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Seung SJ, Moldaver D, Hassan S, Syed I, Shanahan M, Liu G. Real-World Treatment Patterns and Survival Among Patients with Stage I-III, Non-Squamous, Non-Small Cell Lung Cancer Receiving Surgery as Primary Treatment. Oncol Ther 2024; 12:311-326. [PMID: 38485888 PMCID: PMC11187049 DOI: 10.1007/s40487-024-00268-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/27/2024] [Indexed: 04/17/2024] Open
Abstract
INTRODUCTION Approximately half of patients with non-small cell lung cancer (NSCLC) present with early-stage disease at diagnosis. Real-world outcomes data are limited for this population but are of interest given recent and impending results from trials evaluating epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and immunotherapies in neoadjuvant, adjuvant, and perioperative settings. METHODS A retrospective, longitudinal, population-level study was conducted in patients diagnosed with resected stage I-III non-squamous NSCLC in Ontario, Canada, between April 2010 and March 2019. Study outcomes included patient characteristics and median overall survival (mOS), with stratification by disease stage and treatment exposure. Patients receiving EGFR-TKIs (assumed EGFR mutation-positive by proxy) were a key population of interest. RESULTS Among 8255 cases, 4881 had stage I, 2124 had stage II, and 1250 had stage III NSCLC at diagnosis. The mean patient age was 68 years; 53.5% were female. In the overall cohort, 19.6% received adjuvant chemotherapy. Receipt of adjuvant chemotherapy was associated with significantly longer mOS than not receiving such therapy: stage II (7.6 [95% confidence interval: 6.5-8.5] vs. 4.4 [4.0-4.9] years) or stage III (4.4 [3.6-5.1] vs. 2.7 [2.3-3.3] years), both p < 0.0001. Patients receiving treatment (EGFR-TKIs and chemotherapy) were assumed to have experienced disease recurrence/relapse; mOS was longer among those receiving an EGFR-TKI than among those receiving chemotherapy (2.3 [1.8-3.0] vs. 1.1 [1.0-1.3] years). CONCLUSION In Ontario, between 2010 and 2019, uptake of adjuvant therapy was low among patients with resected NSCLC, despite such therapy being associated with improved survival. Patients assumed to have recurred/relapsed had markedly reduced mOS, regardless of subsequent therapy, compared with those who did not relapse/recur. Novel peri-adjuvant treatment options are needed to enhance outcomes after lung resection.
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Affiliation(s)
- Soo Jin Seung
- HOPE Research Centre, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
| | - Daniel Moldaver
- AstraZeneca Canada Inc., 1004 Middlegate Road, Mississauga, ON, L4Y 1M4, Canada
| | - Shazia Hassan
- HOPE Research Centre, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Iqra Syed
- AstraZeneca Canada Inc., 1004 Middlegate Road, Mississauga, ON, L4Y 1M4, Canada
| | - MaryKate Shanahan
- AstraZeneca Canada Inc., 1004 Middlegate Road, Mississauga, ON, L4Y 1M4, Canada
| | - Geoffrey Liu
- Princess Margaret Cancer Centre, 610 University Avenue, Toronto, ON, M5G 2M9, Canada
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Hong Z, Bai X, Sheng Y, Cui B, Cheng T, Lu Y, Wu X, Jin D, Gou Y. Efficacy of Using Maryland Forceps Versus Electrocoagulation Hooks in RATS Lung Cancer Surgery: A Propensity Score-Matched Study. Ann Surg Oncol 2023; 30:5923-5929. [PMID: 37394667 DOI: 10.1245/s10434-023-13813-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/28/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Here we compare the difference in recent outcomes between the use of Maryland forceps (MF) and electrocoagulation hooks (EH) in robotic-assisted thoracoscopic radical lung cancer resection. PATIENTS AND METHODS We retrospectively analyze the clinical data of 247 patients with lung cancer who underwent robotic-assisted thoracoscopic surgery from February 2018 to December 2022. On the basis of the intraoperative use of energy devices, we divided the clinical data into two groups, including 84 cases in the MF group and 163 cases in the EH group, respectively. The patients in the two groups were matched with propensity score matching analysis, and further, the perioperative clinical data of the two groups were compared. RESULTS Compared with the EH group, patients in the MF group had shorter operative time, lesser intraoperative bleeding, shorter postoperative drainage time, and shorter postoperative hospital stay (P < 0.05). By comparing the intraoperative and postoperative complications in the two groups, it was found that the incidence of intraoperative lymph node fragmentation, the incidence of postoperative celiac disease, and the incidence of postoperative food choking were significantly lower in the MF group than that in the EH group. The increase of CRP, IL-6, IL-8, and TNF-α levels in the MF group was less than that in the EH group. CONCLUSIONS The use of MF in robotic-assisted thoracoscopic radical lung cancer surgery is safe and effective, with advantages in lymph node dissection, reduced surgical trauma, and fewer postoperative complications.
