scholarly journals Association between number of dissected lymph nodes and survival in stage IA non-small cell lung cancer: a propensity score matching analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Lei-Lei Wu ◽  
Jia-Jian Lai ◽  
Xuan Liu ◽  
Yang-Yu Huang ◽  
Peng Lin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Propensity Score ◽  
Tumor Size ◽  
Wedge Resection ◽  
Small Cell ◽  
Matched Cohort ◽  
Small Cell Lung ◽  
Group A ◽  
Stage Ia ◽  
Group B

Abstract Background For patients with stage IA non-small cell lung cancer (NSCLC) with tumor size ≤ 2 cm, the prognostic significance of the number of removed lymph nodes (NLNs) through different surgical methods remains unclear. To determine the association of NLNs with cancer-specific survival (CSS) and overall survival (OS) in patients with stage IA NSCLC with tumor size ≤ 2 cm who underwent different lung surgeries. Methods We retrospectively enrolled 7293 patients from the Surveillance, Epidemiology and End Results database. Median NLNs was used to classify the patients into two groups: group A with NLNs ≤ 5 and group B with NLNs > 5. Propensity score matching (PSM) was performed to decrease selection bias. Kaplan–Meier analysis and Cox regression analysis were performed to identify the association between NLNs and survival outcomes. Results Group B had better survival than group A in the unmatched cohort and matched cohort (all P < 0.05). Multivariable analyses revealed that the NLNs significantly affected CSS and OS of eligible cases in the unmatched cohort and matched cohort. Additionally, we found that the NLNs was a protective prognostic predictor of OS for patients who underwent wedge resection, segmental resection, or lobectomy. Conclusion The NLNs was a protective prognostic factor in NSCLC patients with tumor size ≤ 2 cm. We demonstrated that patients with > 5 NLNs in the cohort of wedge resection, segmental resection, or lobectomy exhibited a significantly better OS.

scholarly journals A national analysis of wedge resection versus stereotactic body radiation therapy for stage IA non–small cell lung cancer

2017 ◽  
Vol 154 (2) ◽  
pp. 675-686.e4 ◽  
Author(s):  
Babatunde A. Yerokun ◽  
Chi-Fu Jeffrey Yang ◽  
Brian C. Gulack ◽  
Xuechan Li ◽  
Michael S. Mulvihill ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Stereotactic Body Radiation Therapy ◽  
Wedge Resection ◽  
Small Cell ◽  
Small Cell Lung ◽  
Stage Ia ◽  
National Analysis

Tumor Size Predicts Survival Within Stage IA Non-Small Cell Lung Cancer *

CHEST Journal ◽  
2003 ◽  
Vol 124 (5) ◽  
pp. 1828-1833 ◽  
Author(s):  
Jeffrey L. Port ◽  
Michael S. Kent ◽  
Robert J. Korst ◽  
Daniel Libby ◽  
Mark Pasmantier ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Tumor Size ◽  
Small Cell ◽  
Small Cell Lung ◽  
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.

scholarly journals Characteristics of non-small-cell lung cancer with interstitial pneumonia: variation in cancer location, histopathology, and frequency of postoperative acute exacerbations in interstitial pneumonia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kazumasa Ogawa ◽  
Hironori Uruga ◽  
Takeshi Fujii ◽  
Sakashi Fujimori ◽  
Tadasu Kohno ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Interstitial Pneumonia ◽  
Squamous Cell ◽  
Small Cell ◽  
Normal Lung ◽  
Small Cell Lung ◽  
Acute Exacerbations ◽  
Group A ◽  
Group B

Abstract Background Non–small-cell lung cancer (NSCLC) has been reported to develop in patients with interstitial pneumonia (IP); however, clinical, radiological, and pathological features remain to be elucidated. Methods We retrieved the records of 120 consecutive NSCLC patients associated with IP who underwent surgery at Toranomon Hospital between June 2011 and May 2017. We classified the patients into three groups according to NSCLC location using high-resolution computed tomography: group A, within a fibrotic shadow and/or at the interface of a fibrotic shadow and normal lung; group B, within emphysematous tissue and/or at the interface of emphysematous tissue and normal lung; and group C, within normal lung. In 64 patients, programmed death ligand-1 (PD-L1) status was assessed with immunohistostaining. Results Most of the patients (89; 70%) were classified as group A. This group tended to have squamous cell carcinoma with the usual interstitial pneumonia (UIP). These cancers were located mainly in the lower lobes and seven of the eight postoperative acute exacerbations (pAE) of IP developed in this group. NSCLC in the group B were mainly squamous cell carcinomas located in the upper lobes. No patient with PD-L1 negative was classified into group B. None of the patients in group C showed UIP. and most of the cancers were adenocarcinoma. The frequency of epidermal growth factor receptor mutation-positive NSCLC was the highest in this group. Conclusions The three groups each showed characteristic features in terms of tumor location, histopathology, PD-L1 expression, and frequency of pAEof IP.

The effect of nivolumab treatment for central nervous system metastases in non-small cell lung cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20601-e20601 ◽  
Author(s):  
Hiromi Watanabe ◽  
Toshio Kubo ◽  
Takashi Ninomiya ◽  
Kadoaki Ohashi ◽  
Eiki Ichihara ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Central Nervous System ◽  
Nervous System ◽  
Small Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Group A ◽  
Group B ◽  
Nsclc Patients ◽  
Cns Lesions

e20601 Background: Central nervous system (CNS) metastases (mets) occur in 30% of patients with advanced non-small cell lung cancer (NSCLC) and are associated with poor overall survival (OS). Although nivolumab, a programmed death-1 immune checkpoint inhibitor antibody, has demonstrated a longer survival benefit compared with docetaxel in previously treated NSCLC patients (CheckMate 017 and 057; N Engl J Med, 2015), patients with symptomatic or untreated CNS mets were excluded in these trials. In CheckMate 012 Arm M, 2 of 12 patients (16.7%) with untreated CNS mets showed intracranial responses, but the effect of nivolumab treatment for CNS mets was not fully investigated. Methods: To investigate the effect and safety of nivolumab for CNS mets in NSCLC patients, we retrospectively analyzed 48 patients with NSCLC who were treated with nivolumab from February 2016 to December 2016 at Okayama University Hospital. Results: Twenty-nine patients (60%) had no CNS lesions (group A) and 19 patients (40%) had brain mets (BM) (group B). In group B, 15 patients (79%) received radiotherapy (RT) for BM, including 5 patients who received RT just before nivolumab treatment. The responses of extra-CNS lesions to nivolumab are shown in the table. The PFS was longer in group A than in group B (p=0.14). In group B, the PFS of patients who received prior RT tended to be longer than in those without RT (p=0.42); OS was not reached in either group. In group B, the effects of nivolumab treatment for CNS mets were evaluated in 12 patients: SD occurred in 3 patients (25%), PD in 4 patients (33%), and NE in 5 patients (42%). All 4 patients with PD in the CNS lesion also showed PD in the extra-CNS lesion. In group A, no patients showed progression only in the CNS lesion. Conclusions: In this retrospective study, there were no patients treated only with nivolumab who showed a response to CNS mets. RT prior to nivolumab might be more effective, so future investigations should involve additional cases and prospective studies. [Table: see text]

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