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Non-small cell lung cancer surgery

Gokoulakrichenane Loganadane, Florent Martinetti, Olaf Mercier, Samar Krhili, François-Georges Riet, Rodrigue Mbagui, Hanh To, Cécile Le Péchoux, Antonin Levy
Stereotactic ablative radiation therapy (SABR) has become the standard treatment for peripheral medically non-operable patients with early stage non-small cell lung cancer (NSCLC). Previous attempts of trials to compare SABR and surgery have failed and new randomized studies (SABRtooth, STABLEMATES, and VALOR) are ongoing. While predictive factors of relapse have been extensively studied in patients receiving surgery, there is scarce data on such putative factors in SABR patients. The purpose of this review is to analyze such predictive factors through a critical review of the literature...
October 13, 2016: Cancer Treatment Reviews
Leng Zhou, Haidan Lan, Qinghua Zhou, Xiao Jun Tang, Daxing Zhu, Jianming Yue, Bin Liu
BACKGROUND: Ulinastatin can prevent the perioperative increase in proinflammatory cytokines for lung resection surgery; however, its impact on early clinical outcomes remains unknown. METHODS: The study enrolled 108 non-small cell lung cancer (NSCLC) patients who were randomly allocated into two groups: ulinastatin (group U) and control (group C). Patients in group U ( n = 52) were continuously intravenously infused with ulinastatin at a rate of 20 000 U/kg/hour for the first hour after anesthesia induction, and then at a rate of 5000 U/kg/hour until the conclusion of surgery...
September 2016: Thoracic Cancer
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
Marcello Migliore, Alessandra Criscione, Damiano Calvo, Francesco Borrata, Marco Nardini, Paola Di Masi, Mariapia Gangemi, Francesco Scalieri
Several studies have demonstrated that for complex surgical procedures, surgeons who treat more patients have better outcomes than their lower-volume counterparts. The aim of this paper is to review the experience with video-assisted thoracic surgery (VATS) lobectomies in our small thoracic unit (group A), to understand whether our short-term results were different to the outcomes obtained by the same surgeon previously working in a high-volume unit (group B). Twenty six patients underwent VATS lobectomy. Hospital stay was on average 4...
October 21, 2016: Future Oncology
Yanjiao Zhang, Yushun Gao
BACKGROUND: Lung cancer is a malignancy with high morbidity and mortality rates worldwide. Surgery is the preferred treatment for non-small cell lung cancer. This study aims to investigate the effects of video-assisted thoracoscopic surgery (VATS) lobectomy, VATS segmentectomy, and open thoracotomy on pulmonary function in the early postoperative stage and compare the difference among three groups. METHODS: Pulmonary function data of patients were collected from September 2015 to February 2016 in Department of Thoracic Surgical Oncology, Cancer Hospital Chinese Academy of Medical Sciences...
October 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Yixiang Zhu, Puyuan Xing, Junling Li
Lung cancer is the deadliest cancer in the worldwide. Non-small cell lung cancer (NSCLC) accounts for 85% of lung tumor diagnoses. Squamous cell lung cancer (SQCLC) is a common pathological type, almost 20%-30% of NSCLC. Surgery, chemotherapy, and molecular targeted therapies are the mainstay of treatment for patients with SQCLC. But most patients are diagnosed at advanced stage so that they miss the chance of operation. While noteworthy outcomes have improved with adenocarcinoma of lung with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), a therapeutic plateau for advanced squamous cell lung cancer patients are still not solved...
October 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Kiyohiro Sakai, Masayuki Takeda, Hidetoshi Hayashi, Kaoru Tanaka, Takeshi Okuda, Amami Kato, Yasumasa Nishimura, Tetsuya Mitsudomi, Atsuko Koyama, Kazuhiko Nakagawa
INTRODUCTION: The concept of "oligometastasis" has emerged as a basis on which to identify patients with stage IV non-small cell lung cancer (NSCLC) who might be most amenable to curative treatment. Limited data have been available regarding the survival of patients with node-negative oligometastatic NSCLC. PATIENTS AND METHODS: Consecutive patients with advanced NSCLC who attended Kindai University Hospital between January 2007 and January 2016 were recruited to this retrospective study...
