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Non-small cell Lung cancer mediastinal staging

Keiju Aokage, Junji Yoshida, Tomoyuki Hishida, Masahiro Tsuboi, Hisashi Saji, Morihito Okada, Kenji Suzuki, Syunichi Watanabe, Hisao Asamura
Since 'radical lobectomy' was reported by Cahan in 1960, the standard surgical care for lung cancer has been lobectomy, in which units of the lobe are excised with their specific regional hilar and mediastinal lymphatics. However, pulmonary function-preserving limited resection for lung cancer has gradually become more prevalent in the late 20th century. In 1995, Ginsberg et al. conducted a randomized controlled trial in which limited resection (segmentectomy and wide-wedge resection) and lobectomy for stage I lung cancer were compared and reported that limited resection should not be applied to healthy patients with clinical stage IA lung cancer...
October 20, 2016: Japanese Journal of Clinical Oncology
Frank O Velez-Cubian, Kathryn L Rodriguez, Matthew R Thau, Carla C Moodie, Joseph R Garrett, Jacques P Fontaine, Eric M Toloza
BACKGROUND: We investigated whether robotic-assisted surgery improves mediastinal lymph node dissection (MLND). METHODS: We analyzed patients (pts) who underwent robotic-assisted video-assisted thoracoscopic surgery (R-VATS) lobectomy for non-small cell lung cancer (NSCLC) over 36 months. Perioperative outcomes, tumor histology, numbers, locations, and status of all lymph nodes (LNs), and TNM (tumor, nodal, and metastasis) stage changes were analyzed. RESULTS: One hundred fifty-nine pts had mean tumor size 3...
September 2016: Journal of Thoracic Disease
Naomi E Verstegen, Alexander P W M Maat, Frank J Lagerwaard, Marinus A Paul, Michel I Versteegh, Joris J Joosten, Willem Lastdrager, Egbert F Smit, Ben J Slotman, Joost J M E Nuyttens, Suresh Senan
INTRODUCTION: The literature on surgical salvage, i.e. lung resections in patients who develop a local recurrence following stereotactic ablative radiotherapy (SABR), is limited. We describe our experience with salvage surgery in nine patients who developed a local recurrence following SABR for early stage non-small cell lung cancer (NSCLC). METHODS: Patients who underwent surgical salvage for a local recurrence following SABR for NSCLC were identified from two Dutch institutional databases...
October 3, 2016: Radiation Oncology
Fumihiro Tanaka, Seiki Hasegawa, Nobuyuki Kondo, Ryo Miyahara, Hiroshi Date, Shinji Atagi, Masaaki Kawahara, Takeharu Yamanaka, Toshiaki Manabe, Hiromi Wada
BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard procedure for the pathological evaluation of the mediastinal nodal (N2) status of lung cancer; however, its feasibility in potentially operable patients with suspicion of minimal N2 disease remains unestablished. PATIENTS AND METHODS: A prospective multicenter study was conducted to assess the feasibility of EBUS-TBNA in this setting. Patients with clinical stage IIIA-N2 non-small cell lung cancer (NSCLC) and mediastinal nodal enlargement on computed tomography (CT) were eligible; patients were ineligible when CT revealed bulky (> 3 cm in the long-axis diameter) N2 or multiple (≥ 3) station N2...
2016: Oncology Research and Treatment
Shan Xian Guo, Yan Jian, Ying Lan Chen, Yun Cai, Qing Yuan Zhang, Fang Fang Tou
Neoadjuvant Chemotherapy has been used for the stage III of non-small cell lung cancer (NSCLC) and has shown good clinical effects. However, the survival benefits of radiation therapy added in induction regimens remains controversial. We therefore conducted a meta-analysis of the published clinical trials to quantitatively evaluate the benefit of preoperative chemoradiotherapy. After searching the database of Pubmed, CNKI, EMBASE, ESMO, The Cochrane Library databases, The American Society of Clinical Oncology and Clinical Trials...
