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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
Kenji Yorita, Kazuya Tsuji, Yoko Takano, Naoto Kuroda, Kei Sakamoto, Kaoru Arii, Yukio Yoshimoto, Kimiko Nakatani, Satoshi Ito
BACKGROUND: Acantholytic squamous cell carcinoma (ASQCC), histologically characterized by intercellular bridge loosening, is recognized as a rare variant of squamous cell carcinoma (SQCC). ASQCC may demonstrate a worse prognosis than conventional SQCC. Pulmonary ASQCC is particularly rare; its biological behavior and prognostic data have not been reported. CASE PRESENTATION: We report the clinical and autopsy findings of a 71-year-old Japanese man with pulmonary ASQCC...
March 16, 2018: BMC Cancer
Mustafa Kupeli, Resit Dogan Koseoglu
Large cell neuroendocrine carcinoma (LCNC) is a rare and aggressive cancer accounting for 3% of all lung cancers. A small percentage of LCNC called combined LCNC, can be seen in combinations with other lung tumor types. Multimodal therapy is proposed for this type of tumor but there is no any significant therapy since it is very rare tumor. This patient was a 66-year male and a heavy smoker with no symptoms of lung disease. Computed tomography core biopsy showed suspected adenocarcinoma. Right lower lobectomy was performed with mediastinal lymph node dissection via mini thoracotomy...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Brett W Carter, John P Lichtenberger, Marcelo K Benveniste, Patricia M de Groot, Carol C Wu, Jeremy J Erasmus, Mylene T Truong
Lung cancer remains the leading cause of cancer-related mortality worldwide. To formulate effective treatment strategies and optimize patient outcomes, accurate staging is essential. Lung cancer staging has traditionally relied on a TNM staging system, for which the International Association for the Study of Lung Cancer (IASLC) has recently proposed changes. The revised classification for this eighth edition of the TNM staging system (TNM-8) is based on detailed analysis of a new large international database of lung cancer cases assembled by the IASLC for the purposes of this project...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Shaohua Ma, Tiansheng Yan, Keyi Wang, Jingdi Wang, Jintao Song, Tong Wang, Wei He, Jie Bai, Liang Jin, Hailong Liang
BACKGROUND: Segmentectomy can retains more healthy lung tissue than lobectomy, but it remains controversial in oncology for early stage lung cancer. The aim of this study is to discuss the problems of video-assisted thoracic surgery (VATS) segmentectomy in early stage lung cancer, by analyzing the clinical and pathological data of 35 cases and reviewing the literature. METHODS: There were 35 patients who received segmentectomy by complete video-assisted thoracic surgery, from May 2013 to July 2017, in single operation group in the Third Hospital of Peking University...
February 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Wen-Wen Huang, Wen-Zhi Zhu, Dong-Liang Mu, Xin-Qiang Ji, Xiao-Lu Nie, Xue-Ying Li, Dong-Xin Wang, Daqing Ma
BACKGROUND: Surgical resection is the main treatment for patients with non-small-cell lung cancer (NSCLC), but patients' long-term outcome is still challenging. The purpose of this study was to identify predictors of long-term survival in patients after lung cancer surgery. METHODS: Patients who underwent surgery for NSCLC from January 1, 2006, to December 31, 2009, were enrolled into this retrospective cohort study. The primary outcome was the survival length after surgery...
March 6, 2018: Anesthesia and Analgesia
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
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
Youngkyu Moon, Jae Kil Park, Kyo Young Lee, Min Namkoong, Seha Ahn
BACKGROUND: In clinical T1N0 peripheral lung cancers, lymph node upstaging is occasionally encountered postoperatively. However, nodal upstaging is rare in lung cancers presenting as ground-glass opacities. The aim of this study was to determine if lymph node upstaging could be reliably extrapolated from parameters such the consolidation/tumor ratio of chest computed tomography. METHODS: We conducted a retrospective study of 486 patients treated for peripheral clinical T1N0 non-small cell lung cancer, each undergoing lobectomy with mediastinal lymph node dissection...
February 15, 2018: World Journal of Surgery
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
Stephanie Volpi, Francesco Doenz, Salah D Qanadli
Superior vena cava (SVC) syndrome is a group of clinical signs caused by the obstruction or compression of SVC and characterized by edema of the head, neck, and upper extremities, shortness of breath, and headaches. The syndrome may be caused by benign causes but most of the cases are caused by lung or mediastinal malignant tumors. Stenting of SVC has become widely accepted as the palliative treatment for this condition in malignant diseases, as it offers rapid relief of symptoms and improves the quality of life...
2018: Frontiers in Surgery
Yeong Jeong Jeon, Yong Soo Choi, Kyung Jong Lee, Se Hoon Lee, Hongryull Pyo, Joon Young Choi
Background: We evaluated the feasibility and outcomes of pulmonary resection and mediastinal node dissection (MND) by video-assisted thoracoscopic surgery (VATS) following neoadjuvant therapy for stage IIIA N2 non-small cell lung cancer (NSCLC). Methods: From November 2009 to December 2013, a total of 35 consecutive patients with pathologically or radiologically confirmed stage IIIA N2 lung cancer underwent pulmonary resection and MND, performed by a single surgeon, following neoadjuvant chemoradiation...
