scholarly journals What Are the Survival Factors in Surgically Resected Synchronous Multiple Primary Lung Cancers: A Retrospective Study

2020 ◽  
Author(s):  
Haichao Li ◽  
Kai Wang ◽  
Xingxing Zhang ◽  
Rong Chen ◽  
Jian Zhao
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Lymph Node ◽  
Independent Risk Factor ◽  
Complete Resection ◽  
Tnm Stage ◽  
Smoking History ◽  
Node Dissection ◽  
Multiple Primary ◽  
Independent Risk Factors

Abstract BackgroundWith the popularization of high-resolution computed tomography (HRCT), the detection rate of synchronous multiple primary lung cancer (SMPLC) is increasing. We retrospectively analyzed the surgical results of SMPLC patients in our hospital to determine the best treatment, surgical prognosis and survival analysis.MethodsA total of 78 SMPLC patients met the diagnostic criteria underwent complete resection and lymph node dissection or sampling without any preoperative induction therapy in the Department of Thoracic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University. We analyzed the postoperative survival rate, and further studied the relationship between survival rates and sex, age, preoperative symptoms, tumor location, tumor number, tumor size, lymph node metastasis, TNM stage, surgical type, surgical frequency, histopathologic types, vascular infiltration, visceral pleural invasion and postoperative therapy.ResultsAmong 78 patients, the 1-,2-,3-,4- and 5-year disease free survival (DFS) rates were 93.42%, 86.84%, 77.78%, 62.96%, and 60.00%, respectively, while the 1-,2-,3-,4- and 5-year overall survival (OS) rates were 94.73%, 92.11%, 82.22%, 77.78%, and 65.00%, respectively. TNM stage of the largest tumor (II:HR=7.40,III:9.01,p=0.002) was an independent risk factor for DFS. Smoking history (HR=4.34,p=0.039) and TNM stage of the largest tumor (II:HR=9.38,III:9.42,p=0.003) were independent risk factors for overall survival.ConclusionsFirst, SMPLC is different from intrapulmonary metastasis and its clinical stage is also different from the 8th (2015) edition TNM classification for lung cancer. Second, when pulmonary function permits, surgery (complete resection and lymph node dissection) is a significantly beneficial treatment for patients with SMPLC. Third, TNM stage of the largest tumor (II:HR=7.40,III:9.01,p=0.002) was an independent risk factor for DFS. Smoking history (HR=4.34,p=0.039) and TNM stage of the largest tumor (II:HR=9.38,III:9.42,p=0.003) were independent risk factors for overall survival.

scholarly journals What are the Survival Factors in Surgically Resected Synchronous Multiple Primary Lung Cancers: A Retrospective Study

2020 ◽  
Author(s):  
Haichao Li ◽  
Kai Wang ◽  
Xingxing Zhang ◽  
Rong Chen ◽  
Jian Zhao
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Lymph Node ◽  
Independent Risk Factor ◽  
Complete Resection ◽  
Tnm Stage ◽  
Smoking History ◽  
Node Dissection ◽  
Multiple Primary ◽  
Independent Risk Factors

Abstract Background: With the popularization of high-resolution computed tomography (HRCT), the detection rate of synchronous multiple primary lung cancer (SMPLC) is increasing. We retrospectively analyzed the surgical results of SMPLC patients in our hospital to determine the best treatment, surgical prognosis and survival analysis.Methods: A total of 78 SMPLC patients met the diagnostic criteria underwent complete resection and lymph node dissection or sampling without any preoperative induction therapy in the Department of Thoracic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University. We analyzed the postoperative survival rate, and further studied the relationship between survival rates and sex, age, preoperative symptoms, tumor location, tumor number, tumor size, lymph node metastasis, TNM stage, surgical type, surgical frequency, histopathologic types, vascular infiltration, visceral pleural invasion and postoperative therapy.Results: Among 78 patients, the 1-,2-,3-,4- and 5-year disease free survival (DFS) rates were 93.42%, 86.84%, 77.78%, 62.96%, and 60.00%, respectively, while the 1-,2-,3-,4- and 5-year overall survival (OS) rates were 94.73%, 92.11%, 82.22%, 77.78%, and 65.00%, respectively. TNM stage of the largest tumor (II:HR=7.40,III:9.01,p=0.002) was an independent risk factor for DFS. Smoking history (HR=4.34,p=0.039) and TNM stage of the largest tumor (II:HR=9.38,III:9.42,p=0.003) were independent risk factors for overall survival.Conclusions: First, SMPLC is different from intrapulmonary metastasis and its clinical stage is also different from the 8th (2015) edition TNM classification for lung cancer. Second, when pulmonary function permits, surgery (complete resection and lymph node dissection) is a significantly beneficial treatment for patients with SMPLC. Third, TNM stage of the largest tumor (II:HR=7.40,III:9.01,p=0.002) was an independent risk factor for DFS. Smoking history (HR=4.34,p=0.039) and TNM stage of the largest tumor (II:HR=9.38,III:9.42,p=0.003) were independent risk factors for overall survival.