September 28, 2016: Scientific Reports
S Gao, A W Kim, F C Detterbeck, D Boffa, J Puchalski, R H Decker
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
S Gao, C D Corso, E H Wang, J Blasberg, D Boffa, F C Detterbeck, A W Kim
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
V Agrawal, T P Coroller, Y Hou, S Lee, J Romano, E H Baldini, A B Chen, D E Kozono, S J Swanson, J Wee, H Aerts, R H Mak
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Kavian Toosi, Frank O Velez-Cubian, Jessica Glover, Emily P Ng, Carla C Moodie, Joseph R Garrett, Jacques P Fontaine, Eric M Toloza
BACKGROUND: Mediastinal involvement in resected non-small-cell lung cancer mandates adjuvant therapy and affects survival. This study investigated lymph node dissection efficacy, lymph node metastasis detection, and survival after robotic-assisted lobectomy for non-small-cell lung cancer. METHODS: We retrospectively analyzed patients who underwent robotic-assisted lobectomy for non-small-cell lung cancer. Survival was assessed through chart reviews, Social Security Death Registry, and national obituary searches...
September 21, 2016: Surgery
Inderpaul Singh Sehgal, Sahajal Dhooria, Ashutosh Nath Aggarwal, Digambar Behera, Ritesh Agarwal
Whether endosonography can replace mediastinoscopy as the initial procedure for mediastinal staging of non-small cell lung cancer remains controversial. Herein, we perform a systematic review of randomized controlled trials and observational studies (both procedures performed in same subjects) comparing the two procedures. Nine studies (960 subjects) were identified. The pooled risk-difference of the sensitivity of endosonography versus mediastinoscopy in observational studies and randomized controlled trials was 0...
September 13, 2016: Annals of Thoracic Surgery
Mohamed K Kamel, Mohamed Rahouma, Galal Ghaly, Abu Nasar, Jeffrey L Port, Brendon M Stiles, Andrew B Nguyen, Nasser K Altorki, Paul C Lee
BACKGROUND: Patients with persistent N2 disease after induction have poor survival. Many of these patients may have had mediastinoscopy before induction therapy, making reassessment of the mediastinum by repeat mediastinoscopy hazardous and inaccurate. The sensitivity and specificity of endobronchial ultrasonography and nodal fine-needle aspiration in this setting is unclear. In this study, we sought to identify the clinical predictors of persistent N2 disease after induction therapy, which may help in selecting the patients most likely to benefit from surgical resection...
September 9, 2016: Annals of Thoracic Surgery
Hao Chen, Guobing Xu, Bin Zheng, Wei Zheng, Yong Zhu, Zhaohui Guo, Chun Chen
BACKGROUND: In this study, we evaluate the feasibility and safety of single-port video-assisted thoracoscopic surgery (VATS) sleeve lobectomy (SL) and systematic mediastinal lymphadenectomy and summarize our surgical experience. METHODS: From October 2014 to December 2015, eight cases of single-port VATS SL [seven male patients and one female patient, median age 56.0 (range, 38-63) years] were performed by a single group of surgeons in Fujian Medical University Fujian Union Hospital...
August 2016: Journal of Thoracic Disease
N Rodríguez de Dios, X Sanz, P Foro, I Membrive, A Reig, A Ortiz, R Jiménez, M Algara
PURPOSE: To report interim results from a single-institution study conducted to assess accelerated hypofractionated radiotherapy (AHRT) delivered with 3D conformal radiotherapy in two groups of patients with non-small cell lung cancer: (1) patients with early stage disease unable to tolerate surgery and ineligible for stereotactic body radiation therapy, and (2) patients with locally advanced disease unsuitable for concurrent chemoradiotherapy. METHODS/PATIENTS: A total of 83 patients (51 stage I-II, 32 stage III) were included...
August 23, 2016: Clinical & Translational Oncology
Chen-Ping Hsieh, Ming-Ju Hsieh, Ching-Feng Wu, Jui-Ying Fu, Yun-Hen Liu, Yi-Cheng Wu, Cheng-Ta Yang, Ching-Yang Wu
BACKGROUND: Lung cancer is the leading cause of cancer deaths in the world, and more and more treatment modalities have been introduced in order to improve patients' survival. For patients with advanced non-small cell lung cancer (NSCLC), survival prognosis is poor and multimodality neoadjuvant therapies are given to improve patients' survival. However, the possibility of occult metastases may lead to discrepancy between clinical and pathologic staging and underestimation of the disease severity...
