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Non-small cell Lung cancer mediastinal staging

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https://www.readbyqxmd.com/read/28283236/cost-effectiveness-of-mediastinal-lymph-node-staging-in-non-small-cell-lung-cancer
#1
Katarzyna Czarnecka-Kujawa, Ursula Rochau, Uwe Siebert, Eshetu Atenafu, Gail Darling, Thomas Kenneth Waddell, Andrew Pierre, Marc De Perrot, Marcelo Cypel, Shaf Keshavjee, Kazuhiro Yasufuku
OBJECTIVE: To assess the cost-effectiveness of various modes of mediastinal staging in non-small cell lung cancer (NSCLC) in a single-payer health care system. METHODS: We performed a decision analysis to compare the health outcomes and costs of 4 mediastinal staging strategies: no invasive staging, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), mediastinoscopy, and EBUS-TBNA followed by mediastinoscopy if EBUS-TBNA is negative. We determined incremental cost effectiveness ratios (ICER) for all strategies and performed comprehensive deterministic sensitivity analyses using a willingness to pay threshold of $80,000/quality adjusted life year (QALY)...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28275477/curative-resection-for-lung-cancer-in-octogenarians-is-justified
#2
Michaela Tutic-Horn, Franco Gambazzi, Gaetano Rocco, Monique Mosimann, Didier Schneiter, Isabelle Opitz, Nono Martucci, Sven Hillinger, Walter Weder, Wolfgang Jungraithmayr
BACKGROUND: Due to an increased life expectancy in a healthy aging population and a progressive incidence of lung cancer, curative pulmonary resections can be performed even in octogenarians. The present study aims to investigate whether surgery is justified in patients reaching the age of 80 years and older who undergo resection for non-small cell lung cancer (NSCLC). METHODS: In this retrospective multi-centre analysis, the morbidity, mortality and long-term survival of 88 patients (24 females) aged ≥80 who underwent complete resection for lung cancer between 2000 and 2013 were analysed...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28262300/invasive-mediastinal-staging-guideline%C3%A2-concordance
#3
Anna Bendzsak, Thomas K Waddell, Kazuhiro Yasufuku, Shaf Keshavjee, Marc de Perrot, Marcelo Cypel, Andrew F Pierre, Gail E Darling
BACKGROUND: Despite guidelines for preoperative invasive mediastinal staging (IMS) for non-small cell lung cancer (NSCLC), concordance with guidelines and whether the use of these guidelines results in expected frequency of lymph node metastases has not been evaluated. Our objectives were to determine guideline concordance, reasons for nonconcordance, and, in patients who did not receive IMS, to determine the use of operative nodal sampling and final pathologic staging. METHODS: Patients who had a resection for NSCLC between 2010 and 2012 were identified from the Institutional Cancer Registry...
March 2, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28256095/effect-of-visceral-pleural-invasion-on-the-prognosis-of-patients-with-lymph-node-negative-non-small-cell-lung-cancer
#4
Dan Tian, Yuquan Pei, Qingfeng Zheng, Jianzhi Zhang, Shaolei Li, Xing Wang, Dongmei Lin, Yue Yang
BACKGROUND: Visceral pleural invasion (VPI) is an adverse prognostic factor in non-small cell lung cancer (NSCLC); however, its effect in relation to tumor size remains under debate. To better understand the prognostic impact and potential consequences for staging, we examined correlations between VPI and clinicopathologic characteristics in patients with NSCLC, particularly those with lymph node negative NSCLC. METHODS: We retrospectively analyzed 813 cases of radically resected NSCLC treated in our institution between December 2005 and December 2011...
March 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/28253364/comparison-of-18f-fdg-pet-ct-and-dwi-for-detection-of-mediastinal-nodal-metastasis-in-non-small-cell-lung-cancer-a-meta-analysis
#5
Guohua Shen, You Lan, Kan Zhang, Pengwei Ren, Zhiyun Jia
BACKGROUND: Accurate clinical staging of mediastinal lymph nodes of patients with lung cancer is important in determining therapeutic options and prognoses. We aimed to compare the diagnostic performance of diffusion-weighted magnetic resonance imaging (DWI) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in detecting mediastinal nodal metastasis of lung cancer. METHODS: Relevant studies were systematically searched in the MEDLINE, EMBASE, PUBMED, and Cochrane Library databases...