scholarly journals What are the Survival Factors in Surgically Resected Synchronous Multiple Primary Lung Cancers: A Retrospective Study

2020 ◽  
Author(s):  
Haichao Li ◽  
Kai Wang ◽  
Xingxing Zhang ◽  
Rong Chen ◽  
Jian Zhao
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Primary Lung Cancer ◽  
Disease Free Survival ◽  
Complete Resection ◽  
Postoperative Chemotherapy ◽  
Node Dissection ◽  
Multiple Primary ◽  
Vascular Infiltration

Abstract Background: With the popularization of high-resolution computed tomography (HRCT), the detection rate of synchronous multiple primary lung cancer (SMPLC) is increasing. We retrospectively analyzed the surgical results of SMPLC patients in our hospital to determine the best treatment for SMPLC.Methods: A total of 90 SMPLC patients met the diagnostic criteria underwent complete resection and lymph node dissection or sampling without any preoperative induction therapy in the Department of Thoracic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University. We analyzed the postoperative survival rate, and further studied the relationship between survival rates and sex, age, preoperative symptoms, tumor location, tumor number, tumor size, surgical type, surgical frequency, histopathologic types, vascular infiltration, visceral pleural invasion and postoperative therapy.Results: Among 90 patients, the 1- and 3-year disease free survival (DFS) rates were 97.0% and 76.7% while the 1- and 3-year overall survival (OS) rates were 98.81% and 82.35%. Vascular infiltration (HR=402.46, p=0.005) and postoperative chemotherapy (HR>1000, p<0.001) were independent risk factors for DFS, while only postoperative chemotherapy (HR=184.10, p=0.002) was an independent risk factor for OS.Conclusions: First, SMPLC is different from intrapulmonary metastasis and its clinical stage is also different from the 8th (2015) edition TNM classification for lung cancer. Second, when pulmonary function permits, surgery (complete resection and lymph node dissection) is a significantly beneficial treatment for patients with SMPLC. Third, for early stage SMPLC patients, vascular infiltration and postoperative chemotherapy are harmful to the survival.

scholarly journals Preoperative Risk Assessment of Lymph Node Metastasis in cT1 Lung Cancer: A Retrospective Study from Eastern China

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Chengyan Zhang ◽  
Guanchao Pang ◽  
Chengxi Ma ◽  
Jingni Wu ◽  
Pingli Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Logistic Regression ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Predictive Model ◽  
Smoking History ◽  
Lymph Node Status ◽  
Node Metastasis ◽  
Node Status

Background. Lymph node status of clinical T1 (diameter≤3 cm) lung cancer largely affects the treatment strategies in the clinic. In order to assess lymph node status before operation, we aim to develop a noninvasive predictive model using preoperative clinical information. Methods. We retrospectively reviewed 924 patients (development group) and 380 patients (validation group) of clinical T1 lung cancer. Univariate analysis followed by polytomous logistic regression was performed to estimate different risk factors of lymph node metastasis between N1 and N2 diseases. A predictive model of N2 metastasis was established with dichotomous logistic regression, externally validated and compared with previous models. Results. Consolidation size and clinical N stage based on CT were two common independent risk factors for both N1 and N2 metastases, with different odds ratios. For N2 metastasis, we identified five independent predictors by dichotomous logistic regression: peripheral location, larger consolidation size, lymph node enlargement on CT, no smoking history, and higher levels of serum CEA. The model showed good calibration and discrimination ability in the development data, with the reasonable Hosmer-Lemeshow test (p=0.839) and the area under the ROC being 0.931 (95% CI: 0.906-0.955). When externally validated, the model showed a great negative predictive value of 97.6% and the AUC of our model was better than other models. Conclusion. In this study, we analyzed risk factors for both N1 and N2 metastases and built a predictive model to evaluate possibilities of N2 metastasis of clinical T1 lung cancers before the surgery. Our model will help to select patients with low probability of N2 metastasis and assist in clinical decision to further management.

