scholarly journals Development and Validation of a Nomogram to Predict the Overall Survival of Patients with Stage I Non-Small Cell Lung Cancer After Surgery

2021 ◽  
Author(s):  
haixi yan ◽  
linling cai ◽  
hui lin ◽  
chunlong wu
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Stage I ◽  
Tumor Diameter ◽  
Small Cell Lung ◽  
Laboratory Variables ◽  
Nsclc Patients

Abstract Background: This study aimed to establish an effective prognostic nomogram for stage I non-small cell lung cancer (NSCLC) patients receiving surgery.Methods: Stage I NSCLC patients at Taizhou Hospital of Zhejiang Province from October 2010 to June 2014 were included. Clinical, pathological and laboratory variables ascertained before surgery were selected through least absolute shrinkage and selection operator and Cox regression analysis, and a nomogram model was established. The nomogram model was validated using stage I NSCLC patients from the same institution between July 2014 and December 2015. Results: Training cohort included 274 patients. From 46 potential predictors, the independent risk factors for Overall survival (OS) of patients with stage I NSCLC were age, CA125, and tumor diameter. The C index of the nomogram model was 0.759(95% confidence interval (CI)，0.666–0.852). The area under the ROC curve of the nomogram was 0.776. The patients in the low-risk subgroup had significantly better survival than those in the high-risk subgroup (logrank, p < 0.001). The AUC in the validation cohort was 0.809, and the C index was 0.707(95% CI, 0.572-0.842).Conclusion: We developed a nomogram model that includes clinical, pathological and laboratory variables to predict the OS of stage I NSCLC patients.

scholarly journals Tumor volume shrinkage during stereotactic body radiotherapy is related to better prognoses in patients with stage I non-small-cell lung cancer

2020 ◽  
Vol 61 (5) ◽  
pp. 740-746
Author(s):  
Nam Vu ◽  
Hiroshi Onishi ◽  
Masahide Saito ◽  
Kengo Kuriyama ◽  
Takafumi Komiyama ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Small Cell Lung Cancer ◽  
Local Control ◽  
Cell Lung Cancer ◽  
Tumor Volume ◽  
Small Cell ◽  
Stage I ◽  
Small Cell Lung ◽  
Volume Changes

Abstract The purpose of the study was to investigate the association between tumor volume changes during stereotactic body radiation therapy (SBRT) and prognoses in stage I non-small-cell lung cancer (NSCLC). This retrospective review included stage I NSCLC patients in whom SBRT was performed at a total dose of 48.0–50.5 Gy in four or five fractions. The tumor volumes observed on computed tomography (CT) simulation and on the CT performed at the last treatment session using a CT-on-rails system were measured and compared. Then, the tumor volume changes during the SBRT period were measured and assessed for their association with prognoses (overall survival, local control, lymph node metastases and distant metastases). A total of 98 patients with a mean age of 78.6 years were enrolled in the study. The T-stage was T1a in 42%, T1b in 32% and T2a in 26% of the cases. The gross tumor volume (GTV) shrank and increased ≥10% in 23 (23.5%) and 36 (36.7%) of the cases, respectively. The 5-year local control and overall survival rates in the groups with a tumor shrinkage of ≥10% vs the group with a shrinkage of &lt;10% were 94.7 vs 70.8% and 85.4 vs 47.6%, respectively; these differences were significant, with a P-value &lt; 0.05. During a short SBRT period, the tumor shrank or enlarged in a small number of cases. A decrease of ≥10% in the GTV during SBRT was significantly related to better overall survival and local control.

Stereotactic bradiotherapy (SRT) for operable stage I non-small cell lung cancer: Is SRT comparable to surgery?

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7623-7623 ◽  
Author(s):  
H. Onishi ◽  
H. Shirato ◽  
Y. Nagata ◽  
M. Hiraoka ◽  
G. Kotaro ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Survival Rate ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Stage I ◽  
Overall Survival Rate ◽  
Small Cell Lung ◽  
Radical Treatment

7623 Background: Stereotactic radiotherapy (SRT) has been aggressively performed as a radical treatment for stage I non-small cell lung cancer (NSCLC) in Japan, however most cases were medically inoperable. In a large Japanese multi-institutional experience, we reviewed the treatment outcome of SRT for medically operable stage I NSCLC cases with the patients’ refusal to surgery. Methods: In 1995–2004, 86 medically operable patients with stage I NSCLC (median age, 74 years; 62 T1N0M0; 24 T2N0M0) were treated with SRT alone in 14 reliable institutions. Stereotactic three-dimensional treatment was performed using non-coplanar dynamic arcs or multiple static ports. A total dose of 20 to 72.5 Gy at the isocenter was administered in 1 to 10 fractions. Median calculated biological effective dose (BED) was 115 Gy (range, 100–153 Gy). The data was collected and analyzed in a retrospective manner. Results: During follow-up (median, 43 months), pulmonary complications of above grade 2 arose in 4 patients (5.8%). Local control rates at 3 and 5-year post SRT were 88.1% and 85.5%, respectively. Three and 5-year overall survival rates were 80.7% and 71.3%, respectively. Five-year overall survival rate for patients whose age was over 70 years (n=27) and under 70 years (n=58) were 74.3% and 69.6%, respectively. Five-year overall survival rate for stage IA (n=62) and IB (n=24) cases were 72.3% and 68.4%, respectively. Conclusions: SRT is safe and promising as a radical treatment for operable stage I NSCLC. The survival rate of SRT is potentially comparable to that of surgery. No significant financial relationships to disclose.