2017: PloS One
https://www.readbyqxmd.com/read/28238444/pet-ct-in-presurgical-lymph-node-staging-in-non-small-cell-lung-cancer-the-importance-of-false-negative-and-false-positive-findings
#6
A Bustos García de Castro, J Ferreirós Domínguez, R Delgado Bolton, C Fernández Pérez, B Cabeza Martínez, M García García-Esquinas, J L Carreras Delgado
OBJECTIVE: To assess the importance of false-negative and false-positive findings in computed tomography (CT) and (18)F-FDG positron emission tomography (PET) in mediastinal lymph node staging in patients undergoing surgery for non-small cell lung cancer (NSCLC). MATERIAL AND METHODS: This retrospective study included 113 consecutive patients and 120 resected NSCLCs; 22 patients received neoadjuvant treatment. We compared the findings on preoperative (18)F-FDG PET-CT studies with the postoperative pathology findings...
February 23, 2017: Radiología
https://www.readbyqxmd.com/read/28125698/late-course-adaptive-adjustment-based-on-metabolic-tumor-volume-changes-during-radiotherapy-may-reduce-radiation-toxicity-in-patients-with-non-small-cell-lung-cancer
#7
Linlin Xiao, Ning Liu, Guifang Zhang, Hui Zhang, Song Gao, Zheng Fu, Suzhen Wang, Qingxi Yu, Jinming Yu, Shuanghu Yuan
To reduce the high risk of radiation toxicity and enhance the quality of life of patients with non-small cell lung cancer (NSCLC), we quantified the metabolic tumor volumes (MTVs) from baseline to the late-course of radiotherapy (RT) by fluorodeoxyglucose positron emission tomography computerized tomography (FDG PET-CT) and discussed the potential benefit of late-course adaptive plans rather than original plans by dose volume histogram (DVH) comparisons. Seventeen patients with stage II-III NSCLC who were treated with definitive conventionally fractionated RT were eligible for this prospective study...
2017: PloS One
https://www.readbyqxmd.com/read/28109572/subcarinal-lymph-nodes-should-be-dissected-in-all-lobectomies-for-non-small-cell-lung-cancer-regardless-of-primary-tumor-location
#8
Jens Eckardt, Erik Jakobsen, Peter B Licht
BACKGROUND: Mediastinal staging is of paramount importance for planning of treatment in non-small cell lung cancer (NSCLC). Single institution reports recently claimed that subcarinal lymph node dissection during resection of upper lobe NSCLC could be spared. We used a complete national lung cancer registry to investigate patterns of unsuspected mediastinal lymph node involvement after lobectomy. METHODS: During an 11-year period (2004 to 2014) 5,577 consecutive patients who underwent operations for NSCLC were investigated for unsuspected mediastinal lymph node involvement (N2 disease) discovered at final histopathology...
January 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28074327/when-should-negative-endobronchial-ultrasonography-findings-be-confirmed-by-a-more-invasive-procedure
#9
Basil S Nasir, Kazuhiro Yasufuku, Moishe Liberman
The treatment of non-small cell lung cancer is largely dependent on accurate staging in order to determine appropriate therapy. Despite advances in imaging, such as computed tomography and positron emission tomography, invasive mediastinal staging is frequently needed to rule out mediastinal involvement prior to curative-intent stereotactic ablative radiotherapy or surgical resection. Surgical mediastinal staging with mediastinoscopy, or anterior mediastinotomy, were traditionally considered the gold standard for invasive mediastinal staging...
January 10, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28056871/lung-adenocarcinoma-expressing-receptor-for-advanced-glycation-end-products-with-primary-systemic-al-amyloidosis-a-case-report-and-literature-review
#10
Shouichi Okamoto, Shinsaku Togo, Ichiro Nagata, Kazue Shimizu, Yoshika Koinuma, Yukiko Namba, Jun Ito, Toshimasa Uekusa, Kazuhisa Takahashi
BACKGROUND: Receptor for advanced glycation end-products (RAGE), a receptor for amyloids, is constitutively expressed in lungs and generally observed to be downregulated in lung cancer tissues. However, increasing levels of RAGE or serum amyloids is associated with poor outcome in lung cancer patients. We report a rare case of primary systemic amyloid light-chain (AL) amyloidosis in biopsy-proven multiple organs with early-stage non-small cell lung cancer (NSCLC) that displayed strong staining for RAGE in the tumour tissue...
