Circulating tumor cell (CTC) as a significant prognostic factor in resected primary lung cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e23044-e23044 ◽  
Author(s):  
Kazue Yoneda ◽  
Masaki Hashimoto ◽  
Teruhisa Takuwa ◽  
Seiji Matsumoto ◽  
Yoshitomo Okumura ◽  
...  

e23044 Background: Circulating tumor cell (CTC) is a potentially useful marker in early diagnosis and monitoring therapeutic effects for patients with malignant tumors, but clinical significance of CTC in primary lung cancer remains unclear. We previously showed that CTC was a useful surrogate marker of distant metastasis in primary lung cancer (Clin Cancer Res 2009). In this study, we evaluated the prognostic value among completely resected patients after long-term follow-up. Methods: A total of 94 patients (median age, 68 years; 30 females and 64 males) who underwent complete resection for primary lung cancer (4 with small cell and 90 with non-small cell) were prospectively evaluated. At the time of enrollment into the study, 7.5mL of peripheral blood was sampled from each patient, and an EpCAM-based detection system (CellSearch) was used for detection of CTC. CTC was detected in 16 patients (CTC-positive, 14.9%). Results: CTC-positivity was significantly associated with a poor recurrence-free survival (5-year recurrence-free survival rate, 40% versus 72%; p<0.01) (Table 1), which was confirmed by a multivariate analysis (hazard ratio, 2.57 [95% CI, 1.26-5.26]; P=0.010). CTC-positivity was also associated with a poor overall survival (5-year recurrence-free survival rate, 62% versus 84%; p<0.05) (Table 1), which was confirmed by a multivariate analysis (hazard ratio, 2.76 [95% CI, 1.14-6.71]; P=0.025). Conclusions: CTC-positivity was associated with poor recurrence-free survival and poor overall survival in resected lung cancer. [Table: see text]

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Ying Liu ◽  
Yu-Ping Zhou ◽  
Mai Zhang ◽  
Li Li ◽  
Hu Liao ◽  
...  

Background. Simultaneous multiple primary lung cancer has been detected increasingly nowadays with the development of image technology. However, the clinicopathologic characteristics and outcomes are not clear. Methods. All consecutive patients diagnosed as simultaneous multiple primary lung cancer according to Martini–Melamed and American College of Chest Physicians criteria from June 2010 to June 2019 in our center were enrolled. The clinicopathologic characteristics and outcomes were compared between patients with the same histological type and different histological types. Results. A total of 336 patients were enrolled, consisting of 297 (88.4%) patients with the same histological type and 39 (11.6%) patients with different histological types. Compared to patients with the same histological type, patients with different histological types were more commonly males (87.2% vs. 34.0%; p < 0.001 ) with an older age (65 [62–69] vs. 59 [52–65] yrs; p < 0.001 ) at diagnosis. Also, patients with different histological types showed worse respiratory function and more advanced stage according to TNM staging. The 1-, 2-, and 3-year overall survival of overall patients was 97.7%, 96.1%, and 92.2%, and the 1-, 2-, and 3-year recurrence-free survival of overall patients was 96.8%, 92.9% and 85.7%, respectively. Importantly, patients with different histological types showed worse overall survival ( p < 0.001 ) and recurrence-free survival ( p = 0.002 ) than patients with same histological type. The multivariable Cox proportional hazard model revealed that presence of different histological types was significant predictor for worse overall survival (adjusted hazard ratio: 10.00; 95% confidence interval: 2.92–34.48; p < 0.001 ) and recurrence-free survival (adjusted hazard ratio: 2.59; 95% confidence interval: 1.14–5.88; p = 0.023 ). Conclusions. Although relatively less common in simultaneous multiple primary lung cancer, patients with different histological types showed worse clinical characteristics and outcomes.


Author(s):  
Dong Xie ◽  
Yifan Zhong ◽  
Deng ◽  
Yunlang She ◽  
Lei Zhang ◽  
...  

