scholarly journals Clinical Characteristics and Prognosis of Incidentally Detected Lung Cancers

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
S. Quadrelli ◽  
G. Lyons ◽  
H. Colt ◽  
D. Chimondeguy ◽  
A. Buero
Keyword(s):  
Lung Cancer ◽  
Clinical Characteristics ◽  
Incidental Finding ◽  
Survival Times ◽  
Lung Cancers ◽  
Incidental Diagnosis ◽  
Stage Disease ◽  
Number Of Patients ◽  
History Of ◽  
Curative Intention

Objective. To evaluate clinical characteristics and outcomes in incidentally detected lung cancer and in symptomatic lung cancer.Material and Methods. We designed a retrospective study including all patients undergoing pulmonary resection with a curative intention for NSCLC. They were classified into two groups according to the presence or absence of cancer-related symptoms at diagnosis in asymptomatic (ASX)—incidental diagnosis—or symptomatic.Results. Of the 593 patients, 320 (53.9%) were ASX. In 71.8% of these, diagnosis was made by chest X-ray. Patients in the ASX group were older (P=0.007), had a higher prevalence of previous malignancy (P=0.002), presented as a solitary nodule more frequently (P<0.001), and were more likely to have earlier-stage disease and smaller cancers (P=0.0001). A higher prevalence of incidental detection was observed in the last ten years (P=0.008). Overall 5-year survival was higher for ASX (P=0.001). Median survival times in pathological stages IIIB-IV were not significantly different.Conclusion. Incidental finding of NSCLC is not uncommon even among nonsmokers. It occurred frequently in smokers and in those with history of previous malignancy. Mortality of incidental diagnosis group was lower, but the better survival was related to the greater number of patients with earlier-stage disease.

scholarly journals Collateral effects of the coronavirus disease 2019 pandemic on lung cancer diagnosis in Korea

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ji Young Park ◽  
Ye Jin Lee ◽  
Taehee Kim ◽  
Chang Youl Lee ◽  
Hwan Il Kim ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Diagnosis ◽  
Rapid Progression ◽  
Lung Cancers ◽  
The Past ◽  
Lung Cancer Diagnosis ◽  
Number Of Patients ◽  
Wide Range ◽  
Collateral Effects ◽  
The Impact

Abstract Background The COVID-19 pandemic is predicted to significantly affect patients with lung cancer, owing to its rapid progression and high mortality. Studies on lung cancer diagnosis and treatment during an epidemic are lacking. We analyzed the impact of COVID-19 on lung cancer diagnosis in Korea, where lung cancer incidence continues to rise. Methods The number of newly diagnosed lung cancer cases in three university-affiliated hospitals during the pandemic and their clinical features were compared with lung cancer cases diagnosed during the same period in the past 3 years. The effectiveness of measures taken by the study hospitals to prevent nosocomial transmission was reviewed. Results A total of 612 patients were diagnosed with lung cancer from February through June, 2017–2020. During the pandemic, the number of patients who sought consultation at the division of pulmonology of study hospitals dropped by 16% from the previous year. Responding to the pandemic, the involved hospitals created physically isolated triage areas for patients with acute respiratory infection symptoms. Wide-range screening and preventive measures were implemented, thus minimizing the delay in lung cancer diagnosis. No patient acquired COVID-19 due to hospital exposure. The proportion of patients with stage III–IV non-small-cell lung cancer (NSCLC) significantly increased (2020: 74.7% vs. 2017: 57.9%, 2018: 66.7%, 2019: 62.7%, p = 0.011). The number of lung cancers diagnosed during this period and the previous year remained the same. Conclusions The proportion of patients with advanced NSCLC increased during the COVID-19 pandemic.

scholarly journals Factors Associated With Small Aggressive Non–Small Cell Lung Cancers in the National Lung Screening Trial: A Validation Study

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Matthew T Warkentin ◽  
Martin C Tammemägi ◽  
Matthew T Freedman ◽  
Lawrence R Ragard ◽  
William G Hocking ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Family History ◽  
Small Cell ◽  
Small Cell Lung ◽  
Lung Cancers ◽  
Factors Associated ◽  
National Lung Screening Trial ◽  
History Of ◽  
Lung Screening ◽  
Screening Trial

