Mortality for robotic- versus video-assisted lobectomy treated stage I non-small cell lung cancer patients

Abstract Background To address the United States Food & Drug Administration’s recent safety concern on robotic surgery procedures, we compared short- and long-term mortality for stage I non-small cell lung cancer (NSCLC) patients treated by robotic-assisted thoracoscopic surgical lobectomy (RATS-L) versus video-assisted thoracoscopic surgical lobectomy (VATS-L). Methods From the National Cancer Database, we identified 18,908 stage I NSCLC patients who underwent RATS-L or VATS-L as the primary operation from 2010 to 2014. Cox proportional hazards models were used to estimate hazard ratios (HRs) for short- and long-term mortality using unmatched and propensity score-matched analyses. All statistical tests were two-sided. Results Patients treated by RATS-L had higher 90-day mortality than those with VATS-L (6.6% vs. 3.8%; P=.03) if conversion to open thoracotomy occurred. After excluding first-year observation, multiple regression analyses showed RATS-L was associated with increased long-term mortality, compared to VATS-L, in cases with tumor size ≤20 mm: HRs were 1.33 (95%CI: 1.15-1.55), 1.36 (95%CI: 1.17-1.58) and 1.33 (95%CI: 1.11-1.61) for unmatched, N:1 matched and 1:1 matched analyses, respectively, in the intention-to-treat analysis. Among patients without conversion to an open thoracotomy, the respective HRs were 1.19 (95%CI: 1.10-1.29), 1.19 (95%CI: 1.10-1.29) and 1.17 (95%CI: 1.06-1.29). Similar associations were observed when follow-up time started 18- or 24-months post-surgery. No statistically significant mortality difference was found for patients with tumor size >20 mm. These associations were not related to case volume of VATS-L/RATS-L performed at treatment institutes. Conclusions Patients with small (≤20 mm) stage I NSCLC treated with RATS-L had statistically significantly higher long-term mortality risk than VATS-L after one-year post-surgery.

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Sarcopenia is poor risk for unfavorable short- and long-term outcomes in stage I non-small cell lung cancer

Annals of Translational Medicine ◽

10.21037/atm-20-4380 ◽

2021 ◽

Vol 9 (4) ◽

pp. 325-325

Author(s):

Yusuke Takahashi ◽

Shigeki Suzuki ◽

Kenichi Hamada ◽

Takeo Nakada ◽

Yuko Oya ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Stage I ◽

Small Cell Lung ◽

Long Term Outcomes ◽

Poor Risk ◽

Short And Long Term

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ERK Inhibitor ASN007 Effectively Overcomes Acquired Resistance to EGFR Inhibitor in Non-small Cell Lung Cancer

10.21203/rs.3.rs-249758/v1 ◽

2021 ◽

Author(s):

Bo Mi Ku ◽

Jae Yeong Heo ◽

Jinchul Kim ◽

Jong-Mu Sun ◽

Se-Hoon Lee ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Acquired Resistance ◽

Small Cell ◽

Erk Signaling ◽

Small Cell Lung ◽

Nsclc Patients ◽

Egfr Tki ◽

Egfr Tkis

Abstract The emergence of acquired resistance limits the long-term efficacy of EGFR tyrosine kinase inhibitors (EGFR-TKIs). Thus, development of effective strategies to overcome resistance to EGFR-TKI is urgently needed. Multiple mechanisms to reactivate ERK signaling have been successfully demonstrated in acquired resistance models. We found that in EGFR mutant non-small cell lung cancer (NSCLC) patients, acquired resistance to EGFR-TKIs was accompanied by increased activation of ERK. Increased ERK activation was also found in in vitro models of acquired EGFR-TKI resistance. ASN007 is a potent selective ERK1/2 inhibitor with promising antitumor activity in cancers with BRAF and RAS mutations. ASN007 treatment impeded tumor cell growth and the cell cycle in EGFR-TKI-resistant cells. In addition, combination treatment with ASN007 and EGFR-TKIs synergistically decreased the survival of resistant cells, enhanced induction of apoptosis, and effectively inhibited the growth of erlotinib-resistant xenografts, providing the preclinical rationale for testing combinations of ASN007 and EGFR-TKIs in EGFR-mutated NSCLC patients. This study emphasizes the importance of targeting ERK signaling in maintaining the long-term benefits of EGFR-TKIs by overcoming acquired resistance.

