scholarly journals Incidence and survival analyses for occult lung cancer between 2004 and 2015: a population-based study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lei-Lei Wu ◽  
Chong-Wu Li ◽  
Wei-Kang Lin ◽  
Li-Hong Qiu ◽  
Dong Xie
Keyword(s):  
Lung Cancer ◽  
Surgical Treatment ◽  
Survival Outcomes ◽  
Survival Curves ◽  
Crude Incidence Rate ◽  
Cancer Specific Survival ◽  
Crude Incidence ◽  
Survival Analyses ◽  
Lung Cancers ◽  
Entire Cohort

Abstract Background This study aimed to investigate the incidence and long-term survival outcomes of occult lung cancer between 2004 and 2015. Methods A total of 2958 patients were diagnosed with occult lung cancer in the 305,054 patients with lung cancer. The entire cohort was used to calculate the crude incidence rate. Eligible 52,472 patients (T1-xN0M0, including 2353 occult lung cancers) were selected from the entire cohort to perform survival analyses after translating T classification according to the 8th TNM staging system. Cancer-specific survival curves for different T classifications were presented. Results The crude incidence rate of occult lung cancer was 1.00 per 100 patients, and it was reduced between 2004 and 2015 [1.4 per 100 persons in 2004; 0.6 per 100 persons in 2015; adjusted risk ratio = 0.437, 95% confidence interval (CI) 0.363–0.527]. In the survival analysis, there were 2206 death events in the 2353 occult lung cancers. The results of the multivariable analysis revealed that the prognoses with occult lung cancer were similar to patients with stage T3N0M0 (adjusted hazard ratio = 1.054, 95% CI 0.986–1.127, p = 0.121). Adjusted survival curves presented the same results. In addition, adjusted for other confounders, female, age ≤ 72 years, surgical treatment, radiotherapy, adenocarcinoma, and non-squamous and non-adenocarcinoma non-small cell carcinoma were independent protective prognostic factors (all p < 0.05). Conclusions Occult lung cancer was uncommon. However, the cancer-specific survival of occult lung cancer was poor, therefore, we should put the assessment of its prognoses on the agenda. Timely surgical treatment and radiotherapy could improve survival outcomes for those patients. Besides, we still need more research to confirm those findings.

scholarly journals Impact of pre-existing cardiovascular disease on treatment patterns and survival outcomes in patients with lung cancer

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Atul Batra ◽  
Dropen Sheka ◽  
Shiying Kong ◽  
Winson Y. Cheung
Keyword(s):  
Lung Cancer ◽  
Cardiovascular Disease ◽  
Cox Regression ◽  
Population Based ◽  
Treatment Patterns ◽  
Competing Risk ◽  
Survival Outcomes ◽  
Multistate Model ◽  
Cancer Specific Survival ◽  
Increased Risk

Abstract Background Baseline cardiovascular disease (CVD) can impact the patterns of treatment and hence the outcomes of patients with lung cancer. This study aimed to characterize treatment trends and survival outcomes of patients with pre-existing CVD prior to their diagnosis of lung cancer. Methods We conducted a retrospective, population-based cohort study of patients with lung cancer diagnosed from 2004 to 2015 in a large Canadian province. Multivariable logistic regression and Cox regression models were constructed to determine the associations between CVD and treatment patterns, and its impact on overall (OS) and cancer-specific survival (CSS), respectively. A competing risk multistate model was developed to determine the excess mortality risk of patients with pre-existing CVD. Results A total of 20,689 patients with lung cancer were eligible for the current analysis. Men comprised 55%, and the median age at diagnosis was 70 years. One-third had at least one CVD, with the most common being congestive heart failure in 15% of patients. Pre-existing CVD was associated with a lower likelihood of receiving chemotherapy (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.48–0.58; P < .0001), radiotherapy (OR, 0.76; 95% CI, 0.7–0.82; P < .0001), and surgery (OR, 0.56; 95% CI, 0.44–0.7; P < .0001). Adjusting for measured confounders, the presence of pre-existing CVD predicted for inferior OS (hazard ratio [HR], 1.1; 95% CI, 1.1–1.2; P < .0001) and CSS (HR, 1.1; 95% CI, 1.1–1.1; P < .0001). However, in the competing risk multistate model that adjusted for baseline characteristics, prior CVD was associated with increased risk of non-cancer related death (HR, 1.48; 95% CI, 1.33–1.64; P < 0.0001) but not cancer related death (HR, 0.98; 95% CI, 0.94–1.03; P = 0.460). Conclusions Patients with lung cancer and pre-existing CVD are less likely to receive any modality of cancer treatment and are at a higher risk of non-cancer related deaths. As effective therapies such as immuno-oncology drugs are introduced, early cardio-oncology consultation may optimize management of lung cancer.

