scholarly journals Adjuvant Chemotherapy in Resected Lung Cancer: Two-Year Experience in a University Hospital

2008 ◽  
Vol 15 (5) ◽  
pp. 270-274 ◽  
Author(s):  
Nicole Bouchard ◽  
Francis Laberge ◽  
Bruno Raby ◽  
Sylvie Martin ◽  
Yves Lacasse
Keyword(s):  
Lung Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
Surgical Resection ◽  
Randomized Trials ◽  
Medical Oncology ◽  
Early Stage ◽  
University Hospital ◽  
Quebec City ◽  
Significant Difference

BACKGROUND: Randomized trials have confirmed the benefits of adjuvant chemotherapy in improving survival in resected early-stage non-small-cell lung cancer (NSCLC). The extent to which these results have translated into clinical practice is unknown.OBJECTIVE: To examine the referral pattern of patients with resected lung cancer to adjuvant chemotherapy, and to compare compliance and toxicities with current literature.METHODS: A retrospective analysis of all patients who underwent a surgical resection for lung cancer at Laval Hospital (Quebec City, Quebec) from March 2004 to January 2006 was conducted.RESULTS: A total of 258 patients underwent surgery. Seven patients were excluded because of early postoperative death, and two patients were excluded because of incomplete data. Data from 249 patients were analyzed (94% NSCLC). Fifty per cent were referred to medical oncology for consideration of adjuvant chemotherapy, including 37 of 61 patients with stage II NSCLC. One hundred patients received chemotherapy. No significant difference in age, sex, comorbidities and surgical procedures was observed between those who received chemotherapy and those who did not. Chemotherapy was initiated 47 days (median) after the surgery and consisted mainly of cisplatin-vinorelbine (38%), cisplatin-etoposide (22%) and carboplatin-paclitaxel (20%). Sixty-six per cent of the patients completed all four cycles. Grade 3 or 4 toxicities consisted mainly of fatigue (23%) and cytopenia (40%). No death was registered; 15% had to be hospitalized because of adverse effects.CONCLUSION: Although adjuvant chemotherapy is gaining acceptance in clinical practice, more patients should be referred to medical oncology following surgical resection. Compliance and toxicity are similar to or better than those described in published randomized trials.

Comparison of preoperative and prechemotherapy lymphocyte counts to predict outcome of non-small cell lung cancer patients treated with adjuvant chemotherapy.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e20002-e20002
Author(s):  
Hyun Woo Lee ◽  
Yong Won Choi ◽  
Mi Sun Ahn ◽  
Seok Yun Kang ◽  
Jin-Hyuk Choi
Keyword(s):  
Lung Cancer ◽  
Adjuvant Chemotherapy ◽  
Small Cell Lung Cancer ◽  
Surgical Resection ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Stage Ib ◽  
Significant Difference ◽  
Histologic Types

e20002 Background: Several systemic inflammatory markers in blood have been suggested as prognostic factors in various cancers. We investigated the prognostic significance of neutrophil-to-lymphocyte ratio (NLR) and absolute lymphocyte count (ALC) in patients (pts) with non-small cell lung cancer (NSCLC) treated with adjuvant chemotherapy. Methods: A retrospective review was conducted on 108 pts who received adjuvant chemotherapy after surgical resection of NSCLC. Disease-free survival (DFS) and overall survival (OS) of pts with high NLR and ALC ( > median value) before surgery or chemotherapy were compared to those of pts with low NLR and ALC (≤median value). Results: The number of pts at AJCC stage IB, IIA, IIB, IIIA, and IIIB were 1, 38, 9, 58, and 2, respectively. Adenocarcinoma, squamous cell carcinoma, and other histologic types were present in 66 (61.1%), 32 (29.6%), and 10 (9.3%) pts, respectively. The most frequently used chemotherapy regimen was vinorelbine/cisplatin (81 pts), followed by paclitaxel/carboplatin (22 pts), and others (5 pts). A total of 61 (56.5%) pts received adjuvant radiotherapy (before adjuvant chemotherapy: 53 pts). Preoperative NLR and ALC were not associated with clinicopathologic characteristics including stage and histologic types. High prechemotherapy NLR and low ALC were more frequently observed in pts who underwent radiotherapy before chemotherapy (p < 0.0001). The median follow-up duration was 70 (38-162) months for survivors. Pts with stage III demonstrated poor DFS (p = 0.019) and OS (p = 0.028) compared to those with stage IB or II. The shorter median DFS was observed in pts with low prechemotherapy ALC (20 vs. 65 months, p = 0.021), without significant difference in OS (p = 0.088). On the other hand, NLR and preoperative ALC were not associated with outcome of pts. Conclusions: The present study suggests that high prechemotherapy ALC is associated with poor outcome in stage IB-III NSCLC pts who received adjuvant chemotherapy after surgical resection.

