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Non-small cell Lung cancer mediastinal staging

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https://www.readbyqxmd.com/read/29666816/surgical-approach-in-oligometastatic-non-small-cell-lung-cancer
#1
REVIEW
Davide Patrini, Nikolaos Panagiotopoulos, Benedetta Bedetti, Sofoklis Mitsos, Roberto Crisci, Piergiorgio Solli, Luca Bertolaccini, Marco Scarci
The vast majority of lung cancer (80%) are non-small cell lung cancer (NSCLC) presenting in huge proportion of patients in a metastatic stage at the time of diagnosis with an overall survival (OS) of only 6 months. Standard treatment at this stage involves systemic platinum based chemotherapy improving the OS for only few months. For the vast majority of patients disease progression occurs and cure cannot achieved. An exception to this general rule is represented by patients with a limited number of metastasis (approximately 7% of patients with metastatic NSCLC): in 1995 Hellman and Weichselbaum introduced the term "oligometastatic" for a selected group of patients with metastatic disease...
March 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29664358/tailored-management-of-stage-iiia-non-small-cell-lung-cancer-in-the-era-of-the-8th-edition-of-the-tnm-classification-for-lung-cancer
#2
Michael R Mueller
Stage IIIA is a very heterogeneous group encompassing locally advanced disease with T3 and T4 tumors without any nodal involvement and very small T1a primary tumors with unilateral mediastinal lymphatic disease. Tailored management defines interdisciplinary management requiring board decisions, which can sometimes be difficult particularly in stage IIIa non-small-cell lung cancer (NSCLC). Lobectomy still is standard of care even for stage I NSCLC, which increasingly is implemented using minimally invasive surgical technique...
March 2018: Future Oncology
https://www.readbyqxmd.com/read/29605962/ten-years-experience-in-robotic-assisted-thoracic-surgery-for-early-stage-lung-cancer
#3
Monica Casiraghi, Domenico Galetta, Alessandro Borri, Adele Tessitore, Rosalia Romano, Cristina Diotti, Daniela Brambilla, Patrick Maisonneuve, Lorenzo Spaggiari
BACKGROUND:  This study analyzed the short- and long-term outcomes of robotic-assisted thoracic surgery (RATS) for early stage non-small cell lung cancer (NSCLC). METHODS:  From November 2006 to December 2016, we performed 363 RATS procedures. This study retrospectively reviewed 339 patients who underwent RATS for clinical stages I ( n  = 318) or II ( n  = 21) NSCLC. RESULTS:  Twenty-nine patients underwent segmentectomy, 307 lobectomy, and 3 pneumonectomy...
April 1, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29600085/current-role-of-standardized-uptake-value-max-derived-ratios-in-n2-fluorine-18-fluorodeoxyglucose-positron-emission-tomography-non-small-cell-lung-cancer
#4
REVIEW
Duilio Divisi, Mirko Barone, Roberto Crisci
Mediastinal staging is a crucial moment in management of non-small cell lung cancer (NSCLC) patients. In integrated pathways, 18-fluorine fluorodeoxyglucose positron-emission tomography (18 F-FDG-PET/CT) is an indispensable imaging resource with its peculiarities and its limitations. A critical review of work up protocols would certainly help to standardize procedures with important reflections also on the diagnostic value of this examination. In this regard, new semi-quantitative and semi-qualitative indexes have been proposed with the aim of increasing the accuracy of 18 F-FDG-PET/CT in mediastinal lymph node staging...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29596820/patterns-of-practice-in-mediastinal-lymph-node-staging-for-non-small-cell-lung-cancer-in-canada
#5
Simon R Turner, Nazgol Seyednejad, Basil S Nasir
BACKGROUND: Assessment of mediastinal lymph nodes is integral in staging patients with non-small cell lung cancer (NSCLC). This study aims to delineate the lymph node staging practices of Canadian thoracic surgeons in patients with potentially resectable NSCLC. METHODS: A questionnaire was distributed to Canadian Association of Thoracic Surgeons members (n=86). Items addressed the use of imaging, thresholds/methods for preoperative invasive staging, and intraoperative node staging...