scholarly journals Comparison of the outcomes of stereotactic body radiotherapy versus surgical treatment for elderly (≥70) patients with early-stage non-small cell lung cancer after propensity score matching

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Baiqiang Dong ◽  
Jin Wang ◽  
Xuan Zhu ◽  
Yuanyuan Chen ◽  
Yujin Xu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Surgical Treatment ◽  
Propensity Score ◽  
Elderly Patients ◽  
Stereotactic Body Radiotherapy ◽  
Early Stage ◽  
Clinical Stage ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cancer Specific Survival

Abstract Background The optimal treatment for elderly patients with early-stage non-small cell lung cancer (NSCLC) remains inconclusive. Previous studies have shown that stereotactic body radiotherapy (SBRT) provides encouraging local control though higher incidence of toxicity in elderly than younger populations. The objective of this study was to compare the outcomes of SBRT and surgical treatment in elderly patients with clinical stage I-II NSCLC. Methods This retrospective analysis included 205 patients aged ≥70 years with clinical stage I NSCLC who underwent SBRT or surgery at Zhejiang Cancer Hospital (Hangzhou, China) from January 2012 to December 2017. A propensity score matching analysis was performed between the two groups. In addition, we compared outcomes and related toxicity in both study arms. Results Each group included 35 patients who met the inclusion criteria. Median follow-up was 50.1 (0.8–74.4) months for surgery and 35.5 (11.5–71.4) months for SBRT. The rate of cancer-specific survival was similar between the two treatment arms (p = 0.958). In patients who underwent surgery, the corresponding 3- and 5-year cancer-specific survival rates were 85.3 and 81.7%, respectively. In those who received radiotherapy, these rates were 91.3 and 74.9%, respectively. Moreover, the 3- and 5-year locoregional control in patients who underwent surgery were 90.0 and 80.0%, respectively. In those who received radiotherapy, these rates were 91.1 and 84.1%, respectively. Notably, the observed differences in progression-free survival were not statistically significant (p = 0.934). In the surgery group, grade 1–2 complications were observed in eleven patients (31%). One patient died due to perioperative infection within 30 days following surgery. There was no grade 3–5 toxicity observed in the SBRT group. Conclusions The outcomes of surgery and SBRT in elderly patients with early-stage NSCLC were similar.

Are the presenting characteristics and prognosis of primary salivary gland-type lung cancers (SG) similar to those of other non-small cell lung cancers (NSCLC)?

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 7054-7054
Author(s):  
John M. Varlotto ◽  
Suhail M. Ali ◽  
Malcolm M. DeCamp ◽  
John Charles Flickinger ◽  
Abram Recht ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Proportional Hazards ◽  
Stage Iv ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Optimal Care ◽  
Chi Square ◽  
Cancer Specific Survival ◽  
Lung Cancers ◽  
Survival Difference