Abstract Background A small proportion of non–small cell lung cancers (NSCLCs) have been observed to spread to distant lymph nodes (N3) or metastasize (M1) or both, while the primary tumor is small (≤3 cm, T1). These small aggressive NSCLCs (SA-NSLSC) are important as they are clinically significant, may identify unique biologic pathways, and warrant aggressive follow-up and treatment. This study identifies factors associated with SA-NSCLC and attempts to validate a previous finding that women with a family history of lung cancer are at particularly elevated risk of SA-NSCLC. Methods This study used a case–case design within the National Cancer Institute’s National Lung Screening Trial (NLST) cohort. Case patients and “control” patients were selected based on TNM staging parameters. Case patients (n = 64) had T1 NSCLCs that were N3 or M1 or both, while “control” patients (n = 206) had T2 or T3, N0 to N2, and M0 NSCLCs. Univariate and multivariable logistic regression were used to identify factors associated with SA-NSCLC. Results In bootstrap bias–corrected multivariable logistic regression models, small aggressive adenocarcinomas were associated with a positive history of emphysema (odds ratio [OR] = 5.15, 95% confidence interval [CI] = 1.63 to 23.00) and the interaction of female sex and a positive family history of lung cancer (OR = 6.55, 95% CI = 1.06 to 50.80). Conclusions Emphysema may play a role in early lung cancer progression. Females with a family history of lung cancer are at increased risk of having small aggressive lung adenocarcinomas. These results validate previous findings and encourage research on the role of female hormones interacting with family history and genetic factors in lung carcinogenesis and progression.

scholarly journals Clinical characteristics and lipid lowering treatment of patients initiated on proprotein convertase subtilisin-kexin type 9 inhibitors: a nationwide cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e022702 ◽  
Author(s):  
Jakob Solgaard Jensen ◽  
Peter Ejvin Weeke ◽  
Lia Evi Bang ◽  
Dan Eik Høfsten ◽  
Maria Sejersten Ripa ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Characteristics ◽  
Statin Treatment ◽  
Lipid Lowering ◽  
Proprotein Convertase ◽  
Patient Demographics ◽  
Time Period ◽  
Number Of Patients ◽  
Cross Linkage ◽  
History Of

ObjectivesGiven the novelty of proprotein convertase subtilisin-kexin type 9 inhibitors (PCSK9i), little is known regarding overall implementation or clinical characteristics among patients who initiate treatment. We aimed to assess the total number of patients initiated on PCSK9i along with a description of the clinical characteristics and lipid lowering treatment (LLT) of such patients.SettingA register-based descriptive cohort study of patients receiving a PCSK9i in the time period from 01 January 2016 to 31 March 2017 using a cross linkage between three nationwide Danish registers. Information regarding PCSK9i prescriptions, patient demographics, concurrent pharmacotherapy, comorbidities and previous coronary procedures was identified.ResultsOverall, 137 patients initiated treatment with PCSK9i in the study period from 11 in the first quarter of 2016 to 40 in the first quarter of 2017. The majority had a history of ischaemic heart disease (IHD) (67.9%) with ischaemic stroke and diabetes mellitus being present in 7.3% and 16.8% of patients, respectively. All patients initiated on PCSK9i had been previously prescribed statin treatment with atorvastatin and simvastatin being most frequently prescribed in 53% and 36% of patients, respectively. The majority of patients had received both statins and ezetimibe (94.9%) and approximately half of these patients had also received bile acid sequestrant (45.3%). Clinical characteristics mainly differed in patients receiving triple LLT compared with patients not receiving triple LLT in the regards of heart failure.ConclusionPatients treated with PCSK9i were rare, characterised by having IHD and had received various and intensive conventional LLT prior to PCSK9i initiation in agreement with current international guidelines.

scholarly journals A Comparative Study of Chronic Subdural Hematoma in Patients With and Without Head Trauma: A Retrospective Cross Sectional Study

