the mediastinal tumor could not be biopsied. The patient therefore underwent video-assisted thoracoscopic surgery for diagnostic purposes and to determine a treatment strategy. The examination of an intra-operative frozen section of the left 6th rib tumor revealed a malignant tumor. The mediastinal tumor was removed and an en bloc partial resection of the left upper lobe of the lung was performed. The mediastinal tumor was diagnosed as a primary mixed-type germ cell tumor consisting of a seminoma, a mature teratoma, and an embryonal carcinoma; the rib metastasis originated from a component of the mediastinal tumor. Four courses of chemotherapy (cisplatin, etoposide, and ifosfamide) were administered. Conclusion. Primary germ cell tumors of the mediastinum are primarily found in young men. There are few reports of their occurrence in elderly patients. We herein reported a rare clinical event involving a primary mixed-type germ cell tumor of the mediastinum with an unusual bone metastasis.View full abstractDownload PDF (847K) -
Haruka Matsuo, Hironori Ishibashi, Shunichi Baba, Masashi Kobayashi, T ...2016 Volume 56 Issue 1 Pages 33-37
Published: February 20, 2016
Released on J-STAGE: March 30, 2016
JOURNAL OPEN ACCESSBackground. Pneumothorax with lung cancer is a rare entity, with an incidence of 0.05-1.13% of cases. Case. A 44-year-old male who developed right-sided hemopneumothorax with severe dyspnea and back pain was referred to our hospital. Due to prolonged air leakage, he underwent video-assisted thoracoscopic surgery for pneumothorax. A histological examination of the resected lung showed squamous cell carcinoma lining the inside of the bullae with pleural perforation. Under the diagnosis of primary lung cancer, the patient underwent right upper lobectomy with lymph node dissection (pT2aN0M0). He has been free from recurrence for 6 months after the operation. Conclusion. Patients with hemopneumothorax who are associated with various risk factors, such as an advanced age, heavy smoking, or emphysematous lung cysts, therefore require a careful assessment for occult lung cancer.View full abstractDownload PDF (705K) -
Hisao Mizutani, Hiroshi Yaginuma, Naoki Nishie, Ichio Suzuka2016 Volume 56 Issue 1 Pages 38-42
Published: February 20, 2016
Released on J-STAGE: March 30, 2016
JOURNAL OPEN ACCESSBackground. Although intrapulmonary lymph nodes may masquerade as metastatic pulmonary nodules, metastasis from lung cancer is rare. Case. An 81-year-old woman presented with primary left upper lobe non small cell carcinoma associated with undiagnosed subpleural nodules in the ipsilateral upper and lower lobes. Because she wanted radical left upper lobectomy, she received thoracoscopic thoracotomy to confirm that these nodules were located in the lower lobe. A frozen section in situ analysis revealed intrapulmonary lymph nodes metastases from the primary lung cancer, and therefore further resection was not possible. To the best of our knowledge, the present case is the first report of lung cancer involving ipsilateral intrapulmonary lymph nodes within another lobe. The potential mechanisms of the rare lymphatic metastases are discussed. Conclusion. Although one of the most likely diagnoses of subpleural nodules is intrapulmonary lymph nodes, the nodes may be involved by other malignancies in the lung. General thoracic surgeons should not hesitate in diagnosing the nodules to evaluate the accurate extent of the pulmonary malignancy as their locations are easy to access.View full abstractDownload PDF (939K)
The 30th Lung Cancer Workshop
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Yoichi Nakanishi2016 Volume 56 Issue 1 Pages 43-47
Published: February 20, 2016
Released on J-STAGE: March 30, 2016
JOURNAL OPEN ACCESSUntreated small-cell lung cancer (SCLC) is highly sensitive to both chemotherapy and radiotherapy, although its growth is quite rapid. Clinically, SCLC is classified into limited disease (LD) and extensive disease (ED). Although there are no distinct criteria, LD is generally accepted to be a disease which is confined to the hemithorax of origin, the mediastinum, or the supraclavicular lymph nodes without malignant effusion, i.e., a disease in which curative radiotherapy is applicable. Nearly 30% of SCLC is LD at the initial diagnosis. LD-SCLC is a potentially curable disease, and standard treatment is chemoradiotherapy, and the concurrent use of chemotherapy and radiotherapy is chosen particularly if the performance status of the patient is 2 or less and the organ function is good. Cisplatin plus etoposide is typically administered together with radiotherapy, since the risk of radiation pneumonia is known to be low when this combination is selected. The median survival time of LD-SCLC is 16 to 24 months and the 5-year survival rate is nearly 15%. Conversely, the median survival time of ED-SCLC is 6-12 months, however, a long-term disease-free survival is rare. Chemotherapy alone is chosen for ED-SCLC. In the Japanese guideline, the combination of cisplatin plus irinotecan is the first choice if tolerable.View full abstractDownload PDF (558K) -
