Lower lobe origin is related to unfavorable outcomes in patients with stage I–III lung cancer treated with radical chemoradiotherapy

2020 ◽  
pp. 030089162097135
Author(s):  
Fangfang Liu ◽  
Xun Yuan ◽  
Jizong Jiang ◽  
Peng Zhang ◽  
Yuan Chen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lung Tumor ◽  
Survival Rates ◽  
Lower Lobe ◽  
Tumor Location ◽  
Stage I ◽  
Lung Lobe ◽  
Tumor Origin ◽  
Lower Lung ◽  
The Difference

Purpose: The influence of tumor location on survival was investigated in patients with lung cancer who received radical chemoradiotherapy. Methods: We examined the relationships between radiation site and survival outcome in patients with lung cancer. A total of 14,640 patients with lung cancer who received radical chemoradiotherapy for stage I–III disease were reviewed from Surveillance, Epidemiology, and End Results Program (SEER) datasets. We further retrospectively collected cases from a cohort of 148 eligible patients diagnosed between December 2013 and December 2019. Results: Female sex, adenocarcinoma, and stage III disease were significantly correlated with right lung lobe tumor. Advanced age at diagnosis was associated with lower lung tumor origin. For the patients who received radical chemoradiotherapy, 1- and 3-year survival rates were 56.5% and 22.9%. Lower lobe origin was closely related to a shorter overall survival compared to non-right lower lobe tumors ( p < 0.001). We also validated the difference in our cohort ( p = 0.004). Conclusions: Our results suggest that lower lobe tumor increases mortality risk in patients with lung cancer treated with radical chemoradiotherapy.

Forces involved in lobar atelectasis in intact dogs

1980 ◽  
Vol 48 (1) ◽  
pp. 29-33 ◽  
Author(s):  
G. T. Ford ◽  
C. A. Bradley ◽  
N. R. Anthonisen
Keyword(s):  
Chest Wall ◽  
Lower Lobe ◽  
Transpulmonary Pressure ◽  
Esophageal Pressure ◽  
Lateral Position ◽  
Relative Volume ◽  
Left Lower Lobe ◽  
Lung Lobe ◽  
Left Lateral Position ◽  
The Difference

When an excised lung lobe undergoes atelectasis, its shape differs from that observed when lobar atelectasis occurs in an intact animal: the chest wall deforms the collapsing lobe. In eight anesthetized dogs in the left lateral position we measured lung volume and transpulmonary pressure during the development of atelectasis. We then induced atelectasis of the left lower lobe with the rest of the lung maintained at FRC and measured lobar volume and "translobar" (lobar minus esophageal) pressure. Lung and lobar volumes were measured by prebreathing the animal with 88% O2-12% N2, occluding the airway and observing the increase in lung or lobar N2 concentration. When the left lower lobe alone collapsed, translobar pressures were more negative than transpulmonary pressure at the same relative volume when the whole lung collapsed. This pressure difference, which represents the deforming force applied to the lobe minus the pressure costs of deformation, averaged 3 cmH2O at 50% FRC. Infusion of 25 ml of normal saline into the pleural space sharply reduced the difference pulmonary pressure during lung collapse: this difference was abolished at 80% FRC and halved at 50% FRC. The large effect of the small volume of fluid suggested that deforming forces were largely generated in relatively local areas, such as regions of the chest wall with sharp angulation.

The role of surgery in stage I small-cell lung cancer: A national VA database analysis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e21109-e21109
Author(s):  
Ibrahim Azar ◽  
Adam Austin ◽  
Seongho Kim ◽  
Hyejeong Jang ◽  
Amit Chopra ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Lower Lobe ◽  
Small Cell ◽  
Stage I ◽  
Small Cell Lung ◽  
Subset Analysis

