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Preoperative chemotherapy of NSCLC

Ryu Kanzaki, Naoko Ose, Tomohiro Kawamura, Soichiro Funaki, Yasushi Shintani, Masato Minami, Nobuyuki Takakura, Meinoshin Okumura
BACKGROUND: PDGFR-β is used as a stromal biomarker and is functional in mesenchymal cells of the tumor microenvironment. The significance of stromal PDGFR-β expression in non-small cell lung cancer (NSCLC) in patients undergoing preoperative chemo- or chemoradiotherapy had not been determined. METHODS: Patients with NSCLC undergoing preoperative chemo- or chemoradiotherapy between 1996 and 2014 were assessed for expression of stromal PDGFR-β by immunohistochemistry using resected specimens...
March 6, 2018: World Journal of Surgery
Takuma Tsukioka, Nobuhiro Izumi, Chung Kyukwang, Hiroaki Komatsu, Michihito Toda, Kantaro Hara, Noritoshi Nishiyama
BACKGROUND: We often experienced early recurrence in patients with completely resected N2-positive non-small-cell lung cancer (NSCLC). Loss of muscle mass is a poor prognostic factor in patients with several stages of NSCLC. This study aimed to investigate the relationship between preoperative loss of muscle mass and postoperative early recurrence in patients with N2-positive NSCLC. METHODS: We retrospectively analyzed 47 male patients with completely resected pathological N2-positive NSCLC...
February 16, 2018: Annals of Thoracic and Cardiovascular Surgery
Kang-Seo Park, Yong Wha Moon, Mark Raffeld, Dae Ho Lee, Yisong Wang, Giuseppe Giaccone
OBJECTIVES: Cripto-1 (CR-1) plays a critical role in the activation of SMAD, SRC, and epithelial-to-mesenchymal transition (EMT) pathways and has been shown to be prognostic in several cancer types. In addition, we showed that CR-1 renders EGFR-mutated NSCLC cells resistant to EGFR-TKI through the activation of SRC and EMT via miR-205 downregulation. This study aimed to investigate the correlation between expression of CR-1 and miR-205 and prognosis of NSCLC patients with or without EGFR mutations...
February 2018: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
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
T Wang, T Yan, S Ma, K Wang, J Wang, J Song, W He, J Bai, L Jin
BACKGROUND: The efficacy of surgery alone for patients with nonsmall cell lung cancer (NSCLC) is still unsatisfactory. Preoperative chemotherapy (PCT) is proven effective induction therapies followed by surgery; however, few their superiority remains uncertain. We performed a systemic review and meta-analysis to evaluate the safety and efficacy of the PCT for NSCLC patients. MATERIALS AND METHODS: A literature search was performed in the PubMed, China National Knowledge Infrastructure and Cochrane databases...
January 2017: Indian Journal of Cancer
Shun-Ichi Watanabe, Kazuo Nakagawa, Kenji Suzuki, Kazuya Takamochi, Hiroyuki Ito, Jiro Okami, Keiju Aokage, Hisashi Saji, Hiroshige Yoshioka, Yoshitaka Zenke, Tadashi Aoki, Yasuhiro Tsutani, Morihito Okada
The treatments for advanced non-small cell lung cancer (NSCLC) should control both local and microscopic systemic disease, because the 5-year survival of patients with Stage III NSCLC who underwent surgical resection alone has been dismal. One way to improve surgical outcome is the administration of chemotherapy before or after the surgical procedure. During the last two decades, many clinical studies have focused on developing optimal adjuvant or neoadjuvant chemotherapy regimens that can be combined with surgical treatment and/or radiotherapy...
December 1, 2017: Japanese Journal of Clinical Oncology
Melissa A L Vyfhuis, Neha Bhooshan, Whitney M Burrows, Michelle Turner, Mohan Suntharalingam, James Donahue, Elizabeth M Nichols, Josephine Feliciano, Søren M Bentzen, Shahed Badiyan, Shamus R Carr, Joseph Friedberg, Charles B Simone, Martin J Edelman, Steven J Feigenberg, Pranshu Mohindra
Purpose: Guidelines for locally advanced non-small cell lung cancer (LA-NSCLC) recommend definitive chemoradiation therapy (CRT) for cN2-N3 disease, reserving surgery for patients with minimal nodal involvement at presentation. The current literature suggests that surgery after CRT for stage III NSCLC can improve freedom-from-recurrence (FFR) but has not consistently demonstrated an improvement in overall survival, perhaps partly due to the low (45-50.4 Gy) preoperative doses delivered that result in low rates of mediastinal nodal clearance...