September 12, 2016: Thoracic Cancer
Edward J Caruana, Pierogiorgio Solli, Aman S Coonar
Chest wall invasion is seen in 5% to 8% of patients presenting with lung cancer. We report a case of complete resection of a 14 cm × 9 cm pT3N0M0 squamous cell carcinoma arising from the right lower lobe and invading the lower chest wall posteriorly, in a 75 years old male, via a hybrid thoracoscopic [video-assisted thoracoscopic surgery (VATS)] approach. Following conventional VATS lobectomy, a targeted 10 cm incision was performed to allow wide resection of the 7(th) to 10(th) ribs and 6(th) to 9(th) transverse processes, with the defect being subsequently reconstructed with a composite rigid prosthesis...
September 2016: Journal of Thoracic Disease
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
Alex Herskovic, Elizabeth Mauer, Paul Christos, Himanshu Nagar
BACKGROUND: The role of postoperative radiotherapy (PORT) in the treatment of pathologic stage IIIA (N2) non-small cell lung cancer (NSCLC) remains controversial. We investigated practice patterns and outcomes for these patients in a prospectively maintained nationwide oncology outcomes database. METHODS: Patients with known histologies of pathologic stage IIIA (N2) NSCLC who underwent surgery with negative margins and received adjuvant multiagent chemotherapy from 2004-2013 were identified from the National Cancer DataBase (NCDB) and stratified by the use of PORT...
October 13, 2016: Journal of Thoracic Oncology
Keiju Aokage, Morihito Okada, Kenji Suzuki, Shogo Nomura, Shigeki Suzuki, Norifumi Tsubokawa, Takahiro Mimae, Aritoshi Hattori, Tomoyuki Hishida, Junji Yoshida, Masahiro Tsuboi
OBJECTIVE: Exclusion of patients with a history of other cancer treatment except in situ situation has been considered to be inevitable for clinical trials investigating survival outcome. However, there have been few reports confirming these influences on surgical outcome of lung cancer patients ever. METHODS: Multi-institutional, individual data from patients with non-small cell lung cancer resected between 2000 and 2013 were collected. The patients were divided into two groups: those with a history of gastrointestinal tract cancer (GI group) and those without any history (non-GI group)...
October 15, 2016: Japanese Journal of Clinical Oncology
Alex Herskovic, Bhargava Chitti, Paul Christos, A Gabriella Wernicke, Bhupesh Parashar
OBJECTIVES: Limited work, either retrospective or prospective, has been done to investigate whether or not there is a cause-specific mortality (CSM) or all-cause mortality (ACM) benefit to adding surgery following neoadjuvant treatment for Stage IIIB NSCLC. METHODS: We extracted patients with Stage IIIB NSCLC from the Survival, Epidemiology, and End Results Program (SEER) database treated from 2004 to 2012 with either radiation alone or radiation followed by surgery...
October 14, 2016: World Journal of Surgery
Valerie W Rusch
More than 20% of non-small cell lung cancers (NSCLCs) are classified as stage III disease at diagnosis because they are locoregionally advanced tumors. Local therapy alone (surgery or radiation) leads to poor overall survival in stage III NSCLC because most of the patients with NSCLC die of distant metastases. Therefore, during the past 20 years, studies have focused on developing effective chemotherapy regimens that can be combined with local therapies (surgery and/or radiation). The role of surgery has been extensively evaluated and the selection criteria for resection defined...
October 2016: Seminars in Respiratory and Critical Care Medicine
Huan H Sun, Joanna Sesti, Jessica S Donington
Recent advances in the surgical treatment of early stage non-small cell lung cancer (NSCLC) have focused heavily on making procedures less invasive, less radical, and better tolerated. Advances in accuracy and increased utilization of cross-sectional imaging allows for diagnosis of smaller and more indolent tumors and preinvasive lesions. Similar to advanced disease, early-stage treatment is now being tailored to individual patients and their tumors. Sublobar resections are gaining acceptance as an oncologically equivalent approach to lobectomy in well-selected stage I patients...