e21109 Background: Historically, limited stage Small Cell Lung Cancer (SCLC) has been treated with concurrent chemoradiation (CRT). While current NCCN guidelines recommend consideration of lobectomy in node-negative cT1-T2 SCLC, real world data regarding the role of surgery in very limited SCLC is lacking. To our knowledge, only one retrospective study has evaluated the role of surgery in stage I SCLC. Methods: Data from the National VA Cancer Cube were compiled. A total of 1,028 patients with pathologically confirmed Stage I SCLC were studied. Only 661 patients that either received surgery or CRT were included. Interval-censored Weibull and Cox proportional hazard regression models were used to estimate median overall survival (OS) and hazard ratio (HR), respectively. Two survival curves were compared by a Wald test. Subset analysis was performed based on the location of the tumor in the upper vs lower lobe as delineated by ICD-10 codes C34.1 and C34.3. Results: Four-hundred and forty-two patients received concurrent CRT; while 219 underwent treatment that contained surgery (92 surgery only, 84 surgery/chemo, 39 surgery/chemo/radiation and 4 surgery/radiation). The median OS for the surgery-inclusive treatment was 3.87 years (95% CI 3.25-4.60) while median OS for the CRT cohort was 2.43 years (95% CI 2.15-2.72). HR of death for surgery-inclusive treatment when compared to CRT was 0.65 (95% CI 0.54-0.79; p < 0.001). Subset analysis based on the location of the tumor in upper lobe and lower lobe showed improved survival with surgery as compared to CRT regardless of the location. HR for upper lobe was 0.61 (95% CI 0.48-0.78; p < 0.001) and lower lobe 0.60 (95% CI 0.41-0.87; p = 0.007). Multivariable regression analysis accounting for age and ECOG-PS shows a HR 0.60 (95% CI 0.42-0.85; p = 0.004) favoring surgery. Conclusions: Surgery was used in less than a third of patients with stage I SCLC who received treatment. Surgery-inclusive multimodality treatment was associated with a longer overall survival as compared to chemoradiation, independent of age, performance status or tumor location. Our study supports a more expansive role for surgery in stage I SCLC.

Term Domain Distribution Analysis: a Data Mining Tool for Text Databases

1999 ◽  
Vol 38 (02) ◽  
pp. 96-101 ◽  
Author(s):  
W. W. Chu ◽  
D. S. Parker ◽  
R. M. Goldman ◽  
J. A. Goldman
Keyword(s):  
Lung Cancer ◽  
Data Mining ◽  
Lung Tumor ◽  
Left Lung ◽  
Tumor Location ◽  
Distribution Analysis ◽  
Filter Model ◽  
Frequency Distributions ◽  
Text Databases ◽  
Primary Lung Tumor

AbstractIn this paper, we give a case history illustrating the real-world application of a useful technique for data mining of text databases. The technique, which we call Term Domain Distribution Analysis (TDDA), consists of keeping track of term frequencies for specific finite domains and announcing significant differences from standard frequency distributions over these domains as a hypothesis. TDDA is part of a larger framework, the Digital Filter Model, for data mining of text documents. In the case study presented, the domain of terms was the pair {right, left}, over which we expected a uniform distribution. In analyzing term frequencies in a thoracic lung cancer database, the TDDA technique led to the surprising discovery that primary thoracic lung cancer tumors appear in the right lung more often than the left lung, with a ratio of 3:2. Treating the text discovery as a hypothesis, we verified this relationship against the medical literature in which primary lung tumor sites were reported, using a standard χ2 statistic. We subsequently developed a working theoretical model of lung cancer that may explain the discovery. This discovery and our model may change how oncologists view the mechanisms of primary lung tumor location.

scholarly journals The prognostic value of PET/CT in clinical stage I lung cancer patients: A propensity-match analysis.

2019 ◽  
Author(s):  
Bing-Yen Wang ◽  
Wei-Heng Hung ◽  
Jing-Yang Huang ◽  
Heng-Chung Chen ◽  
Ching-Hsiung Lin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Clinical Stage ◽  
Survival Rates ◽  
Small Cell ◽  
Stage I ◽  
Small Cell Lung ◽  
Lung Cancer Patients ◽  
Pet Ct ◽  
Stage I Lung Cancer

Abstract Introduction The application of PET/CT directly improved treatment choice and management in 25% of non-small cell lung cancer patients and 29% of small cell lung cancer patients. However, the long-term outcome of altering the management of these patients remains unclear. The aim of this study was to compare the 5-year overall survival rates of two groups of clinical stage I lung cancer patients: those who received PET/CT and those who did not.Methods Data were obtained from the Taiwan Society of Cancer Registry. There were 6,587 clinical stage I lung cancer patients analyzed between 2009 and 2014 in this retrospective study. We performed propensity matching to reduce the bias; it resulted in both groups having 2,649 patients. We measured the 1, 3, and 5-year survival rates of all clinical stage I lung cancer patients and the survival rates of pathological I, II and III lung cancer patients and compared the survival rates between clinical stage I lung cancer patients with PET/CT scans and patients without PET/CT scans.Results The 1, 3, and 5-year survival rates of all clinical stage I lung cancer patients are 97.2%, 88.2% and 79.0%, respectively. The 1, 3, and 5-year survival rates are 97.0%, 88.2% and 79.8% in the PET/CT group and 97.5%, 88.1% and 78.2% in the no PET/CT group; there was no statistical difference (p= 0.6528).Conclusion Although stage I lung cancer patients who received PET/CT had their management strategies modified and avoided any unnecessary thoracotomies, our data showed that there was no 5-year survival benefit for these patients.

