The Prevalence of Nodal Upstaging During Robotic Lung Resection in Early Stage Non-Small Cell Lung Cancer

2014 ◽  
Vol 97 (6) ◽  
pp. 1901-1907 ◽  
Author(s):  
Jennifer L. Wilson ◽  
Brian E. Louie ◽  
Robert J. Cerfolio ◽  
Bernard J. Park ◽  
Eric Vallières ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Lung Resection ◽  
Small Cell ◽  
Small Cell Lung ◽  
Nodal Upstaging

scholarly journals Recurrence and Survival After Segmentectomy in Patients With Prior Lung Resection for Early-Stage Non-Small Cell Lung Cancer

2016 ◽  
Vol 102 (4) ◽  
pp. 1110-1118 ◽  
Author(s):  
Lisa M. Brown ◽  
Brian E. Louie ◽  
Nicole Jackson ◽  
Alexander S. Farivar ◽  
Ralph W. Aye ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Lung Resection ◽  
Small Cell ◽  
Small Cell Lung

scholarly journals Nodal Upstaging Evaluation After Robotic-Assisted Lobectomy for Early-Stage Non-small Cell Lung Cancer Compared to Video-Assisted Thoracic Surgery and Thoracotomy: A Retrospective Single Center Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Filippo Tommaso Gallina ◽  
Enrico Melis ◽  
Daniele Forcella ◽  
Edoardo Mercadante ◽  
Daniele Marinelli ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Robotic Surgery ◽  
Lymph Nodes ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Small Cell ◽  
Small Cell Lung ◽  
Radical Lymphadenectomy ◽  
Nodal Upstaging

Introduction: The standard surgical procedures for patients with early-stage NSCLC is lobectomy-associated radical lymphadenectomy performed by using the thoracotomy approach. In the last few years, minimally invasive techniques have increasingly strengthened their role in lung cancer treatment, especially in the early stage of the disease. Although the lobectomy technique has been accepted, controversy still surrounds lymph node dissection. In our study, we analyze the rate of upstaging early non-small cell lung cancer patients who underwent radical surgical treatment using the robotic and the VATS techniques compared to the standard thoracotomy approach.Methods and Materials: We retrospectively reviewed patients who underwent a lobectomy and radical lymphadenectomy at our Institute between 2010 and 2019. We selected 505 patients who met the inclusion criteria of the study: 237 patients underwent robotic surgery, 158 patients had thoracotomy, and 110 patients were treated with VATS. We analyzed the demographic features between the groups as well as the nodal upstaging rate after pathological examination, the number of dissected lymph nodes and the ratio of dissected lymph nodes to metastatic lymph nodes of the three groups.Results: The patients of the three groups were homogenous with respect to age, sex, and histology. The postoperative major morbidity rate was significantly higher in the thoracotomy group, and hospital stay was significantly longer. The percentage of the mediastinal nodal upstaging rate and the number of dissected lymph nodes was significantly higher in the robotic group compared with the VATS group. The ratio of dissected lymph nodes to metastatic lymph nodes was significantly lower compared with the VATS group and the thoracotomy group.Discussion: The prognostic impact of the R(un) status is still highly debated. A surgical approach that allows better results in terms of resection has still not been defined. Our results show that robotic surgery is a safe and feasible approach especially regarding the accuracy of mediastinal lymphadenectomy. These findings can lead to defining a more precise pathological stage of the disease and, if necessary, to more accurate postoperative treatment.

Impact of waiting times on tumour growth and pathologic upstaging in patients with non-small cell lung cancer having lung resection

2020 ◽  
pp. 030089162096021
Author(s):  
Insha Bhat ◽  
Lawrence Okiror ◽  
Arjun Nair ◽  
Andrea Bille
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Tumour Growth ◽  
Early Stage ◽  
Waiting Times ◽  
Lung Resection ◽  
Small Cell ◽  
Consecutive Series ◽  
Small Cell Lung

Objective: There are limited data on tumour growth or pathologic upstaging in patients with early-stage lung cancer awaiting lung resection. We aimed to evaluate whether waiting times on the current lung cancer treatment pathway were associated with significant tumour growth or pathologic upstaging. Methods: This is a retrospective observational study of a consecutive series of patients with early-stage, non-small cell lung cancer who underwent resection for lung cancer. The difference between tumour size at diagnostic and preoperative computed tomography (CT) scans was calculated. Significant tumour growth was defined as a diameter increase of ⩾5 mm or ⩾20%. The time intervals between baseline and repeat CT (CT-int) and between baseline CT and date of surgery (Surg-int), as well as other potential clinical and pathologic prognostic factors, were compared between upstaged and nonupstaged patients. Results: There were 121 patients identified. Fifty-four patients (44.6%) had tumour growth ⩾5 mm and 27 patients (22%) had tumour growth ⩾20%. Median CT-int and Surg-int were 2.4 and 2.6 months, respectively. Forty-four patients (36%) were upstaged at surgery due to new lymph node involvement (n = 19), pleural invasion (n = 12), satellite nodules (n = 4), or increase in tumour diameter (n = 9). There was a marginal, but statistically insignificant, difference in median CT intervals in patients who had tumour growth <20% vs ⩾20% at 2.4 vs 2.6 months ( p = 0.06). Conclusion: Current cancer pathway waiting times are not associated with significant tumour growth or pathologic upstaging in this cohort.

STEREOTACTIC BODY RADIATION THERAPY FOR EARLY-STAGE NON-SMALL CELL LUNG CANCER

2018 ◽  
Vol 64 (5) ◽  
pp. 638-644
Author(s):  
Andrey Arsenev ◽  
Sergey Novikov ◽  
Sergey Kanaev ◽  
Anton Barchuk ◽  
Andrey Nefedov ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Small Cell ◽  
Small Cell Lung ◽  
Stereotactic Radiation ◽  
Screening Programs ◽  
Surgical Methods

An active introduction of screening programs potentially leads to a significant increase in the proportion of patients with early forms of non-small cell lung cancer. Surgical treatment, which is the standard of care for localized forms, due to functional limitations can be performed only in 65-70% of patients. The solution to this problem can be found in the improvement of the results of radiotherapy by using modern equipment, the planning systems, improved fractionation schemes and introduction of methods for summing radiation doses. Stereotactic radiotherapy allows high-precision delivery of high radiation dose to tumor with a minimal damage to surrounding healthy tissues. In this literature review based on the analysis of a large number of publications we show that it is not yet possible to make valid conclusions about the effectiveness and safety of stereotactic radiation therapy as an alternative to the surgical methods. It is necessary to plan and conduct randomized trials without further delay taking into account the expected high relevance of the method.

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