March 26, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29587940/-exploration-of-postoperative-follow-up-strategies-for-early-staged-nsclc-patients-on-the-basis-of-follow-up-result-of-416-stage-i-nsclc-patients-after-lobectomy
#6
Liang Dai, Wanpu Yan, Xiaozheng Kang, Hao Fu, Yongbo Yang, Haitao Zhou, Zhen Liang, Hongchao Xiong, Yao Lin, Keneng Chen
BACKGROUND: Currently, there is no consensus on the follow-up strategy (follow-up time interval and content) of non-small cell lung cancer (NSCLC) in the world, and the relevant clinical evidence is also very limited. In this study, we aimed to summarize the recurrence/metastasis sites and timings of stage I NSCLC patients based on their follow-up data, aiming to provide a basis of follow-up time interval and content for this group of patients. METHODS: We retrospectively analyzed the 416 stage I NSCLC patients that underwent continuous anatomic lobectomy between Jan...
March 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/29587908/-to-explore-clinical-value-of-single-port-video-assisted-thoracoscopic-surgery-in-elderly-patients-with-non-small-cell-lung-cancer-lobectomy-segmentectomy-and-lobectomy-vs-segmentectomy
#7
Lin Huang, Bin Zheng, Chun Chen, Wei Zheng, Yong Zhu, Chaohui Guo
BACKGROUND: The morbidity of lung cancer has long been the highest in cancer. Stage I, stage II and partly of stage III non-small cell lung cancer (NSCLC) are mainly treated by surgery. Lobectomy and segmentectomy both are common lung resection methods. Video-assisted thoracoscopic surgery (VATS) has been widely used in clinical, and the application of single-portvideo-assisted thoracoscopic surgery (SP VATS) has gradually been recognized and accepted by professors. With increasing degree of eldly in society, eldly patients already have become inceasingly difficulties in the diagnosis and treatment of NSCLC...
April 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/29578108/initiative-for-early-lung-cancer-research-on-treatment-development-of-study-design-and-pilot-implementation
#8
Raja Flores, Emanuela Taioli, David F Yankelevitz, Betsy Jane Becker, Artit Jirapatnakul, Anthony Reeves, Rebecca Schwartz, Rowena Yip, Esther Fevrier, Kathleen Tam, Benjamin Steiger, Claudia I Henschke, Raja Flores, Andrew Kaufman, Dong-Seok Lee, Daniel Nicastri, Andrea Wolf, Kenneth Rosenzweig, Jorge Gomez, Mary Beth Beasley, Maureen Zakowski, Michael Chung, David Yankelevitz, Claudia Henschke, Rita Futamura, Sydney Kantor, Carly Wallace, Faiz Bhora, Wissam Raad, Andrew Evans, Walter Choi, Zrzu Buyuk, Adie Friedman, Ronald Dreifuss, Stacey Verzosa, Mariya Yakubox, Karina Aloferdova, Patricia Stacey, Simone De Nobrega, Rita Futamura, Sydney Kantor, Carly Wallace, Ardeshir Hakami, Kathleen Tam, Carly Wallace, Harvey Pass, Berne Crawford, Jessica Donnington, Benjamin Cooper, Andre Moreirea, Audrey Sorensen, Leslie Kohman, Robert Dunton, Jason Wallen, Christopher Curtiss, Ernest Scalzetti, Linda Ellinwood, Ralph Aye, Eric Vallieres, Brian Louie, Alex Frivar, Vivek Mehta, Kristin Manning, Maria Chona, Andrew Smith, Clifford P Connery, Emilo Torres, Dan Cruzer, Bruce Gendron, Sonya Alyea, Daniel Lackaye, Lauren Studer, Raja Flores, Claudia Henschke, Emanuela Taioli, David Yankelevitz, Betsy Becker, Artit Jirapatnakul, Anthony Reeves, Rebecca Schwartz, Rowena Yip, Esther Fevrier, Kathleen Tam, Benjamin Steiger
PURPOSE: To maximize the benefits of CT screening for lung cancer, optimal treatment is for small, early lung cancers is needed. Limiting the extent of surgery spares lung tissue, preserves pulmonary function, and decreases operative time, complications, and morbidities. It also increases the likelihood of resecting future new primary lung cancers. The goal is to assess alternative treatments in a timely manner. METHODS: The focus sessions with patients and physicians separately highlighted the need to consider their perceptions...
