scholarly journals Complex segmentectomy in the treatment of stage IA non-small-cell lung cancer

2019 ◽  
Vol 57 (1) ◽  
pp. 114-121 ◽  
Author(s):  
Yoshinori Handa ◽  
Yasuhiro Tsutani ◽  
Takahiro Mimae ◽  
Yoshihiro Miyata ◽  
Morihito Okada
Keyword(s):  
Lung Cancer ◽  
Regression Analysis ◽  
Cancer Treatment ◽  
Cox Regression ◽  
Clinical Stage ◽  
Cancer Control ◽  
Cox Regression Analysis ◽  
Lung Cancer Treatment ◽  
Clinical Stage Ia ◽  
Stage Ia

AbstractOBJECTIVESAlthough segmentectomy for lung cancer has been widely accepted, complex segmentectomy, which creates several, intricate intersegmental planes, remains controversial. Potential arguments include risk of incurability and ‘failure of cancer control’. We compared the outcomes of complex segmentectomy versus lobectomy and evaluated its use in lung cancer treatment.METHODSWe retrospectively reviewed clinical stage IA lung cancer patients who underwent complex segmentectomy (n = 99) or location-adjusted lobectomy (n = 94) between April 2009 and December 2017. Clinicopathological and postoperative results were compared. Factors affecting survival were assessed by the Kaplan–Meier method and the Cox regression analysis.RESULTSNo significant differences were detected in 30-day mortality (0% vs 0%), overall complications (26.3% vs 21.3%) and prolonged air leakage (11.1% vs 9.6%) rates between the 2 groups, respectively. Comparable results were obtained for 5-year overall (93.5% vs 96.4%, respectively; P = 0.21) or recurrence-free (92.3% vs 88.5%, respectively; P = 0.82) survivals after complex segmentectomy or lobectomy. There were 2 (2.0%) recurrences after complex segmentectomy and 7 (7.5%) after lobectomy (P = 0.094), with 0 (0%) margin relapses in each group. Multivariable Cox regression analysis revealed that complex segmentectomy and lobectomy had a numerically similar impact on recurrence-free survival (hazard ratio 0.93, 95% confidence interval 0.32–2.69; P = 0.90).CONCLUSIONSComplex segmentectomy can provide acceptable short- and long-term outcomes in lung cancer treatment.

Factors Predictive of Distant Metastases in Patients With Breast Cancer Who Have a Pathologic Complete Response After Neoadjuvant Chemotherapy

2005 ◽  
Vol 23 (28) ◽  
pp. 7098-7104 ◽  
Author(s):  
Ana M. Gonzalez-Angulo ◽  
Sean E. McGuire ◽  
Thomas A. Buchholz ◽  
Susan L. Tucker ◽  
Henry M. Kuerer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Neoadjuvant Chemotherapy ◽  
Distant Metastasis ◽  
Cox Regression ◽  
Clinical Stage ◽  
Pathologic Complete Response ◽  
Distant Metastases ◽  
Complete Response ◽  
Cox Regression Analysis

Purpose To identify clinicopathological factors predictive of distant metastasis in patients who had a pathologic complete response (pCR) after neoadjuvant chemotherapy (NC). Methods Retrospective review of 226 patients at our institution identified as having a pCR was performed. Clinical stage at diagnosis was I (2%), II (36%), IIIA (27%), IIIB (23%), and IIIC (12%). Eleven percent of all patients were inflammatory breast cancers (IBC). Ninety-five percent received anthracycline-based chemotherapy; 42% also received taxane-based therapy. The relationship of distant metastasis with clinicopathologic factors was evaluated, and Cox regression analysis was performed to identify independent predictors of development of distant metastasis. Results Median follow-up was 63 months. There were 31 distant metastases. Ten-year distant metastasis-free rate was 82%. Multivariate Cox regression analysis using combined stage revealed that clinical stages IIIB, IIIC, and IBC (hazard ratio [HR], 4.24; 95% CI, 1.96 to 9.18; P < .0001), identification of ≤ 10 lymph nodes (HR, 2.94; 95% CI, 1.40 to 6.15; P = .004), and premenopausal status (HR, 3.08; 95% CI, 1.25 to 7.59; P = .015) predicted for distant metastasis. Freedom from distant metastasis at 10 years was 97% for no factors, 88% for one factor, 77% for two factors, and 31% for three factors (P < .0001). Conclusion A small percentage of breast cancer patients with pCR experience recurrence. We identified factors that independently predicted for distant metastasis development. Our data suggest that premenopausal patients with advanced local disease and suboptimal axillary node evaluation may be candidates for clinical trials to determine whether more aggressive or investigational adjuvant therapy will be of benefit.