July 2017: Advances in Radiation Oncology
Michihito Toda, Takuma Tsukioka, Nobuhiro Izumi, Hiroaki Komatsu, Satoshi Okada, Kantaro Hara, Hikaru Miyamoto, Ryuichi Ito, Toshihiko Shibata, Noritoshi Nishiyama
BACKGROUND: Markers of preoperative tumor immunity, such as platelet-to-lymphocyte ratio (PLR), have been reported to be prognostic factors for patients with various cancers. However, the relationship between PLR and the prognosis of non-small cell lung cancer (NSCLC) patients treated with surgery and adjuvant chemotherapy as a multidisciplinary treatment is unknown. METHODS: We enrolled 327 NSCLC patients treated surgically with or without adjuvant chemotherapy (78 and 249 patients, respectively) at our hospital from 2008 to 2012...
November 3, 2017: Thoracic Cancer
Jong-Mu Sun, Jae Myung Noh, Dongryul Oh, Hong Kwan Kim, Se-Hoon Lee, Yong Soo Choi, Hongryull Pyo, Jin Seok Ahn, Sin-Ho Jung, Yong Chan Ahn, Jhingook Kim, Myung-Ju Ahn, Jae Ill Zo, Young Mog Shim, Keunchil Park
INTRODUCTION: We investigated whether concurrent chemoradiotherapy (CCRT) would increase survival in patients with completely resected unsuspected N2-positive NSCLC versus in patients who received adjuvant chemotherapy alone. METHODS: Eligible patients were randomly assigned (1:1) to either the CCRT arm or the chemotherapy arm. In the CCRT arm, patients received concurrent thoracic radiotherapy (50 Gy in 25 fractions) with five cycles of weekly paclitaxel (50 mg/m2 ) and cisplatin (25 mg/m2 ), followed by two additional cycles of paclitaxel (175 mg/m2 ) plus cisplatin (80 mg/m2 ) at 3-week intervals...
December 2017: Journal of Thoracic Oncology
Nobuyasu Kurihara, Hajime Saito, Hiroshi Nanjo, Hayato Konno, Yoshihiro Minamiya
A 56-year-old man presented with a chest computed tomography (CT) finding of a right upper lobe nodule, which was diagnosed using brush cytology as adenocarcinoma stage IB (cT2aN0M0). Repeat CT scan for preoperative evaluation revealed a small, slightly hypodense spot in the pancreatic body, which was diagnosed as pancreatic metastasis from lung cancer using endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB). Because of the presence of distant metastasis, surgical resection was deferred and chemotherapy was chosen instead...
September 19, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Qing-Feng Liu, Zhi-Fei Zhang, Guang-Jie Hou, Guang-Yu Yang, Yi He
OBJECTIVES: To evaluate the prognostic relevance of four functional single nucleotide polymorphisms (SNPs) in CD133 (rs2240688A>C, rs10022537T>A, rs7686732C>G, and rs3130C>T) on overall survival (OS) of non-small cell lung cancer (NSCLC) patients. DESIGN: Retrospective cohort study. SETTING: Department of General Surgery, in a general hospital, Henan Province, China. PARTICIPANTS: NSCLC patients aged ≥18 years, who were not receiving preoperative neoadjuvant therapies and had a blood sample available for genotyping, were eligible for inclusion...
August 21, 2017: BMJ Open
William G Breen, Kenneth W Merrell, Aaron S Mansfield, Dennis A Wigle, Yolanda I Garces, Sean S Park, Kenneth R Olivier, Christopher L Hallemeier
PURPOSE: For patients with stage III (N2) non-small cell lung cancer (NSCLC) treated with surgical resection, postoperative chemotherapy improves overall survival (OS), but the role of postoperative radiation therapy (PORT) is controversial. The purpose of this study was to evaluate risk factors for local-regional recurrence and to evaluate the impact of PORT on local-regional control (LRC) and OS in a modern series of patients with surgically resected stage III (N2) NSCLC. METHODS AND MATERIALS: A retrospective review was performed of patients with Stage III (N2) NSCLC who underwent curative intent resection at our institution between February 1999 and January 2012...
January 2017: Advances in Radiation Oncology
Milan Savic, Milica Kontic, Maja Ercegovac, Jelena Stojsic, Slavisa Bascarevic, Dejan Moskovljevic, Marko Kostic, Radomir Vesovic, Spasoje Popevic, Marija Laban, Jelena Markovic, Dragana Jovanovic
BACKGROUND: In spite of the progress made in neoadjuvant therapy for operable non small-cell lung cancer (NSCLC), many issues remain unsolved, especially in locally advanced stage IIIA. METHODS: Retrospective data of 163 patients diagnosed with stage IIIA NSCLC after surgery was analyzed. The patients were divided into two groups: a preoperative chemotherapy group including 59 patients who received platinum-etoposide doublet treatment before surgery, and an upfront surgery group including 104 patients for whom surgical resection was the first treatment step...