March 22, 2018: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/29559292/implications-of-pathologic-complete-response-beyond-mediastinal-nodal-clearance-with-high-dose-neoadjuvant-chemoradiation-therapy-in-locally-advanced-non-small-cell-lung-cancer
#9
Melissa A L Vyfhuis, Whitney M Burrows, Neha Bhooshan, Mohan Suntharalingam, James M Donahue, Josephine Feliciano, Shahed Badiyan, Elizabeth M Nichols, Martin J Edelman, Shamus R Carr, Joseph Friedberg, Gavin Henry, Shelby Stewart, Ashutosh Sachdeva, Edward M Pickering, Charles B Simone, Steven J Feigenberg, Pranshu Mohindra
PURPOSE: To determine, in a retrospective analysis of a large cohort of stage III non-small cell lung cancer patients treated with curative intent at our institution, whether having a pathologic complete response (pCR) influenced overall survival (OS) or freedom from recurrence (FFR) in patients who underwent definitive (≥60 Gy) neoadjuvant doses of chemoradiation (CRT). METHODS AND MATERIALS: At our institution, 355 patients with locally advanced non-small cell lung cancer were treated with curative intent with definitive CRT (January 2000-December 2013), of whom 111 underwent mediastinal reassessment for possible surgical resection...
February 13, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29552519/endobronchial-ultrasound-guided-transbronchial-needle-aspiration-for-staging-of-non-small-cell-lung-cancer
#10
Habiba Hashimi, David T Cooke, Elizabeth A David, Lisa M Brown
Accurate staging for non-small cell lung cancer (NSCLC) is essential to guide therapy. While computed tomography (CT) and positron emission tomography (PET) scan can indicate whether mediastinal lymphadenopathy is present, histologic confirmation is required to complete the staging evaluation. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique associated with similar diagnostic yield and improved postoperative pain and complication rates compared to mediastinoscopy...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29548592/tumor-histology-predicts-mediastinal-nodal-status-and-may-be-used-to-guide-limited-lymphadenectomy-in-patients-with-clinical-stage-i-non-small-cell-lung-cancer
#11
Xinghua Cheng, Difan Zheng, Yuan Li, Hang Li, Yihua Sun, Jiaqing Xiang, Haiquan Chen
OBJECTIVE: Methods to minimize surgical trauma from mediastinal lymphadenectomy in patients with early-stage lung cancer are still immature. This study aimed to identify predictors of negative pathologic N2, which may be used to select patients for limited mediastinal lymphadenectomy. METHODS: Clinicopathologic features of 1430 patients with resected clinical stage I non-small cell lung cancer and complete mediastinal lymphadenectomy were retrospectively analyzed for variables associated with negative N2 nodal metastasis (2008-2015)...
February 13, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29545019/photons-protons-or-carbon-ions-for-stage-i-non-small-cell-lung-cancer-results-of-the-multicentric-rococo-in-silico-study
#12
Krista C J Wink, Erik Roelofs, Charles B Simone, David Dechambre, Alina Santiago, Judith van der Stoep, Wim Dries, Julia Smits, Stephen Avery, Filippo Ammazzalorso, Nicolas Jansen, Urszula Jelen, Timothy Solberg, Dirk de Ruysscher, Esther G C Troost
PURPOSE: To compare dose to organs at risk (OARs) and dose-escalation possibility for 24 stage I non-small cell lung cancer (NSCLC) patients in a ROCOCO (Radiation Oncology Collaborative Comparison) trial. METHODS: For each patient, 3 photon plans [Intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT) and CyberKnife], a double scattered proton (DSP) and an intensity-modulated carbon-ion (IMIT) therapy plan were created. Dose prescription was 60 Gy (equivalent) in 8 fractions...