2020 ◽  
Vol 11 ◽  
Author(s):  
Yunwei Ou ◽  
Xiaofan Yu ◽  
Xiaojuan Liu ◽  
Qian Jing ◽  
Baiyun Liu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Head Trauma ◽  
Clinical Characteristics ◽  
Linear Regression Analysis ◽  
Chronic Subdural Hematoma ◽  
Recurrence Rates ◽  
Similar Treatment ◽  
Number Of Patients ◽  
History Of ◽  
Trauma Group

Background: The clinical features of chronic subdural hematomas (CSDHs) in patients with and without a history of head trauma have remained unclear. Here, we investigated differences in clinical characteristics in CSDH patients with and without head trauma.Methods: We retrospectively collected clinical characteristics of CSDH patients who had undergone exhaustive drainage strategies via burr-hole craniostomies from August 2011 to May 2019. We divided patients into a trauma group (i.e., head trauma) and a no-trauma group. Chi-square tests or t-tests were used to analyze differences in clinical characteristics between the two groups. Multiple linear regression analysis was performed to analyze the relationships between the clinical characteristics and either reduction of the hematoma cavity or length of the hospital stay in CSDH patients with trauma.Results: We collected data from 1,307 CSDH patients, among whom 805 patients had a history of head trauma whereas 502 patients did not. The mean age of patients with head trauma was 64.0 ± 16.1 years, while that of patients without head trauma was significantly younger at 61.5 ± 17.9 years (p = 0.010). Furthermore, more patients in the no-trauma group had a history of hypertension compared to those in the trauma group (40.2 vs. 32.9%, p = 0.007). Dizziness occurred in 29.2% of patients with trauma and in 23.1% of patients without trauma (p = 0.016). A greater number of patients with trauma showed a reduction of hematoma cavity after surgery compared to that of patients without trauma (p = 0.002). The length of hospital stay in patients with trauma was 7.9 ± 4.5 days, which was longer than that of patients without trauma (7.3 ± 3.7 days, p = 0.016). In contrast, there were no significant different differences between the two groups in terms of the densities of hematomas on computed-tomography scans, complications, mortality rates, recurrence rates, or outcomes.Conclusion: Our findings indicate that there were some noteworthy differences in the clinical and pathogenic characteristics of CSDH patients with and without head trauma. However, our findings also indicate that if an optimal treatment method is employed, such as our exhaustive drainage strategy, similar treatment outcomes can be achieved between these groups.

scholarly journals Epidemiology, Clinical Characteristics, and Prognostic Factors of Atopic Children Hospitalised for Adenovirus Infection: A Single Institutional Study in Shenyang, China

2020 ◽  
Author(s):  
Miao Li ◽  
Xiao-Hua Han ◽  
Li-Yun Liu ◽  
Hui-Sheng Yao ◽  
Li-Li Yi
Keyword(s):  
Clinical Characteristics ◽  
Severe Infection ◽  
Airway Disease ◽  
Small Airway ◽  
Personal History ◽  
Factors Associated ◽  
Small Airway Disease ◽  
Number Of Patients ◽  
History Of ◽  
Radiological Changes

Abstract Background: Atopy may be associated with the severity of disease and poor prognosis after adenovirus (Adv) infection in children. Our aim was to observe the clinical characteristics and pulmonary radiological changes in atopic children with Adv pneumonia in China.Methods: Children hospitalised for Adv pneumonia from June 2018 to Dec 2019 were analysed. All children were divided into three groups: atopic with Adv, non-atopic with Adv, and atopic without Adv infection. Each group was further divided into mild or severe infection groups according to disease severity. Standard treatment was initiated after admission and regular follow-up evaluations were conducted at 1 month after discharge. Baseline and clinical characteristics, and pulmonary radiological changes of atopic and non-atopic children were collected. Risk factors associated with small airway diseases in Adv pneumonia patients were analyzed.Results: Compared with non-atopic children with Adv infection, the cases of eosinophilic granulocyte count were significantly higher in atopic children than non-atopic children (P<0.05). Among children with mild and severe infection, the number of patients with wheezing and small airway disease as observed by high-resolution computed tomography (HRCT) was significantly higher in atopic children than non-atopic children (P<0.05). Furthermore, coughing was more severe in atopic children than non-atopic children (P<0.05). A family history of asthma (OR 2.1 [95% CI 1.8–3.0]), personal history of asthma (OR 2.7 [95% CI 2.1–3.1]), atopy (OR 2.1 [95% CI 1.8–3.2]), severe infection (OR 1.9 [95% CI 1.0–2.7]), and Adv infection (OR 1.4, [95% CI 0.9–2.0]) were independent factors associated with the development of small airway disease, both after admission and a month after discharge. Conclusions: Atopic children with Adv infection experience more severe coughing during hospitalisation and are prone to wheezing and small airway disease on the HRCT. Family and personal history of asthma, atopy, severe infection, and Adv infection were independent factors associated with the development of small airway disease on the chest HRCT scan.