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Affiliation(s)
- Ziqiang Hong
- The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, China
- Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, China
| | - Xiangdou Bai
- The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, China
- Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, China
| | - Yannan Sheng
- The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, China
| | - Baiqiang Cui
- The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, China
- Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, China
| | - Tao Cheng
- The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, China
- Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, China
| | - Yingjie Lu
- The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, China
| | - Xusheng Wu
- The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, China
- Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, China
| | - Dacheng Jin
- Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, China
| | - Yunjiu Gou
- Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, China.
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Ko G, Hallet J, Jerzak KJ, Chan W, Coburn N, Barabash V, Wright FC, Look Hong NJ. Low Rates of Medical Oncology Consultation for Older Women (≥ 70 Years) with Newly Diagnosed, Non-Metastatic Breast Cancer: A Population-Based Study. Ann Surg Oncol 2023; 30:1054-1062. [PMID: 36255513 DOI: 10.1245/s10434-022-12640-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/22/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Curative intent cancer treatment needs to be balanced with patient comorbidities and quality of life when treating older women with breast cancer. We examined consultation patterns and association of age at diagnosis with lack of specialist cancer consultations for older women with breast cancer. METHODS We conducted a population-based retrospective cohort study of older women (≥ 70 years of age) with incident, non-metastatic breast cancer (2010-2018) by linking administrative databases in Ontario, Canada. The outcomes of interest were lack of specialist cancer consultation (surgeon, medical oncology, or radiation oncology) within 12 months of diagnosis. Association of age with lack of specialist cancer consultation was examined using Poisson regression modeling. RESULTS Of 21,849 older women, 2.4% (n = 517) did not have any specialist cancer consultation within 12 months of diagnosis; lack of any specialist cancer consultation increased with age (0.8% for age 70-74 years, 1.3% for age 75-79 years, 2.5% for age 80-84 years, and 7.0% for age ≥ 85 years; p < 0.001). The proportion of patients who did not have consultations with surgeons, medical oncologists, and radiation oncologists was 8.6% (n = 1888), 34.4% (n = 7510), and 24.7% (n = 5404), respectively. Older age group was independently associated with an increased likelihood of lacking any specialist consultation, as well as not receiving surgical and medical oncology consultations. CONCLUSION More than one-third of women ≥ 70 years of age with non-metastatic breast cancer did not have a consultation with a medical oncologist, with women aged ≥ 85 years least likely to have a medical oncology consultation.
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Affiliation(s)
- Gary Ko
- Division of Surgical Oncology, Odette Cancer Centre - Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Julie Hallet
- Division of Surgical Oncology, Odette Cancer Centre - Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Surgery, University of Toronto, Toronto, ON, Canada.,ICES, Toronto, ON, Canada.,Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Katarzyna J Jerzak
- ICES, Toronto, ON, Canada.,Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.,Division of Medical Oncology and Hematology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Wing Chan
- Department of Surgery, University of Toronto, Toronto, ON, Canada.,ICES, Toronto, ON, Canada
| | - Natalie Coburn
- Division of Surgical Oncology, Odette Cancer Centre - Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Surgery, University of Toronto, Toronto, ON, Canada.,ICES, Toronto, ON, Canada.,Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Victoria Barabash
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Frances C Wright
- Division of Surgical Oncology, Odette Cancer Centre - Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Nicole J Look Hong
- Division of Surgical Oncology, Odette Cancer Centre - Sunnybrook Health Sciences Centre, Toronto, ON, Canada. .,Department of Surgery, University of Toronto, Toronto, ON, Canada.
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Zhu S, Yang C, Chen S, Kang L, Li T, Li J, Li L. Effectiveness of a perioperative support programme to reduce psychological distress for family caregivers of patients with early-stage lung cancer: study protocol for a randomised controlled trial. BMJ Open 2022; 12:e064416. [PMID: 35998958 PMCID: PMC9403120 DOI: 10.1136/bmjopen-2022-064416] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
INTRODUCTION Family caregivers play a key role in providing ongoing long-term care and assistance to their loved ones during cancer treatment. However, family caregivers of patients with lung cancer are frequently unprepared for their roles and they may undergo psychological distress, thus reducing their own quality of life while affecting patients' health outcomes. Interventions that specifically target this population are lacking. This study aims to evaluate the effectiveness of a perioperative support programme on family caregivers of patients with early-stage lung cancer. METHODS AND ANALYSIS This study is guided by the Stress-Coping Model. Family caregivers of patients diagnosed with early-stage lung cancer and those who are scheduled for lung resection treatment will be invited to participate. Participants will be randomised to groups that either receive the perioperative support programme or usual care. The intervention consists of four face-to-face intervention sessions during the hospital stay and two weekly telephone follow-up sessions after discharge. Primary and secondary outcomes will be assessed at baseline and at 4 and 12 weeks after the intervention. Primary outcomes will include psychological distress and secondary outcomes will include caregiving burden, quality of life, coping style and social support. Generalised estimation equation model will be used to analyse the intervention effects. ETHICS AND DISSEMINATION The study was approved by the Ethics Committee of the Second Xiangya Hospital of Central South University (LYG2022003). The authors will disseminate the study's findings by publishing them in international scientific journals. TRIAL REGISTRATION NUMBER ChiCTR2200058280.