Patient-centered wait time measurement in Ontario.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 233-233 ◽  
Author(s):  
Leonard Kaizer ◽  
Monika Karolina Krzyzanowska ◽  
Sherrie Hertz ◽  
John Srigley ◽  
Julian Dobranowski ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Medical Oncology ◽  
Early Stage ◽  
Wait Time ◽  
Breast Cancer Patients ◽  
Patient Centered

233 Background: Since 2005, a concerted effort to measure and manage access to chemotherapy services in Ontario has resulted in a significant reduction in several specific wait time intervals (referral for medical oncology consultation and medical oncology consultation to first treatment). To identify other opportunities to improve access, a comprehensive analysis of the all-inclusive wait times from cancer diagnosis to the start of adjuvant chemotherapy for patients with early stage colon, breast, and lung cancer (patient centered wait time) has been undertaken. Methods: The study cohort comprised all Ontario patients who received adjuvant chemotherapy in 2009 for early stage colon, breast, and lung cancers. The Ontario Cancer Registry, linked to several administrative healthcare databases in Ontario, was used to identify the cohort and variables of interest. Wait time from diagnosis of cancer to the initiation of adjuvant chemotherapy was measured and separated into segments based on the dates of diagnosis (D), surgery (S), referral to medical oncology (R), medical oncology consultation (C), and first adjuvant chemotherapy treatment (T), and each was analyzed for variation at a regional and institutional level. The times from surgery to pathology sign-out (TTPR) and for peripherally inserted central catheter (PICC) acquisition were also studied in a subset of cases. Results: In 2009, 86% of patients with stage III colon cancer, 80% of patients with stage I to III breast cancer and 63% of patients with stage II lung cancer who received adjuvant chemotherapy started their treatment within 120 days of diagnosis. There was significantly better performance and less regional variation for colon cancer patients (82-93%) than for breast cancer patients (63-90%). For the whole cohort of breast cancer patients, the median total time from diagnosis to adjuvant chemotherapy was 81 days with the following segmental breakdown D-S (30 days), S-R (19 days), R-C (16 days), and C-T (16 days). The mean TTPR for colon cancer patients was 11.6 days and PICC insertion was < 7 days in 92% of patients. Conclusions: A number of opportunities for process improvement were identified, including shortening the pathology reporting interval and the timing for initiating referral to a medical oncologist.

scholarly journals Metabolic Changes in Early-Stage Non–Small Cell Lung Cancer Patients after Surgical Resection

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 3012
Author(s):  
Naseer Ahmed ◽  
Biniam Kidane ◽  
Le Wang ◽  
Zoann Nugent ◽  
Nataliya Moldovan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Surgical Resection ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Small Cell ◽  
Resonance Spectroscopy ◽  
Small Cell Lung ◽  
Serum Samples ◽  
Post Surgery