March 12, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29534956/effectiveness-of-implemented-interventions-on-pathologic-nodal-staging-of-non-small-cell-lung-cancer
#13
Meredith A Ray, Nicholas R Faris, Matthew P Smeltzer, Carrie Fehnel, Cheryl Houston-Harris, Paul Levy, Lynn Wiggins, Vishal Sachdev, Todd Robbins, David Spencer, Raymond U Osarogiagbon
BACKGROUND: Accurate pathologic nodal staging improves early-stage non-small-cell lung cancer survival. In an ongoing implementation study, we measured the impact of a surgical lymph node specimen collection kit and a more thorough pathologic gross dissection method, on attainment of guideline-recommended pathologic nodal staging quality. METHODS: We prospectively collected data on curative-intent non-small cell lung cancer resections from 2009-2016 from 11 hospitals in 4 contiguous Dartmouth Hospital Referral Regions...
March 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29521649/overall-survival-results-of-the-feasibility-study-of-adjuvant-chemotherapy-with-docetaxel-plus-cisplatin-followed-by-long-term-single-agent-administration-of-s-1-in-patients-with-completely-resected-non-small-cell-lung-cancer-thoracic-oncology-research-group
#14
Seiji Niho, Norihiko Ikeda, Hiroshi Michimae, Kenji Suzuki, Hiroshi Sakai, Takayuki Kaburagi, Katsuo Yoshiya, Koichi Minato, Terufumi Kato, Hiroaki Okamoto, Takashi Seto, Yukio Hosomi, Kimihiro Shimizu, Haruhiro Saito, Masanori Tsuchida, Hideo Kunitoh, Masahiro Tsuboi, Masahiro Takeuchi, Koshiro Watanabe
OBJECTIVES: The TORG0809 study was a multicenter feasibility study of long-term single-agent therapy with S-1 after docetaxel plus cisplatin therapy in patients with completely resected stage II or stage IIIA non-small cell lung cancer. We report the results of the final overall survival (OS) analysis. PATIENTS AND METHODS: A total of 129 eligible patients received 3 cycles of docetaxel (60 mg/m, day 1) plus cisplatin (80 mg/m, day 1), followed by S-1 at 40 mg/m twice daily for 14 consecutive days, for >6 months (maximum, 1 y)...
March 7, 2018: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29515398/pulmonary-sarcoidosis-activation-following-neoadjuvant-pembrolizumab-plus-chemotherapy-combination-therapy-in-a-patient-with-non-small-cell-lung-cancer-a-case-report
#15
Ghina Fakhri, Reem Akel, Ziad Salem, Ayman Tawil, Arafat Tfayli
Background: Pembrolizumab is a humanized monoclonal antibody which serves to enhance the antitumor immune response by targeting programmed cell death 1 receptor. The use of pembrolizumab plus carboplatin/pemetrexed combination therapy results in improvement in overall survival and progression-free survival rates for non-small cell lung cancer (NSCLC) patients as compared to chemotherapy alone. However, numerous immune-mediated toxicities of pembrolizumab have been reported. Case Presentation: We report the case of a 74-year-old male patient diagnosed with stage IIIA programmed death-ligand 1-positive non-small cell lung adenocarcinoma treated with 4 cycles of carboplatin/pemetrexed plus pembrolizumab combination therapy followed by 2 cycles of pembrolizumab treatment...
September 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/29494598/18f-fluorodeoxyglucose-positron-emission-tomography-fdg-pet-radiomics-of-metastatic-lymph-nodes-and-primary-tumor-in-non-small-cell-lung-cancer-nsclc-a-prospective-externally-validated-study
#16
Sara Carvalho, Ralph T H Leijenaar, Esther G C Troost, Janna E van Timmeren, Cary Oberije, Wouter van Elmpt, Lioe-Fee de Geus-Oei, Johan Bussink, Philippe Lambin
BACKGROUND: Lymph node stage prior to treatment is strongly related to disease progression and poor prognosis in non-small cell lung cancer (NSCLC). However, few studies have investigated metabolic imaging features derived from pre-radiotherapy 18F-fluorodeoxyglucose (FDG) positron-emission tomography (PET) of metastatic hilar/mediastinal lymph nodes (LNs). We hypothesized that these would provide complementary prognostic information to FDG-PET descriptors to only the primary tumor (tumor)...
