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Pan J, Zhang Y, He L, Wu Y, Xiao W, Zhang J, Xu Y. STRIP2 is regulated by the transcription factor Sp1 and promotes lung adenocarcinoma progression via activating the PI3K/AKT/mTOR/MYC signaling pathway. Genomics 2024; 116:110923. [PMID: 39191354 DOI: 10.1016/j.ygeno.2024.110923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 07/26/2024] [Accepted: 08/19/2024] [Indexed: 08/29/2024]
Abstract
BACKGROUND Patients with lung adenocarcinoma (LUAD) generally have poor prognosis. The role of striatin-interacting protein 2 (STRIP2) in LUAD remain unclear. METHODS Liquid chromatography-mass spectrometry analyses were used to screen the STRIP2-binding proteins and co-immunoprecipitation verified these interactions. A dual luciferase reporter assay explored the transcription factor activating STRIP2 transcription. Xenograft and lung metastasis models assessed STRIP2's role in tumor growth and metastasis in vivo. RESULTS STRIP2 is highly expressed in LUAD tissues and is linked to poor prognosis. STRIP2 expression in LUAD cells significantly promoted cell proliferation, invasion, and migration in vitro and in vivo. Mechanistically, STRIP2 boosted the PI3K/AKT/mTOR/MYC cascades by binding AKT. In addition, specificity protein 1, potently activated STRIP2 transcription by binding to the STRIP2 promoter. Blocking STRIP2 reduces tumor growth and lung metastasis in xenograft models. CONCLUSIONS Our study identifies STRIP2 is a key driver of LUAD progression and a potential therapeutic target.
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Affiliation(s)
- Junfan Pan
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, China
| | - Yuan Zhang
- The First Affiliated Hospital of Xiamen University, Xiamen 361003, China
| | - Liu He
- School of Basic Medicine, Fujian Medical University, Fuzhou 350004, China
| | - Yue Wu
- School of Basic Medicine, Fujian Medical University, Fuzhou 350004, China
| | - Weijin Xiao
- Department of Pathology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, China.
| | - Jing Zhang
- Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, China.
| | - Yiquan Xu
- Department of Thoracic Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, China.
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Qi Y, Guo X, Li Z, Ren B, Wang Z. Distinguishing optimal candidates for primary tumor resection in patients with metastatic lung adenocarcinoma: A predictive model based on propensity score matching. Heliyon 2024; 10:e27768. [PMID: 38690000 PMCID: PMC11059407 DOI: 10.1016/j.heliyon.2024.e27768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 05/02/2024] Open
Abstract
Background Primary tumor resection is associated with survival benefits in patients with metastatic lung adenocarcinoma (mLUAD). However, there are no established methods to determine which individuals would benefit from surgery. Therefore, we developed a model to predict the patients who are likely to benefit from surgery in terms of survival. Methods Data on patients with mLUAD were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Depending on whether surgery was performed on the primary tumor, patients were categorized into two groups: cancer-directed surgery (CDS) and no-cancer-directed surgery (No-CDS). Propensity Score Matching (PSM) was utilized to address bias between the CDS and No-CDS groups. The prognostic impact of CDS was assessed using Kaplan-Meier analysis and Cox proportional hazard models. Subsequently, we constructed a nomogram to predict the potential for surgical benefits based on multivariable logistic regression analysis using preoperative factors. Results A total of 89,039 eligible patients were identified, including 6.4% (5705) who underwent surgery. Following PSM, the CDS group demonstrated a significantly longer median overall survival (mOS) compared with the No-CDS group (23 [21-25] vs. 7 [7-8] months; P < 0.001). The nomogram showed robust performance in both the training and validation sets (area under the curve [AUC]: 0.698 and 0.717, respectively), and the calibration curves exhibited high consistency. The nomogram proved clinically valuable according to decision curve analysis (DCA). According to this nomogram, surgical patients were categorized into two groups: no-benefit candidates and benefit candidates groups. Compared with the no-benefit candidate group, the benefit candidate group was associated with longer survival (mOS: 25 vs. 6 months, P < 0.001). Furthermore, no difference in survival was observed between the no-benefit candidates and the no-surgery groups (mOS: 6 vs. 7 months, P = 0.9). Conclusions A practical nomogram was developed to identify optimal CDS candidates among patients with mLUAD.
