scholarly journals Comparison between lymph node station- and zone-based classification for the future revision of node descriptors proposed by the International Association for the Study of Lung Cancer in surgically resected patients with non-small-cell lung cancer

2019 ◽  
Vol 56 (5) ◽  
pp. 849-857 ◽  
Author(s):  
Jae Kwang Yun ◽  
Geun Dong Lee ◽  
Sehoon Choi ◽  
Hyeong Ryul Kim ◽  
Yong-Hee Kim ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
International Association ◽  
Multivariable Analysis ◽  
Small Cell ◽  
Significant Prognostic Factor ◽  
Small Cell Lung ◽  
Single Station

AbstractOBJECTIVESThe International Association for the Study of Lung Cancer (IASLC) proposed further subdivisions of pathological N1 (pN1) and pN2 by including the location and the number of involved lymph node (LN) stations. We adopted the subdivided N descriptors and reclassified them according to the involved LN zones or LN stations, and compared the discrimination abilities of the 2 classifications.METHODSA retrospective analysis was carried out on patients who underwent complete resection with systematic LN dissection for non-small cell lung cancer diagnosed as pathological stages I–III between 2006 and 2015. N classification was grouped into 6 categories: no LN involvement, single-station N1, multiple-station N1, single-station N2 without N1, single-station N2 with N1 and multiple-station N2. LN zones were defined by grouping the LN stations: peripheral or hilar for N1 nodes, and upper mediastinal, lower mediastinal, aortopulmonary and subcarinal for N2 nodes.RESULTSA total of 3971 patients (2451 men, median age: 63 years) were analysed. Median follow-up was 59 months. A multivariable analysis showed that the subdivided N descriptors based on LN station and zone were both independent prognostic factors in terms of both overall survival and freedom from recurrence. Whether multiple LN involvements were confined within a single LN zone was a significant prognostic factor in the multiple-station N2 group. A zone-based classification showed similar discrimination ability to the station-based classification.CONCLUSIONSBoth LN station- and zone-based classifications showed favourable prognostic discrimination abilities. The new N classifications could be considered for future revisions of tumour, node and metastasis (TNM) staging system for lung cancer.

Chemical Anaplasia in Atypical Debut of Non-small Cell Lung Cancer with Inguinal and Obturator Lymph Node Metastases

2018 ◽  
Vol 69 (10) ◽  
pp. 2833-2836
Author(s):  
Laura Rebegea ◽  
Aurel Nechita ◽  
Cristina Serban ◽  
Camelia Diaconu ◽  
Luana Andreea Macovei ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Lymph Node Metastases ◽  
Palliative Chemotherapy ◽  
Small Cell ◽  
Lumbar Region ◽  
Small Cell Lung ◽  
Node Metastases

Non-small cell lung cancer (NSCLC) represents almost 80-85% of lung cancer cases. It is the most frequent malignancy after skin cancer. The therapeutic options for stage IV of disease consider histology, molecular characteristics, age, performance status, comorbidities, and not in the lust, patient�s option. This paper presents the case of a male patient, 73 years old, smoker, presented and treated in May 2016 in the Sf. Ap. Andrei Emergency Clinical Hospital Galati. The first sign of disease was inguinal and obturator right lymph node metastases whose histopathological test revealed metastases from malignant melanoma. Immunohistochemical tests (IHC) indicated undifferentiated carcinoma with lung as starting point, (Ck7 (+), TTF1 (+)). Thorax, abdominal and pelvic computed tomography (CT) imaging not evidenced space replacement processes in lung, but with mediastinal, right obturator and inguinal adenopathy. From personal pathological history we retain basocellular carcinoma in lumbar region, treated with surgery in 2009. It was initiated palliative chemotherapy and radiotherapy with remission of obturator and inguinal adenopathy, and at 9 months from diagnosis the Positron Emission Tomography (PET-CT) evidenced primary lung tumor situated in right superior lobe (RSL). At the present, patient is alive performing palliative chemotherapy. This case presented diagnostic and treatment issues, being a challenge for multidisciplinary team. We are mentioning the paucity of literature data regarding cases of primary tumors situated upper diaphragm which metastases in inguinal lymph nodes.

scholarly journals Differential influence of antibiotic therapy and other medications on oncological outcomes of patients with non-small cell lung cancer treated with first-line pembrolizumab versus cytotoxic chemotherapy

