Peer review report 2 on “Is routine dissection of the station 9 lymph nodes really necessary for primary lung cancer? – Cohort study”

<div>Lung cancer causes the most cancer deaths worldwide and has one of the lowest five-year survival rates of all cancer types. It is reported that more than half of patients with lung cancer die within one year of being diagnosed. Because mediastinal lymph node status is the most important factor for the treatment and prognosis of lung cancer, the aim of this study is to improve the predictive value in assessing the computed tomography (CT) of mediastinal lymph-node malignancy in patients with primary lung cancer. This paper introduces a new method for creating pseudo-labeled images of CT regions of mediastinal lymph nodes by using the concept of recurrence analysis in nonlinear dynamics for the transfer learning. Pseudo-labeled images of original CT images are used as input into deep-learning models. Three popular pretrained convolutional neural networks (AlexNet, SqueezeNet, and DenseNet-201) were used for the implementation of the proposed concept for the classification of benign and malignant mediastinal lymph nodes using a public CT database. In comparison with the use of the original CT data, the results show the high performance of the transformed images for the task of classification. The proposed method has the potential for differentiating benign from malignant mediastinal lymph nodes on CT, and may provide a new way for studying lung cancer using radiology imaging. </div><div><br></div>

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Left upper lobectomy and systematic lymph nodes dissection in enlarged pulmonary hilar lymph nodes in primary lung cancer patient by uniportal video-assisted thoracic surgery

ASVIDE ◽

10.21037/asvide.2016.338 ◽

2016 ◽

Vol 3 ◽

pp. 338-338

Author(s):

Jun-Qiang Fan ◽

Jie Yao ◽

Zhi-Bo Chang ◽

Qi Wang

Keyword(s):

Lung Cancer ◽

Cancer Patient ◽

Thoracic Surgery ◽

Lymph Nodes ◽

Lung Cancer Patient ◽

Primary Lung Cancer ◽

Video Assisted Thoracic Surgery ◽

Video Assisted ◽

Left Upper Lobectomy ◽

Lymph Nodes Dissection

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Histological classification of regional lymph nodes in relation to postoperative survival in primary lung cancer

Human Pathology ◽

10.1016/s0046-8177(81)80256-0 ◽

1981 ◽

Vol 12 (11) ◽

pp. 1000-1005 ◽

Cited By ~ 8

Author(s):

Masanori Kitaichi ◽

Hitoshi Asamoto ◽

Takateru Izumi ◽

Mutsuhiro Furuta

Keyword(s):

Lung Cancer ◽

Lymph Nodes ◽

Primary Lung Cancer ◽

Postoperative Survival ◽

Histological Classification ◽

Regional Lymph Nodes

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Imaging Features and Clinical Decision Analysis of 110 Cases of Intrapulmonary Lymph Nodes

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0039-3400473 ◽

2019 ◽

Vol 68 (07) ◽

pp. 652-658

Author(s):

Zixu Liu ◽

Minjun Du ◽

Xingkai Li ◽

Shaolong Ju ◽

Yushun Gao

Keyword(s):

Lung Cancer ◽

Lymph Nodes ◽

Predictive Value ◽

Primary Lung Cancer ◽

Clinical Decision ◽

Risk Level ◽

Imaging Features ◽

Characteristic Imaging ◽

To Receive ◽

Score Table

Abstract Objective Through the summary and analysis of large samples, the characteristic imaging manifestations of intrapulmonary lymph nodes (IPLNs) were quantified, and two corresponding rating tables were developed. These rating tables could be used to distinguish the IPLNs from primary lung cancer, so as to improve the diagnostic accuracy and help clinicians make correct judgments and decisions. Methods A total of 82 patients with 110 IPLNs and 35 patients with primary lung cancer lesions were collected from June 2017 to December 2018. All lesions were solid nodules of less than 12 mm in diameter, which were confirmed by pathology. Observation indicators included location, size, shape, density, border and internal vacuoles of nodules, linear high-density shadow around the nodules, distance from the pleura, pleural indentation, and so on. Results There were statistically significant differences in the location, size, shape, internal vacuole of the nodules, and distance from the pleura (p < 0.05). The diagnostic scoring table of the nature of solid nodules and the malignant risk table were drawn. The nodule corresponding to Level A was most likely the primary lung cancer, and surgical resection was recommended. The nodule corresponding to Level C was most likely IPLNs, and it was better to receive no treatment currently. The positive predictive value was 81% (23/28), the negative predictive value was 97% (89/92), the sensitivity was 63% (23/35), and the specificity was 81% (89/110). Conclusion For the pulmonary solid nodules of less than 12 mm in diameter and unknown nature, the evaluation in accordance with the Score Table and the Risk Level Table of this study can be more accurate and faster than the original judgment, which will help clinicians in diagnosis and treatment decisions.

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Increased risk of secondary lung cancer in patients with tuberculosis: A nationwide, population-based cohort study

PLoS ONE ◽

10.1371/journal.pone.0250531 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0250531

Author(s):

Li-Ju Ho ◽

Hung-Yi Yang ◽

Chi-Hsiang Chung ◽

Wei-Chin Chang ◽

Sung-Sen Yang ◽

...

Keyword(s):

Lung Cancer ◽

Cohort Study ◽

Large Scale ◽

Primary Lung Cancer ◽

Significant Risk ◽

Population Based ◽

Chronic Obstructive ◽

Primary Cancer ◽

Increased Risk ◽

Subsequent Risk

Background Tuberculosis (TB) presents a global threat in the world and the lung is the frequent site of metastatic focus. A previous study demonstrated that TB might increase primary lung cancer risk by two-fold for more than 20 years after the TB diagnosis. However, no large-scale study has evaluated the risk of TB and secondary lung cancer. Thus, we evaluated the risk of secondary lung cancer in patients with or without tuberculosis (TB) using a nationwide population-based dataset. Methods In a cohort study of 1,936,512 individuals, we selected 6934 patients among patients with primary cancer and TB infection, based on the International Classification of Disease (ICD-p-CM) codes 010–011 from 2000 to 2015. The control cohort comprised 13,868 randomly selected, propensity-matched patients (by age, gender, and index date) without TB exposure. Using this adjusted date, a possible association between TB and the risk of developing secondary lung cancer was estimated using a Cox proportional hazards regression model. Results During the follow-up period, secondary lung cancer was diagnosed in 761 (10.97%) patients with TB and 1263 (9.11%) patients without TB. After adjusting for covariates, the risk of secondary lung cancer was 1.67 times greater among primary cancer in the cohort with TB than in the cohort without TB. Stratification revealed that every comorbidity (including diabetes, hypertension, cirrhosis, congestive heart failure, cardiovascular accident, chronic kidney disease, chronic obstructive pulmonary disease) significantly increased the risk of secondary lung cancer when comparing the TB cohort with the non-TB cohort. Moreover, the primary cancer types (including head and neck, colorectal cancer, soft tissue sarcoma, breast, kidney, and thyroid cancer) had a more significant risk of becoming secondary lung cancer. Conclusion A significant association exists between TB and the subsequent risk for metastasis among primary cancers and comorbidities. Therefore, TB patients should be evaluated for the subsequent risk of secondary lung cancer.

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