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Non-small cell Lung cancer mediastinal staging

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https://www.readbyqxmd.com/read/29901532/sampling-utility-of-the-convex-probe-endobronchial-ultrasound-visible-intrapulmonary-lesion
#1
Francisco A Almeida, Shameen Salam, Atul C Mehta, Luke Yuhico, Yash Sarda, Humberto Choi, Joseph C Cicenia, Thomas Gildea, Michael Machuzak, Peter Mazzone, Eduardo Oliveira, Sonali Sethi, Xiao-Feng Wang, Jordan P Reynolds
BACKGROUND: The value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the mediastinal staging of lung cancer has been well established. However, data regarding its utility in the diagnosis of intrapulmonary lesions has been sparse. This study assesses the sampling utility of convex probe EBUS-visible intrapulmonary lesions not visualized by the white-light bronchoscopy. METHODS: A retrospective analysis of EBUS-TBNA of EBUS-visible intrapulmonary lesions was performed between January 2010 and March 2015...
June 12, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29850149/induction-chemoradiotherapy-versus-induction-chemotherapy-for-potentially-resectable-stage-iiia-n2-non-small-cell-lung-cancer-a-systematic-review-and-meta-analysis
#2
Shaodong Tong, Zhaohui Qin, Minghui Wan, Longzhen Zhang, Yan Cui, Yuanhu Yao
Background: Non-small cell lung cancer (NSCLC) accounts for 85% to 90% of lung cancer cases. At diagnosis, around 30% of NSCLC patients are already at stage IIIA (N2). One standard treatment for this stage is induction chemotherapy followed by surgery, whether induction chemoradiotherapy is superior to induction chemotherapy remains uncertain. We therefore performed a systematic review and meta-analysis of published randomized control trials to evaluate the therapeutic efficacy and toxicity of induction chemoradiotherapy versus induction chemotherapy for potentially resectable stage IIIA (N2) NSCLC...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29803524/use-of-magnetic-resonance-imaging-for-n-staging-in-patients-with-non-small-cell-lung-cancer-a-systematic-review
#3
Tara Pereiro Brea, Alberto Ruano Raviña, José Martín Carreira Villamor, Antonio Golpe Gómez, Anxo Martínez de Alegría, Luís Valdés
INTRODUCTION: The aim of this study is to assess the diagnostic value of the magnetic resonance imaging (MRI) in differentiating metastasic from non-metastatic lymph nodes in NSCLC patients compared with computed tomography (CT) and fluorodeoxyglucose (FDG) - positron emission tomography (PET) or both combined. METHODS: Twenty-three studies (19 studies and 4 meta-analysis) with sample size ranging between 22 and 250 patients were included in this analysis. MRI, regardless of the sequence obtained, where used for the evaluation of N-staging of NSCLC...
May 23, 2018: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/29776444/mediastinal-staging-of-non-small-cell-lung-cancer-by-endobronchial-and-endoscopic-ultrasonography-with-or-without-additional-surgical-mediastinoscopy-mediastrial-study-protocol-of-a-multicenter-randomised-controlled-trial
#4
Jelle E Bousema, Marcel G W Dijkgraaf, Nicole E Papen-Botterhuis, Hermien W Schreurs, Jos G Maessen, Erik H van der Heijden, Willem H Steup, Jerry Braun, Valentin J J M Noyez, Fieke Hoeijmakers, Naomi Beck, Martijn van Dorp, Niels J M Claessens, Birgitta I Hiddinga, Johannes M A Daniels, David J Heineman, Harmen R Zandbergen, Ad F T M Verhagen, Paul E van Schil, Jouke T Annema, Frank J C van den Broek
BACKGROUND: In case of suspicious lymph nodes on computed tomography (CT) or fluorodeoxyglucose positron emission tomography (FDG-PET), advanced tumour size or central tumour location in patients with suspected non-small cell lung cancer (NSCLC), Dutch and European guidelines recommend mediastinal staging by endosonography (endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS)) with sampling of mediastinal lymph nodes. If biopsy results from endosonography turn out negative, additional surgical staging of the mediastinum by mediastinoscopy is advised to prevent unnecessary lung resection due to false negative endosonography findings...