2018: PloS One
https://www.readbyqxmd.com/read/29465766/segmentectomy-versus-lobectomy-in-early-non-small-cell-lung-cancer-of-2-cm-or-less-in-size-a-population-based-study
#17
Mi Hyoung Moon, Young Kyu Moon, Seok Whan Moon
BACKGROUND AND OBJECTIVE: Standard surgical management for early stage lung cancer is lobectomy with mediastinal lymph node dissection. The feasibility of limited resection remains controversial; we retrospectively assessed lung cancer-specific survival (LCSS) and overall survival (OS) in early stage non-small cell lung cancer (NSCLC) to evaluate whether segmentectomy is comparable to standard lobectomy. METHODS: Patients with primary NSCLC of 20 mm or less who were diagnosed from 2000 to 2014 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database...
February 21, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29447330/is-central-lung-tumour-location-really-predictive-for-occult-mediastinal-nodal-disease-in-suspected-non-small-cell-lung-cancer-staged-cn0-on-18f-fluorodeoxyglucose-positron-emission-tomography-computed-tomography
#18
Herbert Decaluwé, Johnny Moons, Steffen Fieuws, Walter De Wever, Christophe Deroose, Alessia Stanzi, Lieven Depypere, Kristiaan Nackaerts, Johan Coolen, Maarten Lambrecht, Eric Verbeken, Dirk De Ruysscher, Johan Vansteenkiste, Dirk Van Raemdonck, Paul De Leyn, Christophe Dooms
OBJECTIVES: Current guidelines recommend preoperative invasive mediastinal staging in centrally located tumours with negative mediastinum on positron emission tomography-computed tomography, based on a 20-30% prevalence of occult mediastinal disease (pN2-3). However, a uniform definition of central tumour location is lacking. Our objective was to determine the best definition in predicting occult pN2-3. METHODS: A single-institution database was queried for patients with (suspected) non-small-cell lung cancer staged cN0 after positron emission tomography-computed tomography and referred to invasive staging and/or primary surgery...
February 13, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29445601/predictors-of-unexpected-nodal-upstaging-in-patients-with-ct1-3n0-non-small-cell-lung-cancer-nsclc-submitted-to-thoracoscopic-lobectomy
#19
Giuseppe Marulli, Enrico Verderi, Giovanni M Comacchio, Nicola Monaci, Giuseppe Natale, Samuele Nicotra, Federico Rea
Background: In the last decades, the use of video-assisted thoracoscopic surgery (VATS) lobectomy for the treatment of early stage non-small cell lung cancer is continuously growing. This is mainly due to the development of more advanced surgical devices, to the rising incidence of peripheral lung tumors and is also favored by the increased reliability of preoperative staging techniques. Despite this progress, postoperative unexpected nodal upstaging is still a relevant issue. Aim of this study is to identify possible predictors of unexpected nodal upstaging in patients affected by cT1-3N0 NSCLC submitted to VATS lobectomy...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29433713/pulmonologist-s-road-map-to%C3%A2-mediastinal-lymph-node%C3%A2-imaging
#20
REVIEW
Hamza Jawad, Jonathan H Chung
Mediastinal lymph node station maps are intended to facilitate nodal staging in patients with non-small cell lung cancer. These maps have been revised over time and the International Association for Study of Lung Cancer (IASLC) map is the latest rendition. This article illustrates the imaging appearance of each of the IASLC map mediastinal lymph node stations, overviews some of the mediastinal lymph node sampling techniques, and discusses common pitfalls of the IASLC map. It also reviews mediastinal anatomic variants and pathologic features that may simulate lymphadenopathy...
March 2018: Clinics in Chest Medicine
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