February 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Fei Yao, Jian Wang, Ju Yao, Lei Xu, Junling Qian, Yongke Cao
BACKGROUND: Anatomic segmentectomy for stage I nonsmall cell lung cancer (NSCLC) has potential advantages such as preserving pulmonary function and reducing postoperative complications. However, many surgeons are deterred from this procedure for its anatomical complexity. Therefore, we presented our early experience with video-assisted thoracoscopic surgery (VATS) anatomic segmentectomy compared with our most recent VATS lobectomy cases. PATIENTS AND METHODS: Forty patients with cT1aN0M0 (ground-glass opacity [GGO] rate >50%) NSCLC underwent VATS segmentectomy from January 2015 to December 2016...
February 9, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Paul A VanderLaan, Deepa Rangachari, Adnan Majid, Mihir S Parikh, Sidharta P Gangadharan, Michael S Kent, Danielle C McDonald, Mark S Huberman, Susumu S Kobayashi, Daniel B Costa
INTRODUCTION: Although a growing list of essential genomic/immune-based biomarkers are linked to approved non-small-cell lung cancer (NSCLC) therapies worldwide, few reports have detailed the evolution of NSCLC predictive biomarker assessment in routine clinical practice. METHODS: We retrospectively reviewed the first one thousand plus NSCLC patient specimens from our institution analyzed for predictive biomarkers from 2004 to 2017 and evaluated patterns of testing as well as correlation with clinical-pathologic characteristics...
February 2018: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Jennifer Lewis, Erin A Gillaspie, Evan C Osmundson, Leora Horn
The treatment of patients with stage IIIA ( N 2) non-small cell lung cancer (NSCLC) is one of the most challenging and controversial areas of thoracic oncology. This heterogeneous group is characterized by varying tumor size and location, the potential for involvement of surrounding structures, and ipsilateral mediastinal lymph node spread. Neoadjuvant chemotherapy, administered prior to definitive local therapy, has been found to improve survival in patients with stage IIIA ( N 2) NSCLC. Concurrent chemoradiation has also been evaluated in phase III studies in efforts to improve control of locoregional disease...
2018: Frontiers in Oncology
Apichat Tantraworasin, Emanuela Taioli, Bian Liu, Andrew J Kaufman, Raja M Flores
BACKGROUND: Mediastinal lymph node evaluation (MLNE) is considered to be the standard of care in curative lung cancer surgery although it is not always performed. This study identifies factors associated with patients not being evaluated (non-MLNE) in cases of resectable non-small cell lung cancer. METHODS: A retrospective observational study using the Surveillance, Epidemiology, and End Results Program database was conducted. Adult patients diagnosed with non-small cell lung cancer stage I to IIIA (2004 to 2013) were included...
January 31, 2018: Annals of Thoracic Surgery
Yi Liu, Dongbo Luo, Tongxin Du, Hongjiang Wang
RATIONALE: Pulmonary blastoma is a rare primary lung cancer that can be categorized into adult type and child type. The clinical symptoms and imaging features of pulmonary blastoma are nonspecific, making it difficult to diagnose preoperatively. Postoperative pathology with immunohistochemical staining can help diagnosis. PATIENT CONCERNS: A 53-year-old male had chest tightness and shortness of breath. DIAGNOSES: The patient was diagnosed as pleural pulmonary blastoma based on computed tomography (CT) scan, pathology, immunohistochemistry, and molecular pathology...
December 2017: Medicine (Baltimore)
Juan Carlos Trujillo-Reyes, Elisabeth Martínez-Téllez, Ramón Rami-Porta, Carme Obiols, Sergi Call, Josep Belda-Sanchis
Surgical staging of lung and pleural cancers is crucial for planning treatment and assessing prognosis. In some cases, we need to explore both the mediastinum and the pleural cavity to confirm or rule out tumor dissemination. The combination of video-assisted mediastinoscopic lymphadenectomy (VAMLA) and thoracoscopy through a single transcervical incision allows the surgeon to widen the range of the exploration and improve the staging for lung and pleural cancers.  VAMLA consists of complete removal of the mediastinal fat and lymph nodes of the subcarinal space, the right paratracheal and pretracheal areas, and the left paratracheal space...
January 18, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Yuqiao Chen, Xiong Peng, Yuan Zhou, Kun Xia, Wei Zhuang
BACKGROUND: Induction chemotherapy has been shown to improve survival of patients with stage III A/N2 (T1-3, N2, M0) non-small cell lung cancer (NSCLC), followed by resection, but the benefits of neoadjuvant radiotherapy still remain controversial. METHODS: PubMed, Embase, and Cochrane library databases were searched for relevant randomized controlled trials (RCTs) comparing the outcomes of induction chemoradiotherapy over induction chemotherapy, in patients with resectable stage IIIA/N2 NSCLC...
January 16, 2018: World Journal of Surgical Oncology
Vidya Jha, Preeti Sharma, Ashish Kumar Mandal
Background: Mediastinum harbors a mixed bag of neoplastic lesions with varied therapeutic and prognostic implications. Distinguishing pulmonary squamous cell carcinoma from thymic carcinoma is a challenging task owing to rather nonspecific clinicoradiological features and a considerable overlap in histomorphological features. Thus, we evaluated the diagnostic utility of cluster of differentiation 5 (CD5) and CD117 immunohistochemical markers in distinguishing these tumors. Materials and Methods: The archives of department of histopathology were retrospectively reviewed from June 2012 to May 2016...
October 2017: Indian Journal of Medical and Paediatric Oncology
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