January 5, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28043483/outcome-of-patients-with-pn2-potentially-resectable-nonsmall-cell-lung-cancer-who-underwent-surgery-after-induction-chemotherapy
#11
Lorenzo Spaggiari, Monica Casiraghi, Juliana Guarize, Daniela Brambilla, Francesco Petrella, Patrick Maisonneuve, Filippo De Marinis
Patients with stage IIIA-ipsilateral mediastinal lymph node involvement (N2) non-small cell lung cancer (NSCLC) represent a heterogeneous group with different clinical presentation. The aim of this study was to analyze a series of patients with "potentially resectable" stage IIIA-pathologically proven N2 (pN2) NSCLC undergoing induction chemotherapy followed by surgery to evaluate their long-term outcomes and to identify prognostic factors. Out of 287 patients who underwent induction chemotherapy for NSCLC with ipsilateral mediastinal lymph node involvement pathologically proven, we retrospectively evaluated 141 (49%) patients with no clinical evidence of progression after induction chemotherapy and candidates for surgery...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27993403/biopsy-of-the-sentinel-node-in-lung-cancer
#12
Naia Uribe-Etxebarria Lugariza-Aresti, Ramón Barceló Galíndez, Joaquín Pac Ferrer, Jaime Méndez Martín, Jose Genollá Subirats, Juan Casanova Viudez
INTRODUCTION AND OBJECTIVE: Mediastinal lymph node involvement can be understaged in cases of lung cancer (up to 20% in stage i). Sentinel node detection is a standard technique recommended in breast cancer and melanoma action guidelines, and could also be useful in cases of lung cancer. MATERIAL AND METHODS: Considering the detection of the sentinel node in non-small cell lung cancer (NSCLC) as feasible, a prospective cohort study was carried out on 48 patients with resectable NSCLC, using the intraoperative injection of colloid sulphate technetium-99...
December 16, 2016: Medicina Clínica
https://www.readbyqxmd.com/read/27942412/surgical-management-of-oligometastatic-non-small-cell-lung-cancer
#13
REVIEW
Nuria M Novoa, Gonzalo Varela, Marcelo F Jiménez
The oligometastatic stage IV non-small cell lung cancer (NSCLC) offers a new surgical opportunity. New reported data is showing that surgery can offer a reasonable benefit, in terms of long-term survival, to some patients. The advantages of surgical treatment rely on a more adequate patient selection and a better understanding of the biology of these tumors. Currently, mediastinal involvement of the primary tumor can be identified as the most important prognostic variable after curative-intent of synchronous or metachronous metastasis...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27931198/fdg-pet-parameters-predicting-mediastinal-malignancy-in-lung-cancer
#14
M Serra Fortuny, M Gallego, Ll Berna, C Montón, L Vigil, M J Masdeu, A Fernández-Villar, M I Botana, R Cordovilla, R García-Luján, E Cases, E Monsó
BACKGROUND: Staging of mediastinal lymph nodes in non-small cell lung cancer (NSCLC) is mandatory. The maximum Standard Uptake Value (SUVmax) obtained using F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) is the best non-invasive technique available for this evaluation, but its performance varies from center to center. The aim of the present study was to identify FDG-PET predictors of mediastinal malignancy that are able to minimize intercenter variability and improve the selection of subsequent staging procedures...
December 8, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27912764/sbrt-for-centrally-localized-nsclc-what-is-too-central
#15
J Roesch, C Panje, F Sterzing, F Mantel, U Nestle, N Andratschke, M Guckenberger
PURPOSE: Current guidelines recommend stereotactic body radiotherapy (SBRT) for stage I non-small-cell lung cancer (NSCLC) in medically inoperable patients. There are excellent outcome and toxicity data for SBRT of peripheral lung tumors. However, the discussion on SBRT for centrally located tumors is controversial. This study evaluated current clinical practice regarding SBRT of centrally located lung tumors, to identify common fractionation schedules and commonly accepted contraindications for SBRT...