May 18, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29759332/sunset-stereotactic-radiation-for-ultracentral-non-small-cell-lung-cancer-a-safety-and-efficacy-trial
#5
Meredith Giuliani, Ashwathy S Mathew, Houda Bahig, Scott V Bratman, Edith Filion, Daniel Glick, Alexander V Louie, Srinivas Raman, Anand Swaminath, Andrew Warner, Vivian Yau, David Palma
BACKGROUND: Lung stereotactic body radiotherapy (SBRT) is considered a standard curative treatment for medically inoperable early stage non-small-cell lung cancer (NSCLC). Patients with ultracentral tumors (signifying tumors whose planning target volume touches or overlaps the central bronchial tree, esophagus, or pulmonary artery) may be at higher risk of serious toxicities such as bronchial stricture and collapse, esophageal strictures, tracheal-esophageal fistula, and hemorrhage. The primary objective of the study is to determine the maximum tolerated dose of radiotherapy for ultracentral NSCLC...
April 18, 2018: Clinical Lung Cancer
https://www.readbyqxmd.com/read/29755071/-salvage-surgery-after-radical-chemotherapy-for-n3-non-small-cell-lung-cancer
#6
Takehiko Shimoyama, Bumpei Kimura
A 49-year-old man was admitted to our hospital for an abnormal chest shadow. Computed tomography showed a pulmonary nodular shadow in the right upper lobe and swelling of the right hilar, mediastinal and supraclavicular lymph nodes. A positron emission tomography(PET) scan showed fluorodeoxyglucose accumulation in the tumor and swollen lymph nodes. He was diagnosed with stage cT1aN3M0 (ⅢB) pulmonary adenocarcinoma and was treated with a combination of cisplatin and paclitaxel. After 6 cycles of chemotherapy, serum carcinoembryonic antigen (CEA) level was markedly decreased...
March 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29707351/endobronchial-ultrasound-guided-transbronchial-needle-aspiration-and-cervical-mediastinoscopy-for-mediastinal-staging-of-non-small-cell-lung-cancer-a-retrospective-comparison-study
#7
Rong Zhang, Yuxiang Ma, Guoliang Xu, Xiaoyan Gao, Guangyu Luo, Qingguang Lin, Yunpeng Yang, Xin Wang, Li Zhang
Background: Invasive mediastinal lymph node staging is essential to resectable non-small cell lung cancer (NSCLC) patients. This retrospective study aimed to compare the diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) against cervical mediastinoscopy (CMS) in radiologically enlarged mediastinal lymph nodes. Methods: Retrospective data were collected from January 2009 to March 2016. Suspected lung cancer patients with enlarged mediastinal lymph nodes (short axis ≥10 mm), underwent EBUS-TBNA or CMS for invasive mediastinal staging were enrolled...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29686741/endobronchial-ultrasound-transbronchial-needle-aspiration-in-thoracic-diseases-much-more-than-mediastinal-staging
#8
Juliana Guarize, Monica Casiraghi, Stefano Donghi, Cristina Diotti, Nicolo Vanoni, Rosalia Romano, Chiara Casadio, Daniela Brambilla, Patrick Maisonneuve, Francesco Petrella, Lorenzo Spaggiari
Background and Objective: EBUS-TBNA has revolutionized the diagnostic approach to thoracic diseases from a surgical to minimally invasive procedure. In non small-cell lung cancer (NCSLC) patients, EBUS-TBNA is able to dictate the consecutive therapy both for early and advanced stages, providing pathological diagnosis, mediastinal staging, and even adequate specimens for molecular analysis. This study reports on the ability of EBUS-TBNA to make different diagnoses and dictates the consecutive therapy in a large cohort of patients presenting different thoracic diseases...
2018: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/29684288/endobronchial-ultrasound-for-nodal-staging-of-non-small-cell-lung-cancer-patients-with-radiologically-normal-mediastinum-a-meta-analysis
#9
Hazem El-Osta, Pushan Jani, Ali Mansour, Philip Rascoe, Syed Jafri
RATIONALE: An accurate assessment of the mediastinal lymph nodes status is essential in the staging and treatment planning of potentially resectable non-small cell lung cancer (NSCLC). OBJECTIVES: We performed this meta-analysis to evaluate the role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in detecting occult mediastinal disease in NSCLC with no radiologic mediastinal involvement. METHODS: The PubMed, Embase, and Cochrane libraries were searched for studies describing the role of EBUS-TBNA in lung cancer patients with radiologically negative mediastinum...
April 23, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29666816/surgical-approach-in-oligometastatic-non-small-cell-lung-cancer
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
Raja Flores, Emanuela Taioli, David F Yankelevitz, Betsy J Becker, Artit Jirapatnakul, Anthony Reeves, Rebecca Schwartz, Rowena Yip, Esther Fevrier, Kathleen Tam, Benjamin Steiger, Claudia I Henschke
INTRODUCTION: To maximize the benefits of computed tomographic screening for lung cancer, optimal treatment 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 23, 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
#18
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...
June 1, 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
#19
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
#20
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)...
June 2018: Journal of Thoracic and Cardiovascular Surgery
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