7054 Background: SG, both adenoid cystic (ACC) and mucoepidermoid (ME) sub-types, are rare lung cancers. We choose to investigate the incidence of these rare sub-types and assess their difference in presentation and prognostic characteristics in comparison to adenocarcinomas (Ad) and squamous cell carcinomas (SCC) during the same time period. Methods: The SEER-17 database was used to collect data during the years 1988-2008. Differences between populations were determined by the chi-square test. Survival curves were generated as Kaplan-Meier techniques. Cox proportional hazards test was used to compare survival differences. Results: During the 20-year study period, ACC (n =100) and ME (n= 178) accounted for 0.03% and 0.06% of NSCLCs. Mean follow-up was 34.5 months for all patients. In comparison to ACC, patients with ME were significantly more likely to be younger (52 yr vs. 60yr), Asian(11.7% vs. 7%), have Stage I disease (62.9% vs 24.0%), and less likely to be in the mainstem bronchi (17.2% vs. 6.3%). In comparison to patients with patients presenting with either SCC or Ad, both ME and ACC were significantly less likely to present with Stage IV disease (26.6% SCC, 41.29% Ad, 16.73% SG), have nodal involvement (35.1% SCC, 27.4% Ad, 23.37% SG), and be older (70 SCC, 68 Ad, 58 years SG). Stratified by stage and treatment, there was no survival (OS) or disease-specific survival difference (DSS) between ACC and ME. The OS of the combined group of ME and ACC was significantly better stage per stage than either Ad (Hazard ratio (HR) range = 0.26- 041), and SCC (HR range = 0.17-0.56). Lung Cancer-Specific survival at 2,3,5 years for surgically-resected Stage I ACC and ME were 83.5%, 80.4%, and 80.4%; and 82.6%, 78.0% and 78%, respectively. Conclusions: Patients with ACC and ME have rare sub-types of lung cancer that present differently and have better survival than patients presenting with either of the more common histologic sub-types (SCC and Ad) of NSCLC. We encourage prospective, multi-institutional studies of these rare sub-types so that care can be optimized. Optimal care may differ for SG because of their stage per stage better prognosis than other NSCLCs.

Outcomes of secondary cancers among myeloma survivors.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 8043-8043 ◽  
Author(s):  
Jorge J. Castillo ◽  
Adam J. Olszewski
Keyword(s):  
Lung Cancer ◽  
Early Stage ◽  
Logistic Models ◽  
Control Analysis ◽  
Cancer Specific Survival ◽  
Biological Difference ◽  
Lung Cancers ◽  
Seer Data ◽  
Index Cancer ◽  
Case Control Analysis

8043 Background: With increasing survival, myeloma patients (pts) experience second cancers. We analyzed receipt of surgery and cancer-specific survival (CSS) among myeloma survivors with common solid tumors, in comparison with pts without myeloma. Methods: We extracted Surveillance, Epidemiology, and End Results (SEER) data on pts diagnosed with common cancers in 2004-2013. Among them, we identified myeloma survivors, and we matched each to 50 randomly sampled controls with the same cancer by age, sex, race, and year of diagnosis. We then compared CSS, cumulative incidence function (CIF) for death from the index cancer (but not from myeloma), and receipt of surgery (for non-metastastic, stage-matched tumors only) using a Cox (for hazard ratio, HR), Fine-Gray (for subhazard ratio, SHR), and conditional logistic models, respectively. Results: Myeloma survivors were significantly older ( P<.001), and more often black (except in bladder cancer) than pts with respective cancers from the general population. In the case-control analysis, breast ( P=.002) and lung cancers ( P=.003) were more often diagnosed at an early stage among myeloma survivors. Receipt of surgery did not significantly differ, except for lower use of prostatectomy in myeloma survivors (odds ratio, 0.59, 95%CI, 0.44-0.81). CSS significantly differed only in lung cancer, and was better among myeloma survivors even when stratified by stage. CIF of cancer death was significantly lower for myeloma cases with lung and colorectal cancer. Conclusions: Despite additional competing mortality from recurrent myeloma, myeloma survivors have similar CSS and CIF of death after common cancers compared with other pts. This highlights the need to treat them similarly to other pts, without assuming a poor prognosis. Better outcomes in lung cancer are not fully explained by earlier detection, suggesting a biological difference. [Table: see text]