July 2016: Journal of Thoracic Disease
Johnathan D Ebben, Ming You
Lung cancer is a clinically difficult disease with rising disease burden around the world. Unfortunately, most lung cancers present at a clinically advanced stage. Of these cancers, many also present with brain metastasis which complicates the clinical picture. This review summarizes current knowledge on the molecular basis of lung cancer brain metastases. We start from the clinical perspective, aiming to provide a clinical context for a significant problem that requires much deeper scientific investigation...
September 2016: International Journal of Biochemistry & Cell Biology
Elizabeth A David, David T Cooke, Yingjia Chen, Kieranjeet Nijar, Robert J Canter, Rosemary D Cress
BACKGROUND: The prognostic significance of the number of lymph nodes sampled (NLNS) during resection for non-small cell lung cancer (NSCLC) is unclear. The NLNS is influenced by many factors, and some have argued that it should be a surrogate for quality. We sought to determine the influence of the NLNS on overall survival and cancer-specific survival for surgically resected NSCLC. METHODS: The California Cancer Registry was queried from 2004 to 2011 for cases of stage I to III NSCLC treated with surgical resection, identifying 16,393 patients...
July 25, 2016: Annals of Thoracic Surgery
Ryosuke Tachi, Aritoshi Hattori, Takeshi Matsunaga, Kazuya Takamochi, Shiaki Oh, Kenji Suzuki
PURPOSE: Predicting the prognosis of advanced non-small-cell lung cancer (NSCLC) patients who present with clinically unsuspected N2 is very different due to the heterogeneity of this cohort. Thus, this study was undertaken to identify the clinicopathological features and survival of patients with clinical N0 or N1 and pathological N2, namely, unsuspected N2. METHODS: Among 239 patients with pathological N2 NSCLC, we reviewed the cases of 92 (38.5 %) patients who showed unsuspected N2...
July 21, 2016: Surgery Today
Hayato Konno, Yoshihiro Minamiya
Systematic lymph node dissection in radical operation for lung cancer is recognized as an operative procedure which is accurate staging. In clinical early-stage non-small cell lung cancer (NSCLC), if the nodes are negative, complete mediastinal lymph node dissection might be omitted. Selective mediastinal dissection for clinico-surgical stage I NSCLC proved to be as effective as complete dissection. When lymph node metastasis was observed, segmentectomy was converted to lobectomy. Sentinel node( SN) identification is useful to determine the final indication of minimally invasive surgery by targeting the lymph nodes needed for intraoperative frozen section diagnosis...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
João Pedro Steinhauser Motta, Axel Tobias Kempa, Alexandre Pinto Cardoso, Marcos Eduardo Paschoal, Ronir Raggio Luiz, José Roberto Lapa E Silva, Franz Stanzel
BACKGROUND: Since the first articles published for over 10 years ago, endobronchial ultrasound (EBUS) has gained a strong scientific backing and has been incorporated into routine medical practice in pulmonology and thoracic surgery centers. How is EBUS performing outside the scientific environment, as a diagnostic and mediastinal staging tool in a subset of patients that undergo thoracic surgery, is an interesting question. METHODS: This study evaluated consecutive patients who, during the period from January 2010 to August 2012, were submitted to EBUS and later to thoracic surgery...
July 19, 2016: BMC Pulmonary Medicine
Pravachan V C Hegde, Moishe Liberman
Combined endosonographic lymph node biopsy techniques are a minimally invasive alternative to surgical staging in non-small cell lung cancer and may be superior to standard mediastinoscopy and surgical mediastinal staging techniques. Endosonography allows for the biopsy of lymph nodes and metastases unattainable with standard mediastinoscopy. Standard cervical mediastinoscopy is an invasive procedure, which requires general anesthesia and is associated with higher risk, cost, and major complication rates compared with minimally invasive endosonographic biopsy techniques...
August 2016: Thoracic Surgery Clinics
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