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PD2.04 Long Term Efficacy and Safety of Ensartinib in Pre-Treated Anaplastic Lymphoma Kinase (ALK) Positive Non-Small Cell Lung Cancer (NSCLC) Patients (eXalt2)

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2019.09.131 ◽

2019 ◽

Vol 14 (11) ◽

pp. S1171-S1172

Author(s):

T. Leal ◽

H. Wakelee ◽

K.L. Reckamp ◽

A. Chiappori ◽

G.R. Oxnard ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Anaplastic Lymphoma Kinase ◽

Small Cell ◽

Efficacy And Safety ◽

Small Cell Lung ◽

Anaplastic Lymphoma ◽

Alk Positive ◽

Nsclc Patients

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Ribonucleotide Reductase Subunit 2 (RRM2) Predicts Shorter Survival in Resected Stage I-III Non-Small Cell Lung Cancer (NSCLC) Patients

Annals of Oncology ◽

10.1016/s0923-7534(20)32751-4 ◽

2012 ◽

Vol 23 ◽

pp. ix79

Author(s):

F. Grossi ◽

G. Barletta ◽

C. Sini ◽

E. Rijavec ◽

C. Genova ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Ribonucleotide Reductase ◽

Small Cell ◽

Stage I ◽

Small Cell Lung ◽

Resected Stage ◽

Nsclc Patients

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Significance of accurate hilar and intrapulmonary lymph node examination and prognostication in stage IA–IIA non-small cell lung cancer, a retrospective cohort study

World Journal of Surgical Oncology ◽

10.1186/s12957-020-02027-y ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Wenyu Zhai ◽

Fangfang Duan ◽

Yuzhen Zheng ◽

Qihang Yan ◽

Shuqin Dai ◽

...

Keyword(s):

Lung Cancer ◽

Prognostic Factors ◽

Small Cell ◽

Small Cell Lung ◽

Term Survival ◽

Differentiation Degree ◽

Stage Ia ◽

Nsclc Patients

Abstract Background The examination of lymph nodes (LNs) plays an important role in the nodal staging of non-small cell lung cancer (NSCLC). For patients without LN metastasis, the main role of thorough LN examination is accurate staging, which weakens the effect of staging migration. To date, the role of hilar and intrapulmonary (N1) station LNs has not been fully appreciated. In this study, we aimed to confirm the significance of N1 LNs in long-term survival for stage IA–IIA NSCLC patients and to find the minimum number of LN to examine. Methods The data of patients who underwent radical lobectomy and were confirmed as having non-metastatic LNs from January 2008 to March 2018 were retrospectively screened. Pathology records were reviewed for the number of LNs examined. The Kaplan-Meier method and Cox regression model were used to identify survival and prognostic factors. Results The median number of resected N1 LNs was 8. The number of patients with 0–2 N1 LNs, 3–5 N1 LNs, 6–8 N1 LNs, 9–11 N1 LNs, and more than 11 N1 LNs examined was 181, 425, 477, 414, and 531, respectively. Sex (P = 0.004), age (P < 0.001), tumor size (P = 0.004), differentiation degree (P = 0.001), and number of N1 LNs examined (P = 0.008) were independent prognostic factors of overall survival. Gender (P = 0.006), age (P = 0.031), tumor size (P = 0.001), differentiation degree (P = 0.001), vascular invasion (P = 0.034), and number of N1 LNs examined (P = 0.007) were independent prognostic factors of disease-free survival. Compared with patients with 0–5 N1 LNs examined, patients with more than 5 N1 LNs examined had better OS (P = 0.015) and had better DFS (P = 0.015) if only a landmark 5-year follow-up was performed. Conclusion Increasing the number of N1 LN examination might improve the long-term survival of T1-2N0 NSCLC patients. These data indicate that at least 6 N1 nodes examined is an essential part in surgical and pathological management but cannot prove this. This finding should be confirmed in a large, prospective randomized clinical study.

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