Kazuto Nishio2016 Volume 56 Issue 1 Pages 48-54
Published: February 20, 2016
Released on J-STAGE: March 30, 2016
JOURNAL OPEN ACCESSThe clinical implementation of genetic profiling for lung cancer is warranted to allow precision medicine for individual lung cancer patients. We currently apply next-generation sequencing (NGS)-based clinical sequencing to detect driver mutations that may inform treatment recommendations in lung cancer. We prospectively applied amplicon sequencing panels and assays to determine variants of ALK, RET, ROS1, and NTRK1 fusion transcripts in patients with lung cancer. We then determined the proportion of patients who received genotype-directed therapy and their overall survival (OS). Tumor FFPE specimens were successfully analyzed by NGS. The OS of patients with advanced or recurrent cancer who had driver mutations followed by targeted therapy was significantly longer than that of patients with no mutations or those with a mutation not treated with targeted therapy. This Kindai Clinical Sequencing for lung cancer patients can assist physicians in matching patients with approved or experimental targeted treatments.View full abstractDownload PDF (834K) -
Seiji Yano2016 Volume 56 Issue 1 Pages 55-60
Published: February 20, 2016
Released on J-STAGE: March 30, 2016
JOURNAL OPEN ACCESSSeveral driver oncogenes, including EGFR mutations, ALK rearrangement, ROS-1 rearrangement, and RET rearrangement, have been identified in lung adenocarcinoma. EGFR tyrosine kinase inhibitors (TKIs) and ALK-TKIs have been approved for lung cancer with EGFR activating mutations and ALK rearrangements, respectively. In addition, many targeted drugs for other oncogenic drivers are also being evaluated for efficacy in clinical trials. EGFR-TKIs and ALK-TKIs show dramatic therapeutic efficacy against lung cancer with EGFR mutation and ALK rearrangement, respectively. However, the responders almost invariably acquire resistance to EGFR-TKIs within several years. The representative mechanism is a secondary mutation in the target. A new generation of TKIs, which inhibit secondary mutations, has been developed and evaluated for efficacy in clinical trials. Apoptosis resistance is another important mechanism of TKI resistance. BIM polymorphism is associated with EGFR-TKI resistance in EGFR mutant lung cancer. We found that a HDAC inhibitor, vorinostat, could overcome EGFR-TKI resistance associated with BIM polymorphism. According to this observation, we are currently evaluating the safety and efficacy of treatment with EGFR-TKI and vorinostat in an investigator initiated trial (VICTORY-J).View full abstractDownload PDF (586K) -
Yoshiko Iwai2016 Volume 56 Issue 1 Pages 61-65
Published: February 20, 2016
Released on J-STAGE: March 30, 2016
JOURNAL OPEN ACCESSIn recent years, immunotherapy has emerged as the fourth pillar of cancer treatment, joining surgery, radiation, and chemotherapy. The concept of cancer immunotherapy dates back to the late nineteenth century, when William Coley, a young surgeon in New York, began intratumoral injections of bacterial products. It took almost a century to discover dendritic cells and their receptor sensing microorganisms. Immunotherapies can be divided into antigen-specific approaches, which induce tumor-specific T cells, or antigen non-specific approaches, which broadly activate T cells. Activating (accelerator) and inhibitory (brake) receptors on T cells regulate the balance between immune responses and immune tolerance. Although previous immunotherapies have focused on pressing the accelerator on T cells, immune checkpoint inhibitors take the brakes off the immune system and unleash anti-tumor immune responses. The success of clinical trials with novel drugs targeting immune checkpoint molecules such as PD-1 may herald a new era for cancer immunotherapy.View full abstractDownload PDF (271K)
Proceeding of Regional Scientific Meeting
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2016 Volume 56 Issue 1 Pages 66-76
Published: February 20, 2016
Released on J-STAGE: March 30, 2016
JOURNAL OPEN ACCESSDownload PDF (598K)
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