scholarly journals Sampling versus systematic full lymphatic dissection in surgical treatment of non-small cell lung cancer

2013 ◽  
pp. e2
Author(s):  
Georgios Koulaxouzidis ◽  
Grigorios Karagkiouzis ◽  
Marios Konstantinou ◽  
Ioannis Gkiozos ◽  
Konstantinos Syrigos
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Small Cell Lung Cancer ◽  
Lymph Node Dissection ◽  
Cell Lung Cancer ◽  
Complete Resection ◽  
Small Cell ◽  
Node Dissection ◽  
Small Cell Lung ◽  
Term Survival

The extent of mediastinal lymph node assessment during surgery for non-small cell cancer remains controversial. Different techniques are used, ranging from simple visual inspection of the unopened mediastinum to an extended bilateral lymph node dissection. Furthermore, different terms are used to define these techniques. Sampling is the removal of one or more lymph nodes under the guidance of pre-operative findings. Systematic (full) nodal dissection is the removal of all mediastinal tissue containing the lymph nodes systematically within anatomical landmarks. A Medline search was conducted to identify articles in the English language that addressed the role of mediastinal lymph node resection in the treatment of non-small cell lung cancer. Opinions as to the reasons for favoring full lymphatic dissection include complete resection, improved nodal staging and better local control due to resection of undetected micrometastasis. Arguments against routine full lymphatic dissection are increased morbidity, increase in operative time, and lack of evidence of improved survival. For complete resection of non-small cell lung cancer, many authors recommend a systematic nodal dissection as the standard approach during surgery, and suggest that this provides both adequate nodal staging and guarantees complete resection. Whether extending the lymph node dissection influences survival or recurrence rate is still not known. There are valid arguments in favor in terms not only of an improved local control but also of an improved long-term survival. However, the impact of lymph node dissection on long-term survival should be further assessed by large-scale multicenter randomized trials.

scholarly journals The Role of Lymph Node Dissection in Intrahepatic Cholangiocarcinoma: A Multicenter Retrospective Study. 

2021 ◽  
Author(s):  
Hanjie Hu ◽  
Gang Xu ◽  
Shunda Du ◽  
Zhiwen Luo ◽  
Hong Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Intrahepatic Cholangiocarcinoma ◽  
Surgical Margin ◽  
Disease Free Survival ◽  
Positive Surgical Margin ◽  
Node Dissection ◽  
Independent Risk Factors

Abstract BackgroundLymph node dissection (LND) is of great significance in intrahepatic cholangiocarcinoma (ICC). Although the National Comprehensive Cancer Network (NCCN) guidelines recommend routine LND in ICC, the effects of LND remains controversial. This study aimed to explore the role and application of LND in ICC.MethodsPatients were identified in two Chinese academic centers. Inverse probability of treatment weighting (IPTW) was used to reduce bias. Kaplan–Meier curves and Cox proportional hazards models were used to compare overall survival (OS) and disease-free survival (DFS).ResultsOf 232 patients, 177 (76.3%) underwent LND, and 71 (40.1%) had metastatic lymph nodes. A minimum of 6 lymph nodes were dissected in 66 patients (37.3%). LND did not improve the prognosis of ICC. LNM >3 may have worse OS and DFS than LNM 1-3, especially in the LND >=6 group. For nLND patients, the adjuvant treatment group had better OS and DFS.ConclusionsCA 19-9, CEA, operative time, positive surgical margin, and T stage were independent risk factors for OS; CEA and differentiation were independent risk factors for DFS. LND has no definite predictive effect on prognosis. Patients with 4 or more LNMs may have a worse prognosis than patients with 1-3 LNMs. Adjuvant therapy may benefit patients of nLND.

scholarly journals Sampling versus systematic full lymphatic dissection in surgical treatment of non-small cell lung cancer

