scholarly journals Prognostic Factors of Patients with Unexpected Pleural Dissemination During Thoracoscopic Surgery for Non-Small Cell Lung Cancer: A Retrospective Study

2021 ◽  
Author(s):  
Jinxiao Liang ◽  
Wei-tian Wei ◽  
Wei Gao ◽  
Xun Yang ◽  
Jin-shi Liu
Keyword(s):  
Lung Cancer ◽  
Prognostic Factors ◽  
Targeted Therapy ◽  
Small Cell Lung Cancer ◽  
Primary Tumor ◽  
Thoracoscopic Surgery ◽  
Small Cell ◽  
Small Cell Lung ◽  
Pleural Dissemination ◽  
Nsclc Patients

Abstract Background: Non-small cell lung cancer (NSCLC) is one of the most common malignant tumors with high degree of malignancy and early metastasis. A preoperative examination is undetectable when pleural dissemination of NSCLC occurs at an early stage, leading surgeons to detect pleural dissemination during surgery. However, there are few studies on the prognostic factors of NSCLC patients with pleural disseminated during surgery. Methods: We retrospectively analyzed 54 patients with NSCLC with pleural dissemination found during video-assisted thoracoscopic surgery to investigate the effects of clinical-pathological features, serum characteristics, surgical methods, and postoperative treatment on their prognosis. Results and conclusion: We found that squamous cell carcinoma (p=0.008), high level of serum GGT (p=0.046) and CA199 (p=0.001) were significantly correlated with the poor prognosis of NSCLC with pleural dissemination. Resection of the primary tumor was not necessary for patients who could receive targeted therapy after surgery, while for patients who receive chemotherapy after surgery, resection of the primary tumor, especially lobectomy, could obtain a better prognosis. Targeted therapy is preferred if there is a driving gene mutation after the operation, and immunotherapy combined with chemotherapy can be selected if there is no mutation. These results can provide a clinical basis for prognosis judgment and treatment decision of NSCLC patients with pleural dissemination found during the operation.

scholarly journals Development and External Validation of a Nomogram for Predicting Cancer-Specific Survival of Non-Small Cell Lung Cancer Patients With Ipsilateral Pleural Dissemination

2021 ◽  
Vol 11 ◽  
Author(s):  
Zhenfan Wang ◽  
Hao Li ◽  
Taorui Liu ◽  
Zewen Sun ◽  
Fan Yang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Prognostic Factors ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
External Validation ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cancer Specific Survival ◽  
Pleural Dissemination ◽  
Nsclc Patients

BackgroundNon-small-cell lung cancer (NSCLC) patients with ipsilateral pleural dissemination are defined as M1a in the eighth of American Joint Committee on Cancer (AJCC) TNM staging. We aimed to build a nomogram to predict lung cancer specific survival (LCSS) of NSCLC patients with ipsilateral pleural dissemination and to compare the impact of primary tumor resection (PTR) on LCSS among patients with different features.MethodsA total of 3,918 NSCLC patients with ipsilateral pleural dissemination were identified from the Surveillance, Epidemiology, and End Results (SEER) database. We selected and integrated significant prognostic factors based on competing risk regression to build a nomogram. The model was subjected to internal validation within SEER cohort and external validation with the cohort of 97 patients from Peking University People’s Hospital.ResultsAge (P < 0.001), gender (P = 0.037), T stage (P = 0.002), N stage (P < 0.001), metastasis pattern (P = 0.005), chemotherapy (P < 0.001), and PTR (P < 0.001) were independent prognostic factors. The calibration curves presented a good consistency and the Harrell’s C-index of nomogram were 0.682 (95%CI: 0.673–0.691), 0.687 (95%CI: 0.670–0.704) and 0.667 (95%CI: 0.584–0.750) in training, internal, and external validation cohort, respectively. Interaction tests suggested a greater LCSS difference caused by PTR in patients without chemotherapy (P < 0.001).ConclusionsWe developed a nomogram based on competing risk regression to reliably predict prognosis of NSCLC patients with ipsilateral pleural dissemination and validated this nomogram in an external Chinese cohort. This novel nomogram might be a practical tool for clinicians to anticipate the 1-, 3- and 5-year LCSS for NSCLC patients with pleural dissemination. Subgroup analysis indicated that patients without chemotherapy could get more benefit from PTR. In order to assess the role of PTR in the management of M1a patients more accurately, further prospective study would be urgently required.

scholarly journals Feasibility and effectiveness of afatinib for poor performance status patients with EGFR-mutation-positive non-small-cell lung cancer: a retrospective cohort study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chiao-En Wu ◽  
Ching-Fu Chang ◽  
Chen-Yang Huang ◽  
Cheng-Ta Yang ◽  
Chih-Hsi Scott Kuo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Prognostic Factors ◽  
Small Cell Lung Cancer ◽  
Disease Control ◽  
Performance Status ◽  
Poor Performance ◽  
Small Cell ◽  
Poor Performance Status ◽  
Small Cell Lung ◽  
Nsclc Patients