Electromagnetic Navigational Bronchoscopy: A Safe and Effective Method for Fiducial Marker Placement in Lung Cancer Patients

2015 ◽  
Vol 81 (7) ◽  
pp. 659-662 ◽  
Author(s):  
William D. Bolton ◽  
John Richey ◽  
Sharon Ben-Or ◽  
Allyson L. Hale ◽  
Joseph A. Ewing ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Hospital Admissions ◽  
Retention Rate ◽  
Lower Lobe ◽  
Fiducial Marker ◽  
Complication Rates ◽  
Fiducial Markers ◽  
Stereotactic Radiation ◽  
The Difference ◽  
Electromagnetic Navigational Bronchoscopy

The emergence of Electromagnetic Navigational Bronchoscopy (ENB) as a diagnostic tool for small peripheral lung nodules has introduced a new method for delivery of fiducial markers. This technique has not been well studied in the literature. The purpose of our study was to evaluate the safety and effectiveness of ENB when used in fiducial marker placement. We reviewed all patients undergoing ENB fiducial placement between June 2010 and February 2014 (n = 64). These 64 patients had 68 lung lesions, in which we placed a total of 190 markers. Primary end points were marker retention and postoperative complications. The retention rate for the study was 82 per cent (n = 156). Upper lobe lesions had a 78 per cent retention rate and the middle/lower lobe lesions had an 89 per cent retention rate; the difference was not significant ( P = 0.126). Complications included hospital admissions, respiratory failure, and pneumothorax. The difference in complication rates between upper and middle/lower lobe markers was not significant. We found ENB to be a safe method for the placement of fiducial markers. We also found that placement of an average of three markers/lesion led to an adequate retention rate to allow for successful treatment of lung cancer in nonsurgical patients using lung-sparing stereotactic radiation.

scholarly journals Radiofrequency Ablation for Early-Stage Nonsmall Cell Lung Cancer

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Takao Hiraki ◽  
Hideo Gobara ◽  
Toshihiro Iguchi ◽  
Hiroyasu Fujiwara ◽  
Yusuke Matsui ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiofrequency Ablation ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Survival Rates ◽  
Nonsmall Cell Lung Cancer ◽  
Stage I ◽  
Sublobar Resection ◽  
Early Stage Nsclc ◽  
Local Progression

This review examines studies of radiofrequency ablation (RFA) of nonsmall cell lung cancer (NSCLC) and discusses the role of RFA in treatment of early-stage NSCLC. RFA is usually performed under local anesthesia with computed tomography guidance. RFA-associated mortality, while being rare, can result from pulmonary events. RFA causes pneumothorax in up to 63% of cases, although pneumothorax requiring chest drainage occurs in less than 15% of procedures. Other severe complications are rare. After RFA of stage I NSCLC, 31–42% of patients show local progression. The 1-, 2-, 3-, and 5-year overall survival rates after RFA of stage I NSCLC were 78% to 100%, 53% to 86%, 36% to 88%, and 25% to 61%, respectively. The median survival time ranged from 29 to 67 months. The 1-, 2-, and 3-year cancer-specific survival rates after RFA of stage I NSCLC were 89% to 100%, 92% to 93%, and 59% to 88%, respectively. RFA has a higher local failure rate than sublobar resection and stereotactic body radiation therapy (SBRT). Therefore, RFA may currently be reserved for early-stage NSCLC patients who are unfit for sublobar resection or SBRT. Various technologies are being developed to improve clinical outcomes of RFA for early-stage NSCLC.

scholarly journals Assessment of Respiration-Induced Motion and Its Impact on Treatment Outcome for Lung Cancer

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Yan Wang ◽  
Yong Bao ◽  
Li Zhang ◽  
Wei Fan ◽  
Han He ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Treatment Outcome ◽  
Lung Tumor ◽  
Free Breathing ◽  
Tumor Location ◽  
Lung Cancer Patients ◽  
Improved Outcomes ◽  
Induced Motion ◽  
Impact On Treatment ◽  
Motion Characteristics

This study presented the analysis of free-breathing lung tumor motion characteristics using GE 4DCT and Varian RPM systems. Tumor respiratory movement was found to be associated with GTV size, the superior-inferior tumor location in the lung, and the attachment degree to rigid structure (e.g., chest wall, vertebrae, or mediastinum), with tumor location being the most important factor among the other two. Improved outcomes in survival and local control of 43 lung cancer patients were also reported. Consideration of respiration-induced motion based on 4DCT for lung cancer yields individualized margin and more accurate and safe target coverage and thus can potentially improve treatment outcome.

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