Metabolic alterations in malignant cells play a vital role in tumor initiation, proliferation, and metastasis. Biofluids from patients with non–small cell lung cancer (NSCLC) harbor metabolic biomarkers with potential clinical applications. In this study, we assessed the changes in the metabolic profile of patients with early-stage NSCLC using mass spectrometry and nuclear magnetic resonance spectroscopy before and after surgical resection. A single cohort of 35 patients provided a total of 29 and 32 pairs of urine and serum samples, respectively, pre-and post-surgery. We identified a profile of 48 metabolites that were significantly different pre- and post-surgery: 17 in urine and 31 in serum. A higher proportion of metabolites were upregulated than downregulated post-surgery (p < 0.01); however, the median fold change (FC) was higher for downregulated than upregulated metabolites (p < 0.05). Purines/pyrimidines and proteins had a larger dysregulation than other classes of metabolites (p < 0.05 for each class). Several of the dysregulated metabolites have been previously associated with cancer, including leucyl proline, asymmetric dimethylarginine, isopentenyladenine, fumaric acid (all downregulated post-surgery), as well as N6-methyladenosine and several deoxycholic acid moieties, which were upregulated post-surgery. This study establishes metabolomic analysis of biofluids as a path to non-invasive diagnostics, screening, and monitoring in NSCLC.

scholarly journals Radiomics is feasible for prediction of spread through air spaces in patients with nonsmall cell lung cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yuki Onozato ◽  
Takahiro Nakajima ◽  
Hajime Yokota ◽  
Jyunichi Morimoto ◽  
Akira Nishiyama ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Predictive Model ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Characteristic Curve ◽  
Sublobar Resection ◽  
Tumor Spread ◽  
Early Stage Disease ◽  
Significant Difference ◽  
Spread Through Air Spaces

AbstractTumor spread through air spaces (STAS) in non-small-cell lung cancer (NSCLC) is known to influence a poor patient outcome, even in patients presenting with early-stage disease. However, the pre-operative diagnosis of STAS remains challenging. With the progress of radiomics-based analyses several attempts have been made to predict STAS based on radiological findings. In the present study, patients with NSCLC which is located peripherally and tumors ≤ 2 cm in size on computed tomography (CT) that were potential candidates for sublobar resection were enrolled in this study. The radiologic features of the targeted tumors on thin-section CT were extracted using the PyRadiomics v3.0 software package, and a predictive model for STAS was built using the t-test and XGBoost. Thirty-five out of 226 patients had a STAS histology. The predictive model of STAS indicated an area under the receiver-operator characteristic curve (AUC) of 0.77. There was no significant difference in the overall survival (OS) for lobectomy between the predicted-STAS (+) and (−) groups (p = 0.19), but an unfavorable OS for sublobar resection was indicated in the predicted-STAS (+) group (p < 0.01). These results suggest that radiomics with machine-learning helped to develop a favorable model of STAS (+) NSCLC, which might be useful for the proper selection of candidates who should undergo sublobar resection.

Systematic review of adjuvant therapy for early stage (epithelial) ovarian cancer

2003 ◽  
Vol 13 (4) ◽  
pp. 395-404 ◽  
Author(s):  
B. Winter-Roach ◽  
L. Hooper ◽  
H. Kitchener
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Early Stage ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Significant Difference ◽  
Well Differentiated ◽  
Platinum Chemotherapy

A systematic review and meta analysis has been undertaken in order to evaluate the effectiveness of adjuvant therapy following surgery for early ovarian cancer. Trials reported since 1990 have been of a higher quality enabling a meta analysis of adjuvant chemotherapy vs adjuvant radiotherapy and a meta analysis of adjuvant chemotherapy vs observation. There was no significant difference between radiotherapy and chemotherapy, though these comprised studies which demonstrated considerable heterogeneity. Chemotherapy did confer significant benefit over observation in terms of both overall and disease free survival. Except for women in whom adequate surgical staging has revealed well differentiated disease confined to one or both ovaries with intact capsule, platinum chemotherapy should be offered to reduce risk of recurrence.

scholarly journals Prognostic and Predictive Markers of Benefit from Adjuvant Chemotherapy in Early-Stage Non-small Cell Lung Cancer

2009 ◽  
Vol 4 (7) ◽  
pp. 891-910 ◽  
Author(s):  
Ana Belén Custodio ◽  
José Luis González-Larriba ◽  
Jana Bobokova ◽  
Antonio Calles ◽  
Rafael Álvarez ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Adjuvant Chemotherapy ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Small Cell ◽  
Predictive Markers ◽  
Small Cell Lung ◽  
Prognostic And Predictive Markers
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