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Affiliation(s)
- Yuying Qi
- Fourth Hospital of Hebei Medical University, Qiao Dong Qu, Shi Jia Zhuang Shi, He Bei Sheng, 050010, China
| | - Xiaojin Guo
- Fourth Hospital of Hebei Medical University, Qiao Dong Qu, Shi Jia Zhuang Shi, He Bei Sheng, 050010, China
| | - Zijie Li
- Fourth Hospital of Hebei Medical University, Qiao Dong Qu, Shi Jia Zhuang Shi, He Bei Sheng, 050010, China
| | - Bingzhang Ren
- Fourth Hospital of Hebei Medical University, Qiao Dong Qu, Shi Jia Zhuang Shi, He Bei Sheng, 050010, China
| | - Zhiyu Wang
- Fourth Hospital of Hebei Medical University, Qiao Dong Qu, Shi Jia Zhuang Shi, He Bei Sheng, 050010, China
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Tong Y, Jiang L, Gong Y, Zhu D, Zhao D. Analysis of survival benefit from primary tumor resection and individualized prediction of overall survival for lung cancer patients with bone metastasis: Worth it or not? Asian J Surg 2024; 47:333-349. [PMID: 37741753 DOI: 10.1016/j.asjsur.2023.08.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/15/2023] [Accepted: 08/30/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND The clinical management of lung cancer (LC) patients with bone metastasis (BM) is still a significant challenge. This study aimed to explore the role of primary tumor resection (PTR) on survival outcome of LC patients with BM and to develop two web-based nomograms for predicting the overall survival (OS) of LC patients with BM who received PTR and those who did not. METHODS We enrolled LC patients with BM from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. Propensity score matching (PSM) was then conducted to balance the baseline characteristics of covariates between patients in surgery and non-surgery groups. Next, Kaplan-Meier analysis with log-rank test was performed to evaluate the survival benefit of PTR before and after PSM methods and to explore the impact of surgical resection extent on the prognosis of LC patients with BM and clinical outcomes in patients with different metastatic patterns. Cox proportional hazard regression analysis was then applied to determine the independent prognostic factors for OS of patients receiving PTR and did not receiving PTR, respectively. Subsequently, we constructed two individualized nomograms for predicting the 12-, 18- and 24-months OS. Finally, receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) were generated to evaluate discrimination, accuracy and clinical utility of the nomograms. RESULTS A total of 7747 eligible patients were included in this analysis. The survival analysis revealed that PTR was closely associated with better survival outcome among LC patients with BM(P < 0.05), while the survival benefit of PTR was suboptimal in patients presented with multiple metastases(P > 0.05). Besides, lobectomy shows best survival benefit. Two nomograms were then constructed based on independent prognostic factors of patients in the surgery group and the non-surgery group. The ROC curves showed good discrimination of the two nomograms, with the area under curve (AUC) of each time point being higher than 0.7 in both the training set and testing set. The calibration curves also demonstrated satisfactory consistency between actual survival and nomogram-predicted OS of both nomograms. The DCA showed high benefit of nomogram in a clinical context. Moreover, the study population was stratified into three groups based on the scores of the nomogram, and the survival analysis showed that this prognostic stratification was statistically significant (p < 0.05). CONCLUSIONS This study showed that surgical resection of the primary site strategy can prolong survival of LC patients with BM to some extent, depending on different sites of metastasis and highly selected patients. Furthermore, the web-based nomograms showed significant accuracy in predicting OS for patients with or without surgery, which may provide valuable insights for patients' counseling and individualized decision-making for clinicians.
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Affiliation(s)
- Yuexin Tong
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, No 126 Xiantai Street, Changchun, Jilin, 130033, PR China
| | - Liming Jiang
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, No 126 Xiantai Street, Changchun, Jilin, 130033, PR China
| | - Yan Gong
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, No 126 Xiantai Street, Changchun, Jilin, 130033, PR China
| | - Dejing Zhu
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, No 126 Xiantai Street, Changchun, Jilin, 130033, PR China
| | - Dongxu Zhao
- Department of Orthopedics, The China-Japan Union Hospital of Jilin University, No 126 Xiantai Street, Changchun, Jilin, 130033, PR China.