Outcomes of non-small cell lung cancer patients with adenocarcinoma histology compared with other histologies: SEER registry data 2004-2008.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e17560-e17560 ◽  
Author(s):  
Monika Joshi ◽  
John M. Varlotto ◽  
Suhail M. Ali ◽  
Jennifer Toth ◽  
Michael Reed ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Stage Iv ◽  
P Value ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Lung Cancers ◽  
Lung Cancer Patients ◽  
Stage Disease ◽  
The Difference ◽  
Nsclc Patients

e17560 Background: For convenience, the majority of lung cancers are commonly lumped together as non-small lung cancer (NSCLC). Patients with adenocarcinoma of the lung have a higher incidence of driver mutation as compared to those with squamous histology. In addition pemetrexed containing regimens have preferential activity in this histology and agents such as bevacizumab are administered to this subgroup only based on toxicity. The currentanalysis was performed to compare outcomes for patients in the SEER database between 2004 and 2008 with adenocarcinoma (Adenoca), squamous cell carcinoma (SCCA) and NSCLC not otherwise specified (NOS). Methods: Data for 161,175 patients was available in SEER database between 2004 and 2008 with 38 different histology ICD codes. 134,947 patients (83.7%) were included in the study. NSCLC NOS (ICD-3 8046) n=36,408, SCCA (ICD-3 8070) n= 36, 454 and Adenoca (ICD-3 8140) n=62,085. Overall survival (OS) and lung cancer specific survival (LCSS) were analyzed using cox proportional Hazard model for the 3 groups. Results: Patients in the three groups were age-matched. Male gender was more common in patients who had SCCA compared to Adenoca (62.6% vs. 49.5%). Percentage of poorly differentiated tumors was higher in patients with SCCA (35.9%) compared to NSCLC NOS (32%) and Adenoca (27.5%). SCCA had fewer stage IV patients at diagnosis (29.5%) vs. 51.4 % for NSCLC NOS and 45% for Adenoca. OS and LCSS are listed in the table below with Hazard ratio (HR) and p value. Total of 23.54% (n=31,768) patients underwent surgical resection. Stage I patients who underwent surgery (n=18,517) also had similar results. Conclusions: NSCLC patients who have adenocarcinoma histology have significantly better overall outcome when compared to other histologies. The difference is more pronounced in an earlier stage disease. [Table: see text]

scholarly journals Impact of Pre-Existing Cardiovascular Disease on Treatment Patterns and Survival Outcomes in Patients With Lung Cancer

2020 ◽  
Author(s):  
Atul Batra ◽  
Dropen Sheka ◽  
Shiying Kong ◽  
Winson Y Cheung
Keyword(s):  
Lung Cancer ◽  
Cardiovascular Disease ◽  
Cox Regression ◽  
Population Based ◽  
Treatment Patterns ◽  
Survival Outcomes ◽  
Cancer Specific Survival ◽  
Diagnosis Of Lung Cancer ◽  
Treatment Trends ◽  
To Receive

Abstract Background: Baseline cardiovascular disease can impact the patterns of treatment and hence the outcomes of patients with lung cancer. This study aimed to characterize treatment trends and survival outcomes of patients with pre-existing cardiovascular disease prior to their diagnosis of lung cancer.Methods: We conducted a retrospective, population-based cohort study of patients with lung cancer diagnosed from 2004 to 2015in a large Canadian province. Multivariable logistic regression and Cox regression models were constructed to determine the associations between cardiovascular disease and treatment patterns, and its impact on overall and cancer-specific survival, respectively.Results: A total of 20,689 patients with lung cancer were eligible for the current analysis. Men comprised 55%, and the median age at diagnosis was 70 years. One-third had at least one cardiovascular disease, with the most common being congestive heart failure in 15% of patients. Pre-existing cardiovascular disease was associated with a lower likelihood of receiving chemotherapy (odds ratio [OR],0.53;95% confidence interval [CI],0.48-0.58;P < .0001), radiotherapy (OR,0.76;95% CI,0.7-0.82;P < .0001), and surgery (OR, 056; 95% CI,0.44-0.7;P < .0001). Adjusting for measured confounders, the presence of pre-existing cardiovascular disease predicted for inferior OS (hazard ratio [HR], 1.1; 95% CI, 1.1-1.2; P < .0001) and CSS (HR,1.1; 95% CI, 1.1-1.1; P < .0001). Conclusions: Patients with lung cancer and pre-existing cardiovascular disease are less likely to receive any modality of cancer treatment and have poor OS and CSS. As effective therapies such as immuno-oncology drugs are introduced, early cardio-oncology consultation may optimize management and outcomes of lung cancer.