scholarly journals A meta-analysis of 2019 novel corona virus patient clinical characteristics and comorbidities

2020 ◽  
Author(s):  
Subodh Sharma Paudel
Keyword(s):  
High Risk ◽  
Clinical Characteristics ◽  
English Language ◽  
Meta Analysis ◽  
Previous History ◽  
Female Ratio ◽  
Number Of Patients ◽  
New Variant ◽  
History Of ◽  
Male To Female

Abstract IntroductionBeing a new variant of coronavirus, detailed information regarding the virulence, its clinical characters, high risk individuals are yet to be defined. This study was done with the objective of finding out clinical features of corona infection and also studies what are the comorbidities that are associated with it.MethodsThis is a single arm meta-analysis in which relevant data were derived from searches in PubMed. It includes study papers which were written in English language and their completely published article is found. Seven articles published from 24th Jan to 16th March, 2020 are included in this study. ResultsThe total number of patients was 1786 with 1044 males and 742 females with male to female ratio of 1.4:1. The median age of patients was 41 years). Fever was present in 88.8% cases. Dry Cough in 68% followed by fatigue in 33%. Hypertension (15.8%) is the most common comorbidity followed by cardio and cerebrovascular condition (11.7%). ConclusionPatients often presented with symptoms of fever, dry cough, lethargy and fatigue, muscle pain, productive cough. Similarly, patients with previous history of HTN, DM, COPD, cardio and cerebrovascular condition, immune-deficient states are at high risk of developing into the severe COVID-19 infection.

Outcomes of non-small cell lung cancer patients with adenocarcinoma histology compared with other histologies: SEER registry data 2004-2008.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e17560-e17560 ◽  
Author(s):  
Monika Joshi ◽  
John M. Varlotto ◽  
Suhail M. Ali ◽  
Jennifer Toth ◽  
Michael Reed ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Stage Iv ◽  
P Value ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Lung Cancers ◽  
Lung Cancer Patients ◽  
Stage Disease ◽  
The Difference ◽  
Nsclc Patients

e17560 Background: For convenience, the majority of lung cancers are commonly lumped together as non-small lung cancer (NSCLC). Patients with adenocarcinoma of the lung have a higher incidence of driver mutation as compared to those with squamous histology. In addition pemetrexed containing regimens have preferential activity in this histology and agents such as bevacizumab are administered to this subgroup only based on toxicity. The currentanalysis was performed to compare outcomes for patients in the SEER database between 2004 and 2008 with adenocarcinoma (Adenoca), squamous cell carcinoma (SCCA) and NSCLC not otherwise specified (NOS). Methods: Data for 161,175 patients was available in SEER database between 2004 and 2008 with 38 different histology ICD codes. 134,947 patients (83.7%) were included in the study. NSCLC NOS (ICD-3 8046) n=36,408, SCCA (ICD-3 8070) n= 36, 454 and Adenoca (ICD-3 8140) n=62,085. Overall survival (OS) and lung cancer specific survival (LCSS) were analyzed using cox proportional Hazard model for the 3 groups. Results: Patients in the three groups were age-matched. Male gender was more common in patients who had SCCA compared to Adenoca (62.6% vs. 49.5%). Percentage of poorly differentiated tumors was higher in patients with SCCA (35.9%) compared to NSCLC NOS (32%) and Adenoca (27.5%). SCCA had fewer stage IV patients at diagnosis (29.5%) vs. 51.4 % for NSCLC NOS and 45% for Adenoca. OS and LCSS are listed in the table below with Hazard ratio (HR) and p value. Total of 23.54% (n=31,768) patients underwent surgical resection. Stage I patients who underwent surgery (n=18,517) also had similar results. Conclusions: NSCLC patients who have adenocarcinoma histology have significantly better overall outcome when compared to other histologies. The difference is more pronounced in an earlier stage disease. [Table: see text]

scholarly journals Potential genetic modifiers for somatic EGFR mutation in lung cancer: a meta-analysis and literature review