October 2016: Seminars in Respiratory and Critical Care Medicine
Sarah Burdett, Larysa Rydzewska, Jayne Tierney, David Fisher, Mahesh Kb Parmar, Rodrigo Arriagada, Jean Pierre Pignon, Cecile Le Pechoux
BACKGROUND: The role of postoperative radiotherapy (PORT) in the treatment of patients with completely resected non-small cell lung cancer (NSCLC) was not clear. A systematic review and individual participant data meta-analysis was undertaken to evaluate available evidence from randomised controlled trials (RCTs). These results were first published in Lung Cancer in 2013. OBJECTIVES: To evaluate the effects of PORT on survival and recurrence in patients with completely resected NSCLC...
October 11, 2016: Cochrane Database of Systematic Reviews
Sarah J Gao, Christopher D Corso, Elyn H Wang, Justin D Blasberg, Frank C Detterbeck, Daniel J Boffa, Roy H Decker, Anthony W Kim
INTRODUCTION: A subset of patients with potentially resectable clinical stage IIIA non-small cell lung cancer (NSCLC) are managed with trimodality therapy. However, little data exist to guide the timing of surgery after neoadjuvant therapy. This study examined whether the time interval between neoadjuvant chemoradiation (NCRT) and surgical resection impacts overall survival. METHODS: Clinical stage IIIA disease (T1-3 N2) NSCLC patients who underwent neoadjuvant chemoradiation therapy were identified in the National Cancer Data Base (NCDB) between 2004-2012 and categorized based on the interval between chemoradiation and surgery (0 to ≤3, 3 to ≤6, 6 to ≤9, and 9 to ≤12 weeks)...
October 5, 2016: Journal of Thoracic Oncology
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
Soyeon Lee, Hyo Gyoung Kang, Jin Eun Choi, Jang Hyuck Lee, Hyo Jung Kang, Sun Ah Baek, Eungbae Lee, Yangki Seok, Won Kee Lee, Shin Yup Lee, Seung Soo Yoo, Jaehee Lee, Seung Ick Cha, Chang Ho Kim, Sukki Cho, Jae Yong Park
Vascular endothelial growth factor (VEGF) contributes to tumor angiogenesis. The role of VEGF single nucleotide polymorphisms (SNPs) in lung cancer susceptibility and its prognosis remains inconclusive and controversial. This study was performed to investigate whether VEGF polymorphisms affect survival outcomes of patients with early stage non-small cell lung cancer (NSCLC) after surgery. Three potentially functional VEGF SNPs (rs833061T>C, rs2010963G>C, and rs3025039C>T) were genotyped. A total of 782 NSCLC patients who were treated with surgical resection were enrolled...
November 2016: Journal of Korean Medical Science
Nan Ding, ZhaoFei Pang, Hongchang Shen, Yang Ni, Jiajun Du, Qi Liu
Recently, many studies have been conducted to explore prognostic value of platelet to lymphocyte ratio (PLR) for patients with lung cancer, while the results remain controversial. We collected pretreatment, clinicopathological and follow-up data of 1388 lung cancer patients receiving surgery between 2006 and 2011 in our hospital, and reviewed relevant articles from Embase, Pubmed, Web of science databases, then performed a meta-analysis to clarify the relationship between PLR and prognosis of lung cancer patients...
October 5, 2016: Scientific Reports
Hidehito Horinouchi
A number of promising new approaches for both local and systemic control of locally advanced non-small cell lung cancer have been examined in clinical trials, aimed at improving the patient survival. Development of better systemic therapies by adopting newer agents (such as epidermal growth factor receptor-tyrosine kinase inhibitors and immune checkpoint inhibitors) from advanced non-small cell lung cancer is mandatory. As for radiotherapy, adaptive radiotherapy and proton therapy are under investigation after the RTOG 0617 trial unexpectedly failed to show the efficacy of high-dose radiotherapy for Stage III disease...
October 4, 2016: Japanese Journal of Clinical Oncology
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