Abstract Background Afatinib is one of the standard treatments for patients with epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC). However, data on the use of afatinib in patients with poor performance status (PS ≥ 2) are limited. This study aimed to retrospectively review the clinical outcomes and safety of afatinib treatment in EGFR-mutation-positive (EGFRm+) NSCLC patients with PS ≥ 2. Methods The data for 62 patients who were treated at Linkou Chang Gung Memorial Hospital from January 2010 to August 2019 were retrospectively reviewed. Patients’ clinicopathological features were obtained, and univariate and multivariate analyses were performed to identify possible prognostic factors. Data on adverse events were collected to evaluate general tolerance for afatinib therapy. Results Until February 2020, the objective response rate, disease control rate, median progression-free survival (PFS), and overall survival (OS) were 58.1% (36/62), 69.4% (43/62), 8.8 months, and 12.9 months, respectively. The absence of liver metastasis (PFS: p = 0.044; OS: p = 0.061) and good disease control (p < 0.001 for PFS and OS) were independent favorable prognostic factors for PFS and OS. Bone metastasis (p = 0.036) and dose modification (reduction/interruption, p = 0.021) were predictors of disease control. Conclusion Afatinib demonstrated acceptable efficacy and safety in the current cohort. This study provided evidence to support the use of afatinib as a first-line treatment in EGFRm+ NSCLC patients with poor PS.

Clinical Model to Predict Survival in Chemonaive Patients With Advanced Non–Small-Cell Lung Cancer Treated With Third-Generation Chemotherapy Regimens Based on Eastern Cooperative Oncology Group Data

2005 ◽  
Vol 23 (1) ◽  
pp. 175-183 ◽  
Author(s):  
Tien Hoang ◽  
Ronghui Xu ◽  
Joan H. Schiller ◽  
Philip Bonomi ◽  
David H. Johnson
Keyword(s):  
Lung Cancer ◽  
Prognostic Factors ◽  
Small Cell Lung Cancer ◽  
Eastern Cooperative Oncology Group ◽  
Small Cell ◽  
Third Generation ◽  
Oncology Group ◽  
Small Cell Lung ◽  
Clinical Model ◽  
Nsclc Patients

Purpose (1) Identify clinical factors that can be used to predict survival in chemotherapy-naive patients with advanced non–small-cell lung cancer (NSCLC) treated with third-generation chemotherapy regimens, and (2) build a clinical model to predict survival in this patient population. Patients and Methods Using data from two randomized, phase III Eastern Cooperative Oncology Group (ECOG) trials (E5592/E1594), we performed univariate and multivariate stepwise Cox regression analyses to identify survival prognostic factors. We used 75% of randomly sampled data to build a prediction model for survival, and the remaining 25% of data to validate the model. Results From 1993 to 1999, 1,436 patients with stage IV or IIIB NSCLC with effusion were treated with platinum-based doublets (involving either paclitaxel, docetaxel, or gemcitabine). The response rate and median survival time were 20% and 8.2 months, respectively. One- and 2-year survivals were 33% and 11%, respectively. In multivariate analysis, six independent poor prognostic factors were identified: skin metastasis (hazard ratio [HR], 1.88), lower performance status (ECOG 1 or 2; HR, 1.46), loss of appetite (HR, 1.62), liver metastasis (HR, 1.32), ≥ four metastatic sites (HR, 1.20), and no prior surgery (HR, 1.16). A nomogram using six pretreatment prognostic factors was built to predict 1- and 2-year survival. Conclusion Six pretreatment factors can be used to predict survival in chemotherapy-naive NSCLC patients treated with standard chemotherapy. Using our prognostic nomogram, 1- and 2-year survival probability of NSCLC patients can be estimated before treatment. This prognostic model may help clinicians and patients in clinical decision making, as well as investigators in research planning.

Potential molecular prognostic factors in non-small cell lung cancer (NSCLC) patients treated with gefitinib

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 7089-7089
Author(s):  
C. Polowy ◽  
J. Coon ◽  
V. Villaflor ◽  
W. Leslie ◽  
I. Lukic ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Prognostic Factors ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Nsclc Patients

Potential clinical prognostic factors in non-small cell lung cancer (NSCLC) patients treated with gefitinib

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 7088-7088
Author(s):  
V. M. Villaflor ◽  
C. R. Polowy ◽  
J. S. Coon ◽  
W. T. Leslie ◽  
I. Lukic ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Prognostic Factors ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Nsclc Patients

scholarly journals Highlights on the morphology, prognostic factors, diagnostics, and treatment (chemotherapy, chemotherapy + radiation, targeted therapy, immunotherapy, and surgery) in small cell lung cancer