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yue I. Cheng ◽  
Yun Cui Gan ◽  
Dan Liu ◽  
Michael P. A. Davies ◽  
Wei Min Li ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Family History ◽  
Egfr Mutation ◽  
Meta Analysis ◽  
Genetic Modifiers ◽  
Mutation Status ◽  
Lung Cancers ◽  
Predisposing Genes ◽  
History Of ◽  
History Of Cancer

Abstract Background Accumulating evidence indicates inherited risk in the aetiology of lung cancer, although smoking exposure is the major attributing factor. Family history is a simple substitute for inherited susceptibility. Previous studies have shown some possible yet conflicting links between family history of cancer and EGFR mutation in lung cancer. As EGFR-mutated lung cancer favours female, never-smoker, adenocarcinoma and Asians, it may be argued that there may be some underlying genetic modifiers responsible for the pathogenesis of EGFR mutation. Methods We searched four databases for all original articles on family history of malignancy and EGFR mutation status in lung cancer published up to July 2018. We performed a meta-analysis by using a random-effects model and odds ratio estimates. Heterogeneity and sensitivity were also investigated. Then we conducted a second literature research to curate case reports of familial lung cancers who studied both germline cancer predisposing genes and their somatic EGFR mutation status; and explored the possible links between cancer predisposing genes and EGFR mutation. Results Eleven studies have been included in the meta-analysis. There is a significantly higher likelihood of EGFR mutation in lung cancer patients with family history of cancer than their counterparts without family history, preferentially in Asians (OR = 1.35[1.06–1.71], P = 0.01), those diagnosed with adenocarcinomas ((OR = 1.47[1.14–1.89], P = 0.003) and those with lung cancer-affected relatives (first and second-degree: OR = 1.53[1.18–1.99], P = 0.001; first-degree: OR = 1.76[1.36–2.28, P < 0.0001]). Familial lung cancers more likely have concurrent EGFR mutations along with mutations in their germline cancer predisposition genes including EGFR T790 M, BRCA2 and TP53. Certain mechanisms may contribute to the combination preferences between inherited mutations and somatic ones. Conclusions Potential genetic modifiers may contribute to somatic EGFR mutation in lung cancer, although current data is limited. Further studies on this topic are needed, which may help to unveil lung carcinogenesis pathways. However, caution is warranted in data interpretation due to limited cases available for the current study.

scholarly journals ALKin Lung Cancer: Past, Present, and Future

2013 ◽  
Vol 31 (8) ◽  
pp. 1105-1111 ◽  
Author(s):  
Alice T. Shaw ◽  
Jeffrey A. Engelman
Keyword(s):  
Lung Cancer ◽  
Kinase Inhibitors ◽  
Small Subset ◽  
Lung Cancers ◽  
Treatment Practices ◽  
Anaplastic Lymphoma ◽  
Challenges And Opportunities ◽  
Future Challenges ◽  
History Of ◽  
Alk Positive

In 2007, scientists discovered that anaplastic lymphoma kinase (ALK) gene rearrangements are present in a small subset of non–small-cell lung cancers. ALK-positive cancers are highly sensitive to small-molecule ALK kinase inhibitors, such as crizotinib. Phase I and II studies of crizotinib in ALK-positive lung cancer demonstrated impressive activity and clinical benefit, leading to rapid US Food and Drug Administration approval in 2011. Although crizotinib induces remissions and extends the lives of patients, cures are not achieved as resistance to therapy develops. In this review, we will discuss the history of this field, current diagnostic and treatment practices, and future challenges and opportunities to advance outcomes for patients with ALK-positive lung cancers.

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