Abstract OBJECTIVES This study aimed to investigate the efficacy of bronchial sleeve lobectomy with pulmonary arterioplasty by uniportal video-assisted thoracoscopic surgery (UniVATS) in centrally located non-small-cell lung cancer. METHODS One hundred and two thoracotomy and 31 UniVATS cases were included in this retrospective, single-centre study. Baseline characteristics, perioperative performance and survival outcomes were compared between the 2 groups. RESULTS Compared with the thoracotomy group, the UniVATS group was associated with lower postoperative blood transfusion rate (P = 0.043), decreased postoperative hospital stays (P = 0.008), shorter drainage duration (P = 0.003) and less drainage volume during the first postoperative 24 h (P = 0.005). Besides, the 3-year overall survival and recurrence-free survival were comparable between the 2 groups (log-rank, P = 0.81 and P = 0.78, respectively). In addition, squamous cell carcinoma was proved to be the independent favourable predictor for overall survival [hazard ratio (HR) 0.44, 95% confidence interval (CI) 0.24–0.80; P = 0.008], and advanced pathological stage was found to be independently associated with worse overall survival (IIIB stage: HR 3.21, 95% CI 1.13–9.12; P = 0.028) and recurrence-free survival (IIIB stage: HR 3.54, 95% CI 1.32–9.51; P = 0.012). CONCLUSIONS With appropriate patient selection, UniVATS sleeve lobectomy with pulmonary arterioplasty is feasible and safe for centrally located lung cancer in the hands of thoracic surgeons with extensive thoracoscopy experience.


2020 ◽  
Vol 31 (3) ◽  
pp. 305-314
Author(s):  
Tomohiro Maniwa ◽  
Akiisa Ohmura ◽  
Takashi Hiroshima ◽  
Akihiro Ike ◽  
Toru Kimura ◽  
...  

Abstract OBJECTIVES Characterizing pathological nodes (pNs) by location alone is sometimes inadequate as patients with pN1 or pN2 non-small-cell lung cancer (NSCLC) show prognostic heterogeneity. We aimed to assess the relationship of the number of metastatic lymph nodes (LNs) and zones with prognosis in NSCLC patients. METHODS We analysed 1393 patients who underwent lobectomy with mediastinal LN dissection for NSCLC at the Osaka International Cancer Institute between January 2006 and December 2015. Patients were classified into 3 groups according to the number of LNs: n1–3, n4–6 and n7–. We investigated the relationship of prognosis with the number of metastatic LNs and metastatic zones. RESULTS In the multivariable analyses, the number of metastatic LNs and zones were not independent factors for overall survival or recurrence-free survival in patients with pN1 disease after adjustment for age, sex, tumour histology and tumour diameter. However, n4–6 (ref. n1–3) was an independent prognostic factor for overall survival [hazard ratio (HR) 4.148, P &lt; 0.001] in those with pN2 disease. There were no significant differences in overall survival and recurrence-free survival between pN1 (HR 0.674, P = 0.175) and pN2n1–3 disease (HR 1.056, P = 0.808). Moreover, patients with pN2 disease with a higher number of metastatic zones had a poor prognosis for recurrence-free survival [3 zones (ref. 1): HR 1.774, P = 0.051, and 4 zones (ref. 1): HR 2.173, P &lt; 0.047]. CONCLUSIONS The number of metastatic LNs and metastatic zones were useful prognostic factors in NSCLC patients. The findings could help in establishing a new pN classification.


2020 ◽  
Author(s):  
Shugo Uematsu ◽  
Atsushi Sano ◽  
Kazutoshi Isobe ◽  
Kazuhiro Usui ◽  
Jun Matsumoto ◽  
...  

Abstract Background Although platinum-based chemotherapy is accepted as adjuvant chemotherapy for resectable advanced non-small cell lung cancer (NSCLC), its completion rate is low due to severe adverse events. S-1 plus cisplatin is associated with relatively low toxicity and an unimpaired quality of life, and has been used for unresectable advanced lung cancer. We investigated the acceptability and feasibility of combination therapy with S-1 plus cisplatin as postoperative adjuvant chemotherapy following complete resection of pathological stage II-IIIA NSCLC. Methods Enrolled patients received oral S-1 at a dose depending on their body weight twice daily for 21 days with intravenous cisplatin 60 mg/m2 on day 8, with 1 cycle comprising 5 weeks and 4 cycles. Patients received standard precautions against adverse events and received standard treatment when adverse events occurred. The primary endpoint was completion rate; secondary endpoints included safety, status of drug administration, disease-free survival, and overall survival. Results A total of 19 patients [14 men, 5 women; mean age, 59.1 years; mean body surface area, 1.688 m2; 17 with an Eastern Cooperative Oncology Group performance status (PS) of 0 and 2 with a PS of 1; 7 (36.8%) with stage II disease and 12 (63.2%) with stage IIIA disease] were enrolled. The rate of completion of 4 cycles was 68.4%. Grade 3 adverse events that occurred in ≥10% of patients included neutropenia (21.1%), nausea (21.1%), and anorexia (15.8%). No grade 4 adverse events, febrile neutropenia, or treatment-related deaths occurred. The mean relative dose intensity was 79% for S-1 and 80% for cisplatin. The 2-year disease-free survival rate was 42.1%, and 2-year overall survival rate was 83.3%. Conclusion This study demonstrated the acceptability and feasibility of using S-1 plus cisplatin as adjuvant chemotherapy.


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