2013 ◽  
Vol 7 (1) ◽  
pp. 2 ◽  
Author(s):  
Georgios Koulaxouzidis ◽  
Grigorios Karagkiouzis ◽  
Marios Konstantinou ◽  
Ioannis Gkiozos ◽  
Konstantinos Syrigos
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Small Cell Lung Cancer ◽  
Lymph Node Dissection ◽  
Cell Lung Cancer ◽  
Complete Resection ◽  
Small Cell ◽  
Node Dissection ◽  
Small Cell Lung ◽  
Term Survival

The extent of mediastinal lymph node assessment during surgery for non-small cell cancer remains controversial. Different techniques are used, ranging from simple visual inspection of the unopened mediastinum to an extended bilateral lymph node dissection. Furthermore, different terms are used to define these techniques. Sampling is the removal of one or more lymph nodes under the guidance of pre-operative findings. Systematic (full) nodal dissection is the removal of all mediastinal tissue containing the lymph nodes systematically within anatomical landmarks. A Medline search was conducted to identify articles in the English language that addressed the role of mediastinal lymph node resection in the treatment of non-small cell lung cancer. Opinions as to the reasons for favoring full lymphatic dissection include complete resection, improved nodal staging and better local control due to resection of undetected micrometastasis. Arguments against routine full lymphatic dissection are increased morbidity, increase in operative time, and lack of evidence of improved survival. For complete resection of non-small cell lung cancer, many authors recommend a systematic nodal dissection as the standard approach during surgery, and suggest that this provides both adequate nodal staging and guarantees complete resection. Whether extending the lymph node dissection influences survival or recurrence rate is still not known. There are valid arguments in favor in terms not only of an improved local control but also of an improved long-term survival. However, the impact of lymph node dissection on long-term survival should be further assessed by large-scale multicenter randomized trials.

Independent risk factors for lymph node metastasis in 2623 patients with Non–Small cell lung cancer

2020 ◽  
Vol 34 ◽  
pp. 256-260
Author(s):  
Xinying Xue ◽  
Xuelei Zang ◽  
Yuxia Liu ◽  
Dongliang Lin ◽  
Tianjiao Jiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Node Metastasis ◽  
Independent Risk Factors

scholarly journals Prognostic Factors of Complications After Thoracoscopic Lobectomy for Non-Small Cell Lung Cancer-A Retrospective Study

2021 ◽  
Author(s):  
Kai Wang ◽  
Derun Xia ◽  
Yi Yin ◽  
Yu Wang ◽  
Sibo Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Thoracoscopic Surgery ◽  
Univariate Analysis ◽  
Pulmonary Complications ◽  
Smoking History ◽  
Cardiopulmonary Complications ◽  
Independent Risk Factors ◽  
Postoperative Cardiopulmonary Complications

Abstract Background: Video-assisted thoracoscopic surgery, safe and minimally invasive, is the first strategy recommended for non-small cell lung cancer. The purpose of this study was to determine the risk factors for postoperative cardiopulmonary complications (including cardiac and pulmonary complications) in patients with NSCLC who underwent video-assisted thoracoscopic surgery (VATS).Methods: We retrospectively collected information of 3142 lung cancer patients undergoing VATS tumor resection at Jiangsu Provincial People's Hospital from January 2017 to June 2018, and established a clinical prediction model using the factors selected by univariate analysis.Results: A total of 305 in 3142 patients developed postoperative cardiopulmonary complications. In univariate analysis, age, PNI, CCI, long-term smoking history before surgery, conversion to thoracotomy, albumin before surgery, pre-albumin, Δalbumin and pleura adhesion were all associated with cardiac and pulmonary complications. Multivariate analysis showed that age, PNI, CCI, long-term smoking history before surgery, conversion to thoracotomy, pre-albumin, Δalbumin were important independent risk factors for complications. Finally, age, PNI, CCI, long-term smoking history before surgery, conversion to thoracotomy, Δalbumin variables were included in the model (AUC=0.743).Conclusion: Nutritional status (PNI, pre-albumin), CCI, age, long-term smoking history before surgery, conversion to thoracotomy were all independent risk factors for postoperative complications and poor prognosis. Experienced surgeons should instruct the operation of high-risk patients to avoid long-term hospitalization and possible poor prognosis after surgery.

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