The prognostic impact of combined pulmonary fibrosis and emphysema in patients with clinical stage IA non-small cell lung cancer

Surgery Today ◽  
2017 ◽  
Vol 48 (2) ◽  
pp. 229-235 ◽  
Author(s):  
Tomoyoshi Takenaka ◽  
Kiyomi Furuya ◽  
Koji Yamazaki ◽  
Naoko Miura ◽  
Kana Tsutsui ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Pulmonary Fibrosis ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Clinical Stage ◽  
Small Cell ◽  
Prognostic Impact ◽  
Small Cell Lung ◽  
Clinical Stage Ia ◽  
Stage Ia

scholarly journals Computed Tomography Histogram Approach to Predict Lymph Node Metastasis in Patients With Clinical Stage IA Lung Cancer

2019 ◽  
Vol 108 (4) ◽  
pp. 1021-1028
Author(s):  
Yoshihisa Shimada ◽  
Yujin Kudo ◽  
Hideyuki Furumoto ◽  
Kentaro Imai ◽  
Sachio Maehara ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Clinical Stage ◽  
Node Metastasis ◽  
Clinical Stage Ia ◽  
Stage Ia

scholarly journals Assessment of non‐lobe‐specific lymph node metastasis in clinical stage IA non‐small cell lung cancer

2019 ◽  
Vol 10 (7) ◽  
pp. 1597-1604 ◽  
Author(s):  
Zhirong Zhang ◽  
Jinbai Miao ◽  
Qirui Chen ◽  
Yili Fu ◽  
Hui Li ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Small Cell Lung Cancer ◽  
Clinical Stage ◽  
Small Cell ◽  
Small Cell Lung ◽  
Node Metastasis ◽  
Clinical Stage Ia ◽  
Stage Ia

scholarly journals Mean Computed Tomography Value to Predict the Tumor Invasiveness in Clinical Stage IA Lung Cancer

2017 ◽  
Vol 104 (1) ◽  
pp. 261-266 ◽  
Author(s):  
Masaya Tamura ◽  
Isao Matsumoto ◽  
Daisuke Saito ◽  
Shuhei Yoshida ◽  
Seiichi Kakegawa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Clinical Stage ◽  
Tumor Invasiveness ◽  
Clinical Stage Ia ◽  
Stage Ia

scholarly journals A multi-institutional randomized phase III trial comparing anatomical segmentectomy and wedge resection for clinical stage IA non-small cell lung cancer in high-risk operable patients: Japan Clinical Oncology Group Study JCOG1909 (ANSWER study)

2020 ◽  
Vol 50 (10) ◽  
pp. 1209-1213 ◽  
Author(s):  
Ryo Shimoyama ◽  
Yasuhiro Tsutani ◽  
Masashi Wakabayashi ◽  
Hiroshi Katayama ◽  
Haruhiko Fukuda ◽  
...  
Keyword(s):  
Lung Cancer ◽  
High Risk ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Wedge Resection ◽  
Clinical Stage ◽  
Small Cell ◽  
Small Cell Lung ◽  
Clinical Stage Ia ◽  
Stage Ia

Abstract Anatomical segmentectomy or wedge resection is recommended for high-risk operable patients with clinical stage IA non-small cell lung cancer in guidelines of the National Comprehensive Cancer Network and the Japanese Lung Cancer Society. However, there is no clear evidence comparing the sublobar resections. The less invasive and more generally performed is wedge resection but anatomical segmentectomy may have better survival benefits than wedge resection owing to its superiority in locoregional control. In April 2020, we have initiated a randomized phase III trial in Japan to confirm the superiority of anatomical segmentectomy over wedge resection in high-risk operable patients with clinical stage IA non-small cell lung cancer. We plan to enroll a total of 370 patients from 47 institutions over a period of 5 years. The primary endpoint is overall survival; the secondary endpoints are adverse events, postoperative respiratory function, relapse-free survival, proportion of local recurrence, operative time and blood loss.

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