scholarly journals Etiologies of delayed diagnosis and characteristics of patients with newly diagnosed advanced lung cancer initially presented with respiratory failure

2020 ◽  
Author(s):  
Tseng How-Yang ◽  
Yi-Cheng Shen ◽  
Yen-Sung Lin ◽  
Chih-Yeh Tu ◽  
Hung-Jen Chen
Keyword(s):  
Lung Cancer ◽  
Targeted Therapy ◽  
Respiratory Failure ◽  
Cancer Patients ◽  
Diagnostic Error ◽  
Advanced Lung Cancer ◽  
Newly Diagnosed ◽  
Central Airway Obstruction ◽  
Lung Cancer Patients ◽  
Central Airway

Abstract Objective This study aimed to evaluate the characteristics of patients with newly diagnosed advanced lung cancer who initially presented with respiratory failure. Methods A retrospective study analyzed the outcome of patients in the intensive care unit (ICU) with newly diagnosed advanced lung cancer placed on mechanical ventilation (MV). We defined newly-diagnosed lung cancer as pathological or molecular results for treatment decisions not being out when the patient was admitted to ICU. Results During the 14-year inclusion period, 845 lung cancer patients requiring MV were screened. 56 newly diagnosed extensive lung cancer patients were analyzed. Cancer-related to central airway obstruction (n=29, 51.8%) was the leading cause of respiratory failure. The significant etiologies of delay in the diagnosis of lung cancer were diagnostic error, mistaking the cancer for tuberculosis, and missed hilar lesion. The 6-month survival was only 7.1% (n=4). SOFA score was significantly associated with mortality (HR = 1.144, 95% CI = 1.014-1.291, p = 0.028). The 6-month survival rate in patients receiving suitable targeted therapy and accepting chemotherapy and best supportive care was 40%(2/5), 0%(0/7), and 4.5%(2/44), respectively. Conclusions Patients with newly diagnosed advanced lung cancer with acute life-threatening respiratory failure have poor outcomes. Cancer-related to central airway obstruction is a leading cause of respiratory failure. Diagnostic error as tuberculosis and missed hilar lesions are two main etiologies of delay in the diagnosis. The SOFA score is correlated with mortality. For patients with oncogenic mutation adenocarcinoma, after survival from critical condition, targeted therapy can raise their six month survival rates.

scholarly journals Outcome of advanced lung cancer with central airway obstruction versus without central airway obstruction

2018 ◽  
Vol 4 (2) ◽  
pp. 00173-2017 ◽  
Author(s):  
Akash Verma ◽  
Soon Keng Goh ◽  
Dessmon Y.H. Tai ◽  
Ai Ching Kor ◽  
Chun Ian Soo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Airway Obstruction ◽  
Medical Records ◽  
Advanced Lung Cancer ◽  
Significant Morbidity ◽  
Central Airway Obstruction ◽  
Assisted Mechanical Ventilation ◽  
Central Airway

Patients with central airway obstruction (CAO) from advanced lung cancer present with significant morbidity and are assumed to have lower survival. Hence, they are offered only palliative support. We asked if patients who have advanced lung cancer with CAO (recanalised and treated) will behave similarly to those with advanced lung cancer without CAO.This study was a retrospective review of the medical records of the patients managed for advanced lung cancer during 2010 and 2015 at our institution.85 patients were studied. Median survival and 1-, 2- and 5-year survival were 5.8 months, 30.3%, 11.7% and 2.3% versus 9.3 months, 35.7%, 9.6% and 4.7%, respectively, in the CAO and no CAO groups (p=0.30). More patients presented with respiratory failure (15 (35%) versus none; p=0.0001) and required assisted mechanical ventilation (10 (23.3%) versus none; p=0.001) in the CAO group compared with the no CAO group. Fewer patients received chemotherapy in the CAO group (11 (25.5%)) compared with the no CAO group (23 (54.7%); p=0.008).There was no difference in survival among patients with advanced lung cancer whether they presented with CAO or without CAO. Survival was similar to those without CAO in patients with recanalised CAO despite greater morbidity and lesser use of chemotherapy, strongly advocating bronchoscopic recanalisation of CAO. These findings dispel the nihilism associated with such cases.

TP53 Exon 8 Mutations are Associated with Shorter Survival in Advanced Lung Cancer Patients

2018 ◽  
Author(s):  
Yutao Liu ◽  
Fang Xu ◽  
Yubo Wang ◽  
Qingchen Wu ◽  
Buhai Wang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Advanced Lung Cancer ◽  
Lung Cancer Patients

scholarly journals Association of Brain Metastases With Immune Checkpoint Inhibitors Efficacy in Advanced Lung Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Yanning Wang ◽  
Qianning Zhang ◽  
Chuansheng Chen ◽  
Yuxuan Hu ◽  
Liyun Miao ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Overall Survival ◽  
Brain Metastases ◽  
Cancer Patients ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Advanced Lung Cancer ◽  
Lung Cancer Patients ◽  
Hazard Ratios

BackgroundIn pivotal immunotherapy trials, the efficacy of immune checkpoint inhibitors as treatments for lung cancer patients with brain metastases remains controversial. The aim of this study was to assess the relative efficacy of immunotherapy versus standard systemic therapy in advanced lung cancer patients with and without brain metastases.MethodsSystematic searches of PubMed, Embase, Cochrane database, and conference proceedings up to Aug 6, 2020 without year and language restrictions. The main outcomes were the overall survival in patients with and without brain metastases measured by hazard ratios, and the difference in efficacy between patients with and without brain metastases was measured by ratio of hazard ratios.ResultsNine eligible randomized controlled trials involving 6241 patients (682 [11%] with brain metastases and 5559 [89%] without brain metastases) were included in the analysis. A survival benefit of immunotherapy was observed for both patients with brain metastases (HR, 0.75; 95%CI, 0.53-0.97; P = .026) and patients without brain metastases (HR, 0.75; 95%CI, 0.67-0.83; P <.001). However, patients without brain metastases benefit more from immunotherapy than patients with brain metastases (HR, 1.37; 95%CI, 1.15-1.63; P = .001). Additionally, subgroup analyses indicated that tumor type affect the efficacy of immunotherapy in patients with brain metastases (HR, 1.04 vs 1.54; interaction, P = .041).ConclusionsImmunotherapy can significantly improve overall survival for advanced lung cancer patients with asymptomatic brain metastases, especially in patients with non-small-cell lung cancer, but the magnitude of benefit is brain metastases dependent.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020206597.

Prevalence of emotional distress in newly diagnosed lung cancer patients

2009 ◽  
Vol 17 (12) ◽  
pp. 1493-1497 ◽  
Author(s):  
Tracy Steinberg ◽  
Michelle Roseman ◽  
Goulnar Kasymjanova ◽  
Sarah Dobson ◽  
Lucie Lajeunesse ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Emotional Distress ◽  
Newly Diagnosed ◽  
Lung Cancer Patients

scholarly journals Dyadic psychosocial intervention for advanced lung cancer patients and their family caregivers: Results of a randomized pilot trial

Cancer ◽  
2014 ◽  
Vol 121 (1) ◽  
pp. 150-158 ◽  
Author(s):  
Hoda Badr ◽  
Cardinale B. Smith ◽  
Nathan E. Goldstein ◽  
Jorge E. Gomez ◽  
William H. Redd
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Family Caregivers ◽  
Psychosocial Intervention ◽  
Pilot Trial ◽  
Advanced Lung Cancer ◽  
Lung Cancer Patients
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