2020 ◽  
Vol 25 (4) ◽  
pp. 127-135
Author(s):  
Mark B. Bychkov ◽  
A. E. Kuzminov
Keyword(s):  
Lung Cancer ◽  
Prognostic Factors ◽  
Targeted Therapy ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Treatment Algorithm ◽  
Genetic Alterations ◽  
Small Cell ◽  
Line Treatment ◽  
Small Cell Lung

The article present a review and experience from a a single institution on the morphology, diagnostics, and treatment (chemotherapy, radiation, targeted therapy, and immunotherapy)) of small cell lung cancer (SCLC). The characteristic molecular, genetic, histological, and immunohistochemical features of NSCLC and SCLC are compared. An important issue of SCLC histogenesis is highlighted, taking into account its neuroendocrine characteristics. Paraneoplastic syndromes associated with SCLC and other clinical features of SCLC are discussed. The algorithm of examination of a patient with histologically or cytologically confirmed SCLC, staging schemes, and main prognostic factors are presented. The following aspects of chemoradiotherapy of localized SCLC are considered: features of early, late, simultaneous, and sequential therapy, and the need for whole brain radiotherapy in patients with localized and extensive SCLC. The article discusses the treatment algorithm for extensive disease SCLC, taking into account the recent success of chemoimmunotherapy in the first-line treatment of SCLC. As is known, the combinations of atezolizumab, etoposide, carboplatin and durvalumab, etoposide, cisplatin, or carboplatin showed a real benefit compared to chemotherapy alone. Although the second line treatment has not changed, it is now possible to prescribe a third line therapy because of the proven effectiveness of immunotherapy. Targeted therapy, although not shown to be effective in SCLC, is discussed in terms of the key features of genetic alterations as a possible target for therapy. An important issue in the treatment of patients with superior vena cava syndrome is considered separately. The tasks of future prospective research in SCLC are described.

Single center, open and prospective evaluation of genomic sequencing on cerebro-spinal fluid, brain metastatic lesions and plasma from patients in non-small cell lung cancer with brain metastasis.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13578-e13578
Author(s):  
Chunhua Ma ◽  
Chuoji Huang ◽  
Zhi Li ◽  
Rong Jiang ◽  
Juncheng Zhang
Keyword(s):  
Lung Cancer ◽  
Brain Metastasis ◽  
Small Cell Lung Cancer ◽  
Primary Tumor ◽  
Brain Lesion ◽  
Gene Mutations ◽  
Small Cell ◽  
Egfr Mutations ◽  
Small Cell Lung ◽  
Nsclc Patients

e13578 Background: Leptomeningeal metastases are observed in 9.4% non–small Cell Lung Cancer (NSCLC) patients with EGFR mutations. Depending on patient specific gene mutations, tumor cells may also have different proliferative activity, leading to differential metastatic potential. However, the clinical significance of observed gene mutation differences between CSF, plasma, primary pulmonary tumor and metastatic brain tumor samples remains unclear and should be further explored. Methods: From Apr. 2018 to Jan. 2019, plasma and CSF paired samples were drawn from consented NSCLC patients with diagnosed brain metastasis. Of these 21, brain lesion samples were obtained from 5 patients. All the samples were tested by next-generation sequencing. Patients were treated based on the detection results. Results: For this cohort, the detection rate of EGFR mutations in CSF cfDNA versus plasma cfDNA/CTC was 57.1% and 23.8% respectively (p < 0.05). For patients who had not received tyrosine kinase inhibitor (TKI) therapy, the CSF cfDNA EGFR mutation results were consistent with results for plasma, brain lesion and primary tumor samples. Conversely, for patients who had received TKI therapy, EGFR mutations detected in CSF were consistent with those from brain samples, but different from those observed in plasma or primary tumor samples. A high response rate (ORR, 70%; DCR, 90%) was observed in patients with EGFR positive detected in CSF after treatment with second orthird-generation TKI. Among the EGFR mutations detected in CSF, the EGFR uncommon mutation frequency was 58.3%(7/12), including G7I9A/L861Q/L703P/R776H/G575R/T790M 85.7% (6/7) of these occurred in LM patients. One patient who progressed from BM to LM had an uncommon mutation in the CSF sample. Among these five patients with EGFR G719A or L861Q positive and T790M negative, 4 patients had PR and 1 patient had SD after the second-generation TKI therapy. Conclusions: Differences in EGFR gene mutations were observed between CSF, plasma, primary pulmonary lesion and brain tissue samples in NSCLC patients with diagnosed brain metastasis after TKI therapy. The reasons for this discrepancy remain to be understood. Nevertheless, CSF may be a useful prognostic tool for patient monitoring and metastasis risk evaluation. The detection of uncommon EGFR mutations may increase the risk of LM in NSCLC patients. Clinical trial information: ChiCTR1800017499.

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