September 2017: Thoracic Cancer
Erdoğan Cetinkaya, Ozan Usluer, Aydın Yılmaz, Nuri Tutar, Ertan Çam, Mehmet Akif Özgül, Nilgün Yılmaz Demirci
BACKGROUND AND OBJECTIVES: Selecting the diagnostic procedure for mediastinal restaging after chemotherapy and/or radiotherapy in Stage IIIA-N2 non-small cell lung cancer (NSCLC) patients remains a problem. The aim of the study was to determine the efficacy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the evaluation of mediastinal lymph nodes in the restaging of NSCLC patients. MATERIALS AND METHODS: The present multicentric study retrospectively analyzed the results of Stage IIIA-N2 NSCLC patients who had undergone EBUS for mediastinal restaging after preoperative chemotherapy or radiotherapy or both...
May 2017: Endoscopic Ultrasound
P Song, R C Zang, M Y Zhang, L Liu, S G Gao
Objective: To study the prognostic factors for patients with stage ⅠB non-small cell lung cancer (NSCLC) after radical operation (R0). Methods: The clinical data of 458 patients who underwent radical resection for NSCLC and were pathologically diagnosed with stage ⅠB lung cancer from January 2009 to December 2010, were reviewed retrospectively. Those cases include 269 male patients and 189 female, aged between 28 and 88, with a median age of 61 years. The Kaplan-Meier method and Log rank test were used for univariate survival analysis and the Cox proportional hazards model for multivariate survival analysis...
April 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
Fei Xiao, Deruo Liu, Yongqing Guo, Bin Shi, Zhiyi Song, Yanchu Tian, Zhenrong Zhang, Chaoyang Liang
BACKGROUND: The diagnosis, staging, and therapeutic strategy for synchronous multiple primary non-small cell lung cancer (SMP-NSCLC) remain unclear. Distinguishing SMP-NSCLC from intrapulmonary metastasis is difficult but of great importance for selecting the surgical procedure and prognoses. METHODS: Fifty-two patients diagnosed with SMP-NSCLC according to the modified Martini-Melamed criteria in the thoracic surgery department of the China-Japan Friendship Hospital from November 2004 to December 2015 were enrolled in this retrospective study...
April 2017: Journal of Thoracic Disease
Vishesh Agrawal, Thibaud P Coroller, Ying Hou, Stephanie W Lee, John L Romano, Elizabeth H Baldini, Aileen B Chen, David Kozono, Scott J Swanson, Jon O Wee, Hugo J W L Aerts, Raymond H Mak
BACKGROUND: Locally advanced non-small cell lung cancer (LA-NSCLC) patients have poorer survival and local control with mediastinal node (N2) tumor involvement at resection. Earlier assessment of nodal burden could inform clinical decision-making prior to surgery. This study evaluated the association between clinical outcomes and lymph node volume before and after neoadjuvant therapy. MATERIALS AND METHODS: CT imaging of patients with operable LA-NSCLC treated with chemoradiation and surgical resection was assessed...
2017: PloS One
Paul E Van Schil, Krishan Yogeswaran, Jeroen M Hendriks, Patrick Lauwers, Corinne Faivre-Finn
Stage IIIA-N2 non-small cell lung cancer (NSCLC) represents a heterogeneous group of bronchogenic carcinomas with locoregional involvement. Different categories of N2 disease exist, ranging from unexpectedly encountered N2 involvement after detailed preoperative staging or 'surprise' N2, to potentially resectable disease treated within a combined modality setting, and finally, bulky N2 involvement treated by chemoradiation. Areas covered: Large randomised controlled trials and meta-analyses on stage IIIA-N2 NSCLC have been published but their implications for treatment remain a matter of debate...
June 2017: Expert Review of Anticancer Therapy
Tomohito Saito, Koji Tsuta, Kento J Fukumoto, Hiroshi Matsui, Toshifumi Konobu, Yoshitaro Torii, Takashi Yokoi, Takayasu Kurata, Hiroaki Kurokawa, Yoshiko Uemura, Yukihito Saito, Tomohiro Murakawa
BACKGROUND: Combined small cell lung carcinoma (SCLC) is defined as SCLC combined with elements of non-small cell lung carcinoma (NSCLC), accounting for approximately 30% of cases of SCLC. However, combined SCLC and giant cell carcinoma (GC) is very rare. CASE PRESENTATION: A 50-year-old woman with a 45 pack-year smoking history was referred to our hospital for further investigation of an abnormal left hilar shadow. Chest computed tomography (CT) revealed a 28-mm solid pulmonary nodule in the left lower lobe and an enlarged left hilar lymph node adjacent to the left main pulmonary artery...
December 2017: Surgical Case Reports
Cuiping Tang, Si Qin, Wanchun Wu, Yang Wu, Tao Zhang
BACKGROUND: The therapeutic effect and side effect of neoadjuvant chemotherapy were still disputing issues when applied to resectable IIIa stage non-small cell lung cancer (NSCLC) patients. The retrospective analysis was aimed to investigate the short-term efficacy and postoperative complications in resectable IIIa NSCLC patients treated with neoadjuvant chemotherapy. METHODS: According to inclusion criteria and exclusion criteria, 370 patients with clinical diagnosis of IIIa NSCLC were selected from our hospital between January 2011 and October 2013 were retrospectively analyzed...
February 20, 2017: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
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