December 3, 2016: Radiation Oncology
https://www.readbyqxmd.com/read/27884195/lymph-node-ratio-as-a-prognostic-factor-in-patients-with-pathological-n2-non-small-cell-lung-cancer
#16
Masaya Tamura, Isao Matsumoto, Daisuke Saito, Shuhei Yoshida, Munehisa Takata, Hirofumi Takemura
BACKGROUND: The aim of this study was to investigate whether the lymph node ratio (LNR) was associated with the prognosis of patients, who underwent surgery for pathological N2 non-small cell lung cancer (NSCLC). METHODS: A total of 182 patients were diagnosed with pathological N2 disease and underwent complete resection surgeries with systematic lymphadenectomies. We counted the number of positives and removed lymph nodes to calculate a ratio between them (LNR)...
November 25, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27870565/concurrent-chemotherapy-and-radiation-therapy-for-inoperable-locally-advanced-non-small-cell-lung-cancer
#17
Kenneth E Rosenzweig, Jorge E Gomez
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
January 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27866516/-gsi-quantitative-parameters-preoperative-diagnosis-of-metastasis-lymph-nodes-in-lung-cancer
#18
Fengfeng Yang, Jie Dong, Xiaolong Yan, Xiuting Wang, Xiaojiao Fu, Tong Zhang
BACKGROUND: Mediastinal involvement in lung cancer is an important prognostic factor affecting survival, and accurate staging of the mediastinum lymph node correctly identifies patients who can benefit the most from surgery. The aim of this study is to investigate the value of dual-energy spectral computed tomography (DEsCT) imaging in differentiating metastatic from non-metastatic lymph nodes in lung cancer. METHODS: Forty-eight patients with non-small cell lung cancer (NSCLC) underwent arterial (AP) and portal venous (PP) phase contrast-enhanced DEsCT imaging followed by surgical treatment...
November 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/27826571/lymph-node-dissection-after-pulmonary-resection-for-lung-cancer-a-mini-review
#19
REVIEW
Stylianos Korasidis, Cecilia Menna, Claudio Andreetti, Giulio Maurizi, Antonio D'Andrilli, Anna Maria Ciccone, Francesco Cassiano, Erino Angelo Rendina, Mohsen Ibrahim
An accurate staging of a malignant disease is imperative in order to plan pre- and post-operative therapy, define prognosis and compare studies. According to the European Society of Thoracic Surgeons (ESTS) guidelines a systematic lymph node (LN) dissection is recommended in all cases of pulmonary resection for non-small cell lung cancer (NSCLC). The current lung cancer staging system considers the lymphatic stations involved but not the number of LNs. Up to date, published scientific studies on hilar and mediastinal lymphadenectomy mainly have been regarded the type of LN dissection procedure after pulmonary resection (selected LN biopsy, LN sampling, systematic nodal dissection, lobe specific nodal dissection and extended LN dissection) focusing particularly on the comparison between mediastinal LN dissection (MLND) and mediastinal LN sampling (MLNS)...
October 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27794400/pre-and-postoperative-care-for-stage-i-iii-nsclc-which-quality-of-care-indicators-are-evidence-based
#20
REVIEW
Rachel C Numan, Martijn Ten Berge, Jacobus A Burgers, Houke M Klomp, Johanna W van Sandick, Paul Baas, Michel W Wouters
Identification of evidenced-based Quality of Care (QoC) indicators for lung cancer care is essential to quality improvement. The aim of this review was to identify evidence-based quality indicators for the pre- and postoperative care of stage I-III Non Small Cell Lung Cancer (NSCLC) provided by the lung physician. To obtain these indicators, a search in PubMed, Embase and the Cochrane library database was performed. English literature published between 1980 and 2012 was included and search terms regarding 'lung neoplasms', 'quality of care', 'pathology', 'diagnostic methods', 'preoperative and postoperative treatment' were used...
November 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
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