Surgical treatment strategy for small-sized, non-small cell lung cancer: A proposed algorithm for limited resection

2010 ◽  
Vol 24 (7) ◽  
pp. 1004-1010 ◽  
Author(s):  
Masayoshi Inoue ◽  
Masato Minami ◽  
Noriyoshi Sawabata ◽  
Yoshihisa Kadota ◽  
Yasushi Shintani ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Surgical Treatment ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Treatment Strategy ◽  
Small Cell ◽  
Limited Resection ◽  
Small Cell Lung

Enhancing 18F-FDG-PET/CT analysis in lung cancer patients

2015 ◽  
Vol 54 (06) ◽  
pp. 247-254 ◽  
Author(s):  
A. Kapfhammer ◽  
T. Winkens ◽  
T. Lesser ◽  
A. Reissig ◽  
M. Steinert ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Image Fusion ◽  
Chest Wall ◽  
Fdg Pet ◽  
Ct Image ◽  
Lung Cancers ◽  
Pet Ct ◽  
Peripheral Lung ◽  
Fdg Pet Ct ◽  
Tumour Infiltration

SummaryAim: To retrospectively evaluate the feasibility and value of CT-CT image fusion to assess the shift of peripheral lung cancers with/-out chest wall infiltration, comparing computed tomography acquisitions in shallow-breathing (SB-CT) and deep-inspiration breath-hold (DIBH-CT) in patients undergoing FDG-PET/ CT for lung cancer staging. Methods: Image fusion of SB-CT and DIBH-CT was performed with a multimodal workstation used for nuclear medicine fusion imaging. The distance of intrathoracic landmarks and the positional shift of tumours were measured using semitransparent overlay of both CT series. Statistical analyses were adjusted for confounders of tumour infiltration. Cutoff levels were calculated for prediction of no-/infiltration. Results: Lateral pleural recessus and diaphragm showed the largest respiratory excursions. Infiltrating lung cancers showed more limited respiratory shifts than non-infiltrating tumours. A large respiratory tumour-motility accurately predicted non-infiltration. However, the tumour shifts were limited and variable, limiting the accuracy of prediction. Conclusion: This pilot fusion study proved feasible and allowed a simple analysis of the respiratory shifts of peripheral lung tumours using CT-CT image fusion in a PET/CT setting. The calculated cutoffs were useful in predicting the exclusion of chest wall infiltration but did not accurately predict tumour infiltration. This method can provide additional qualitative information in patients with lung cancers with contact to the chest wall but unclear CT evidence of infiltration undergoing PET/CT without the need of additional investigations. Considering the small sample size investigated, further studies are necessary to verify the obtained results.

Drug Combinatorial Therapies for the Treatment of KRAS Mutated Lung Cancers

2019 ◽  
Vol 19 (23) ◽  
pp. 2128-2142 ◽  
Author(s):  
Hao He ◽  
Chang Xu ◽  
Zhao Cheng ◽  
Xiaoying Qian ◽  
Lei Zheng
Keyword(s):  
Lung Cancer ◽  
Adjuvant Therapy ◽  
Combination Therapy ◽  
Clinical Benefit ◽  
Poor Prognosis ◽  
Egfr Mutations ◽  
Kras Mutations ◽  
Lung Cancers ◽  
Egfr Tki ◽  
Egfr Tkis

: KRAS is the most common oncogene to be mutated in lung cancer, and therapeutics directly targeting KRAS have proven to be challenging. The mutations of KRAS are associated with poor prognosis, and resistance to both adjuvant therapy and targeted EGFR TKI. EGFR TKIs provide significant clinical benefit for patients whose tumors bear EGFR mutations. However, tumors with KRAS mutations rarely respond to the EGFR TKI therapy. Thus, combination therapy is essential for the treatment of lung cancers with KRAS mutations. EGFR TKI combined with inhibitors of MAPKs, PI3K/mTOR, HDAC, Wee1, PARP, CDK and Hsp90, even miRNAs and immunotherapy, were reviewed. Although the effects of the combination vary, the combined therapeutics are one of the best options at present to treat KRAS mutant lung cancer.

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