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Affiliation(s)
- Song Zhu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Shihao Chen
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lu Kang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Tong Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jina Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lezhi Li
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
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Wang C, Gu X, Zhang X, Zhou M, Chen Y. Development and Validation of an E2F-Related Gene Signature to Predict Prognosis of Patients With Lung Squamous Cell Carcinoma. Front Oncol 2021; 11:756096. [PMID: 34745990 PMCID: PMC8569707 DOI: 10.3389/fonc.2021.756096] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/01/2021] [Indexed: 01/21/2023] Open
Abstract
Background Lung squamous cell carcinoma (LUSC) generally correlates with poor clinical prognoses due to the lack of available prognostic biomarkers. This study is designed to identify a potential biomarker significant for the prognosis and treatment of LUSC, so as to provide a scientific basis for clinical treatment decisions. Methods Genomic changes in LUSC samples before and after radiation were firstly discussed to identify E2 factor (E2F) pathway of prognostic significance. A series of bioinformatics analyses and statistical methods were combined to construct a robust E2F-related prognostic gene signature. Furthermore, a decision tree and a nomogram were established according to the gene signature and multiple clinicopathological characteristics to improve risk stratification and quantify risk assessment for individual patients. Results In our investigated cohorts, the E2F-related gene signature we identified was capable of predicting clinical outcomes and therapeutic responses in LUSC patients, besides, discriminative to identify high-risk patients. Survival analysis suggested that the gene signature was independently prognostic for adverse overall survival of LUSC patients. The decision tree identified the strong discriminative performance of the gene signature in risk stractification for overall survival while the nomogram demonstrated a high accuracy. Conclusion The E2F-related gene signature may help distinguish high-risk patients so as to formulate personalized treatment strategy in LUSC patients.
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Affiliation(s)
- Cailian Wang
- Department of Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Xuyu Gu
- School of Medicine, Southeast University, Nanjing, China
| | - Xiuxiu Zhang
- School of Medicine, Southeast University, Nanjing, China
| | - Min Zhou
- Department of Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yan Chen
- Department of Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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Lu T, Yang X, Huang Y, Zhao M, Li M, Ma K, Yin J, Zhan C, Wang Q. Trends in the incidence, treatment, and survival of patients with lung cancer in the last four decades. Cancer Manag Res 2019; 11:943-953. [PMID: 30718965 PMCID: PMC6345192 DOI: 10.2147/cmar.s187317] [Citation(s) in RCA: 312] [Impact Index Per Article: 62.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Purpose This study used the Surveillance, Epidemiology, and End Results (SEER) data to investigate the changes in incidence, treatment, and survival of lung cancer from 1973 to 2015. Patients and methods The clinical and epidemiological data of patients with lung cancer were obtained from the SEER database. Joinpoint regression models were used to estimate the rate changes in lung cancer related to incidence, treatment, and survival. Results From 1973 to 2015, the average incidence of lung cancer was 59.0/100,000 person-years. The incidence increased initially, reached a peak in 1992, and then gradually decreased. A higher incidence rate was observed in males than in females and in black patients than in other racial groups. Since 1985, adenocarcinoma became the most prevalent histopathological type. The surgical rate for lung cancer was about 25%, and treatment with chemotherapy showed an increasing trend, while the radiotherapy rate was in downward trend. The surgical rate for non-small-cell lung cancer (NSCLC) was higher than that for small cell lung cancer (SCLC), while chemotherapy for SCLC far exceeded that for NSCLC. Treatment with chemotherapy and radiotherapy for advanced stage had higher rate than early stage. The 5-year relative survival rate of lung cancer increased with time, but <21%. Conclusion In the past four decades, the lung cancer incidence increased initially and then gradually decreased. Surgical rate experienced a fluctuant reduction, while the chemotherapy rate was in upward trend. The 5-year relative survival rate increased with years, but was still low.
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Affiliation(s)
- Tao Lu
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China, ;
| | - Xiaodong Yang
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China, ;
| | - Yiwei Huang
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China, ;
| | - Mengnan Zhao
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China, ;
| | - Ming Li
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China, ;
| | - Ke Ma
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China, ;
| | - Jiacheng Yin
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China, ;
| | - Cheng Zhan
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China, ;
| | - Qun Wang
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China, ;
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Invited Commentary. Ann Thorac Surg 2017; 103:910-911. [DOI: 10.1016/j.athoracsur.2016.09.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 09/09/2016] [Accepted: 09/12/2016] [Indexed: 11/17/2022]
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