Non-examination of lymph nodes (LN) and overall survival (OS) in non-small cell lung cancer (NSCLC) patients.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. 8547-8547
Author(s):  
Ahmedin Jemal ◽  
Chun Chieh Lin ◽  
Matthew Smeltzer ◽  
Raymond U. Osarogiagbon
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Lymph Nodes ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Nsclc Patients

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.

scholarly journals Dissociated responses at initial computed tomography evaluation is a good prognostic factor in non-small cell lung cancer patients treated with anti-program cell death-1/ligand 1 inhibitors

2019 ◽  
Author(s):  
Takehiro Tozuka ◽  
Satoru Kitazono ◽  
Hiroaki Sakamoto ◽  
Hiroshi Yoshida ◽  
Yoshiaki Amino ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Cell Death ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Cox Proportional Hazards ◽  
Small Cell ◽  
Small Cell Lung ◽  
Nsclc Patients ◽  
Program Cell Death

Abstract Background Dissociated responses (DR) are phenomena in which some tumors shrink, whereas others progress during treatment of patients with cancer. The purpose of the present study was to evaluate the frequency and prognosis of DR in non-small cell lung cancer (NSCLC) patients treated with anti-program cell death-1/ligand 1 (anti-PD-1/L1) inhibitors. Methods This retrospective study included NSCLC patients who received anti-PD-1/L1 inhibitor as second- or later-line treatment. We excluded patients without radiological evaluation, including brain imaging within 28 days prior to the treatment, and those without measurable lesions. We evaluated all measurable lesions in each organ. We defined DR as a disease with some shrinking lesions as well as growing or emerging new lesions in patients who showed progressive disease (PD), according to the RECIST 1.1 at the initial CT evaluation. Cases not classified as DR were defined as ‘true PD’. Overall survival was compared between patients with DR and those with true PD using Cox proportional hazards models. Results The present study included 62 NSCLC patients aged 27–82 years (median: 65 years). DR and true PD were observed in 11 and 51 patients, respectively. Nivolumab, pembrolizumab, and atezolizumab were administered to 45, 7, and 10 patients, respectively. Median overall survival was significantly longer in patients with DR versus true PD (14.0 vs. 6.6 months; hazard ratio for death: 0.40; 95% confidence interval: 0.17–0.94). Conclusions The frequency of DR in NSCLC patients who showed PD to anti-PD-1/L1 was 17.7%. Patients with DR exhibited a relatively favorable prognosis.

scholarly journals The association of aspirin use with overall survival of patients with inoperable non-small cell lung cancer: a retrospective study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Min-Chun Chuang ◽  
Yao-Hsu Yang ◽  
Meng-Jer Hsieh ◽  
Yu-Ching Lin ◽  
Tsung-Ming Yang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Propensity Score ◽  
Small Cell Lung Cancer ◽  
Propensity Score Matching ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Time Dependent ◽  
Small Cell Lung ◽  
Nsclc Patients

Abstract Background Studies have indicated that individuals taking aspirin have a reduced risk of cancers and have also established chemo-preventive benefit of aspirin in colorectal cancer. However, research on the association between aspirin use and the survival in patients with lung cancer has revealed inconsistent results. In this study, we investigated the effect of aspirin use on the survival of inoperable non-small cell lung cancer (NSCLC) patients. Methods We identified a cohort of 38,842 patients diagnosed with NSCLC between 2000 and 2012 using the Taiwan’s National Health Insurance Research Database and used propensity score matching to reduce possible confounding factors. In total, 9864 patients (4932 matched pairs) were included in the matched cohort. Aspirin exposure was analyzed to identify a possible association with mortality in patients with inoperable NSCLC. Time-dependent Cox regression models were used to calculate the hazard ratios (HRs) and the 95% confidence intervals (95% CIs) that corresponded with aspirin exposure. Results A total of 4979 patients used aspirin at the time of diagnosis of NSCLC. The median overall survival (OS) of the aspirin users was 1.73 (interquartile range, 0.94–3.53) years compared with the 1.30 (interquartile range, 0.69–2.62) years of the non-aspirin users. The Cox proportional hazard model with the time-dependent covariate revealed that aspirin use was associated with a significantly longer OS (HR: 0.83, 95.0% CI: 0.80–0.86). After controlling the sociodemographic characteristics (age, sex, income, and level of urbanization) and lung cancer treatments by propensity score matching, the aspirin users still had a significantly longer OS than the non-aspirin users (HR: 0.79, 95.0% CI: 0.75–0.83). Conclusion Aspirin use is associated with a longer OS in patients with inoperable NSCLC, suggesting that aspirin has a potential anticancer effect. These results warrant further randomized clinical trials to evaluate the actual role of aspirin in the treatment of NSCLC patients.

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