2021 ◽  
Vol 9 (4) ◽  
pp. e002421
Author(s):  
Alessio Cortellini ◽  
Massimo Di Maio ◽  
Olga Nigro ◽  
Alessandro Leonetti ◽  
Diego L Cortinovis ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Objective Response ◽  
Multivariable Analysis ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Metastatic Nsclc ◽  
The Impact

BackgroundSome concomitant medications including antibiotics (ATB) have been reproducibly associated with worse survival following immune checkpoint inhibitors (ICIs) in unselected patients with non-small cell lung cancer (NSCLC) (according to programmed death-ligand 1 (PD-L1) expression and treatment line). Whether such relationship is causative or associative is matter of debate.MethodsWe present the outcomes analysis according to concomitant baseline medications (prior to ICI initiation) with putative immune-modulatory effects in a large cohort of patients with metastatic NSCLC with a PD-L1 expression ≥50%, receiving first-line pembrolizumab monotherapy. We also evaluated a control cohort of patients with metastatic NSCLC treated with first-line chemotherapy. The interaction between key medications and therapeutic modality (pembrolizumab vs chemotherapy) was validated in pooled multivariable analyses.Results950 and 595 patients were included in the pembrolizumab and chemotherapy cohorts, respectively. Corticosteroid and proton pump inhibitor (PPI) therapy but not ATB therapy was associated with poorer performance status at baseline in both the cohorts. No association with clinical outcomes was found according to baseline statin, aspirin, β-blocker and metformin within the pembrolizumab cohort. On the multivariable analysis, ATB emerged as a strong predictor of worse overall survival (OS) (HR=1.42 (95% CI 1.13 to 1.79); p=0.0024), and progression free survival (PFS) (HR=1.29 (95% CI 1.04 to 1.59); p=0.0192) in the pembrolizumab but not in the chemotherapy cohort. Corticosteroids were associated with shorter PFS (HR=1.69 (95% CI 1.42 to 2.03); p<0.0001), and OS (HR=1.93 (95% CI 1.59 to 2.35); p<0.0001) following pembrolizumab, and shorter PFS (HR=1.30 (95% CI 1.08 to 1.56), p=0.0046) and OS (HR=1.58 (95% CI 1.29 to 1.94), p<0.0001), following chemotherapy. PPIs were associated with worse OS (HR=1.49 (95% CI 1.26 to 1.77); p<0.0001) with pembrolizumab and shorter OS (HR=1.12 (95% CI 1.02 to 1.24), p=0.0139), with chemotherapy. At the pooled analysis, there was a statistically significant interaction with treatment (pembrolizumab vs chemotherapy) for corticosteroids (p=0.0020) and PPIs (p=0.0460) with respect to OS, for corticosteroids (p<0.0001), ATB (p=0.0290), and PPIs (p=0.0487) with respect to PFS, and only corticosteroids (p=0.0033) with respect to objective response rate.ConclusionIn this study, we validate the significant negative impact of ATB on pembrolizumab monotherapy but not chemotherapy outcomes in NSCLC, producing further evidence about their underlying immune-modulatory effect. Even though the magnitude of the impact of corticosteroids and PPIs is significantly different across the cohorts, their effects might be driven by adverse disease features.

Increased high-mobility group A2 correlates with lymph node metastasis and prognosis of non-small cell lung cancer

2018 ◽  
Vol 21 (3) ◽  
pp. 547-555 ◽  
Author(s):  
Xiangjun Guo ◽  
Jiaxin Shi ◽  
Yan Wen ◽  
Mengmeng Li ◽  
Qin Li ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
High Mobility ◽  
Small Cell ◽  
High Mobility Group ◽  
Small Cell Lung ◽  
Node Metastasis

Overexpression of SLC1a5 in lymph node metastases outperforms assessment in the primary as a negative prognosticator in non-small cell lung cancer

Pathology ◽  
2018 ◽  
Vol 50 (3) ◽  
pp. 269-275 ◽  
Author(s):  
Agnes Csanadi ◽  
Annika Oser ◽  
Konrad Aumann ◽  
Vera Gumpp ◽  
Justyna Rawluk ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Lymph Node Metastases ◽  
Small Cell ◽  
Small Cell Lung ◽  
Node Metastases
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