128P - Cryosurgery for advanced stages of non small cell lung cancer (5 years experience)

Date 15 April 2016
Event European Lung Cancer Conference 2016 (ELCC) 2016
Session Poster lunch
Topics Surgical Oncology
Non-Small Cell Lung Cancer
Therapy
Radiation Oncology
Presenter DARMAWAN Ismail
Citation Journal of Thoracic Oncology (2016) 11 (supplement 4): S57-S166. S1556-0864(16)X0004-4
Authors D. Ismail
  • Cardiothoracic And Vascular Surgery, Sebelas Maret University, 57162 - Surakarta/ID

Abstract

Background

Lung cancer (LC) is well known as the most common cause of cancer mortality in the world. Most cases of lung cancer are Non-Small Cell Lung Cancer (NSCLC). In Indonesia more than 90% LC patients come to the doctor are diagnosed in advanced stages, therefore open surgery is not recommended. Recently, in the treatment of cancer there is a new method known as cryosurgery. Cryosurgery is a surgical technique that employs freezing to destroy undesirable tissue. It has been used as a treatment modality in other types of cancer. Cryosurgery has potential benefits in the field of thoracic malignancies, because it is a minimally invasive procedure, relatively safe, effective and can be repeated as necessary. Cryosurgery is not intended to replace the mainstream therapy of cancer such as chemotherapy and or radiation therapy. This study is to analyze the potential use of cryosurgery for complimentary treatment in advanced stages of LC.

Methods

Since 2010 collected 72 patients with advanced stages (IIIB/IV) of NSCLC, consist of 46 males and 26 females with patients aged between 21 and 82 years. Various co-morbidities were identified and listed in this study. 71 patients were performed cryosurgery percutaneously guided by Computed Tomography (CT) and 1 patient was performed guided by Video Assisted Thoracoscopic Surgery (VATS). All procedures were done by one surgeon and under local anesthesia and some add mild sedation. Cryosurgery was performed by two cycles of freeze / thaw and then followed for analysis.

Results

Cryosurgery successfully destroyed more than 90% (almost all) cancer mass in 9 (12.5%) patients because cancer location in peripheral and free from heart, vascular structure and respiratory tract. In 63 (87.5%) other patients, the mass could be partially destroyed (60–90%) caused by large size and its location. The most common postoperative complication was hemoptysis (11 pts/15.3%). Chest tube insertion in 4 (5.5%) patients, caused by 3 (4.2%) pneumothorax cases and 1 (1.4%) hematothorax case. 7 (9.7%) patients underwent tapping due to pleural effusion at one week after in the outpatient clinic. Pain is minimal and hospital LOS (length of stay) was 4 days (64 pts/88.9%).

Conclusions

In this study, cryosurgery showed potential benefit as a complementary treatment in advanced stages NSCLC. However ongoing researches and by using better methods should be conducted to evaluate the long-term result and survival rate associated by the use of this procedure.

Clinical trial identification

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Legal entity responsible for the study

Sebelas Maret University

Funding

Surgical Department Sebelas Maret University

Disclosure

All authors have declared no conflicts of interest.