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Tafenzi HA, Choulli F, Baladi A, Essaadi I, Belbaraka R. Lung cancer in middle and southern Morocco. Ecancermedicalscience 2023; 17:1518. [PMID: 37113715 PMCID: PMC10129405 DOI: 10.3332/ecancer.2023.1518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Indexed: 03/14/2023] Open
Abstract
Purpose Determining risk factors associated with a fatal disease such as lung cancer (LC) remains an important key to understanding the factors related to its development and therefore using the correct emergent or accessible treatments. For that, we sought to highlight by describing, and analysing, the risk factors related to LC survival, reflecting the actual situation in Morocco. Patients and methods We included 987 LC patients diagnosed from 2015 to 2021 at the Medical Oncology Department at the Mohammed VI University Hospital of Marrakech. An overview of the LC situation was described, and analysed, to determine the risk factors related to survival. The independent prognostic factors were determined using Cox Proportional Hazards Regression Analysis. To create a distinction between different risks group in the survival curve, stratification was done, respectively, within sex, age, histology type, treatments and radiation therapy. Results We finally included 862 patients with 15 parameters among the 27 extracted, all meeting the inclusion criteria. 89.1% of the patients were male (n = 768) and 10.9% were female (n = 94), of whom 83.5% had a history of tobacco smoking (n = 720). The median survival of both sexes was 716 (5-2,167) days. The average age at diagnosis was 60 years. Five hundred and thirty-four patients presented with advanced stage. Patients above 66 years were the more diagnosed category with adenocarcinoma at T4N2M1c pathological category, and endocrinal comorbidity, in addition to pleurisy syndrome. Moreover, family history was found to be a bad prognostic factor. Interestingly, smoking status was not a bad contributor to survival. Age at diagnosis, histology subtype, performance status, haemoglobin, numbers of cures of the first-line chemotherapy, radiotherapy, anaemia and treatments were identified as risk factors related to survival. Conclusion We established a descriptive and analytical overview of the current LC epidemiology situation in the oncology division of Mohammed VI University Hospital in a non-industrialised state taking into account smoking status.
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Affiliation(s)
- Hassan Abdelilah Tafenzi
- Department of Medical Oncology, Mohammed VI University Hospital of Marrakech, Marrakech 40000, Morocco
- Biosciences and Health Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech 40000, Morocco
| | - Farah Choulli
- Department of Medical Oncology, Mohammed VI University Hospital of Marrakech, Marrakech 40000, Morocco
- Biosciences and Health Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech 40000, Morocco
| | - Anass Baladi
- Department of Medical Oncology, Mohammed VI University Hospital of Marrakech, Marrakech 40000, Morocco
| | - Ismail Essaadi
- Biosciences and Health Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech 40000, Morocco
- Department of Medical Oncology, Avicenna Military Hospital of Marrakech, Marrakech 40000, Morocco
| | - Rhizlane Belbaraka
- Department of Medical Oncology, Mohammed VI University Hospital of Marrakech, Marrakech 40000, Morocco
- Biosciences and Health Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech 40000, Morocco
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Zhao Z, Gao Y, Tan F, Xue Q, Gao S, He J. Specific organ metastases and prognosis in lung adenocarcinoma. Thorac Cancer 2023; 14:736-745. [PMID: 36694094 PMCID: PMC10008679 DOI: 10.1111/1759-7714.14801] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES This study aims to characterize the specific organ metastatic rates in lung adenocarcinoma (LUAD) patients and identify the prognosis-associated factors. METHODS Using the Surveillance, Epidemiology and End Results database, 40 117 patients diagnosed with positive histology as the only primary LUAD were included. We stratified patients by diagnosed year, age, sex, race/ethnicity, marital status, insurance, location, TNM stage, organ-specific metastases, surgery, chemotherapy, and radiation therapy. We performed multivariable logistic and Cox regression to identify the factors associated with the presence of specific organ metastases and prognosis predictors. RESULTS For the 40 117 LUAD patients, 43.69%, 26.25%, 19.66%, 10.60%, and 17.89% had specific organ, bone, brain, liver, and lung metastases, respectively. The average survival in patients with organ metastases was 12.19 months, compared to 36.40 months in patients without metastases. In different kinds of metastatic organ cohorts, the longest average survival was 12.60 months in the lung metastases cohort, and the shortest was 8.43 months in liver metastases cohort. In total, 571 patients with metastases received surgery, which was significantly associated with decreased mortality (hazard ratio 1.82, 95% confidence interval 1.65-2.01, p < 0.01). Patients received surgery of lobectomy or extended (251 of 571, 43.96%) displayed the longest average survival (35.16 months); patients (294 of 571, 51.49%) received sub-lobar resection, had the average survival (19.90 months); patients received local tumor destruction (26 of 571, 4.55%) had the shortest average survival (13.73 months). CONCLUSION This study provides insights into the specific organ metastatic rates and prognosis in LUAD patients on a population level. These findings suggest that surgery resection should be taken into consideration in the treatment for these LUAD patients.
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Affiliation(s)
- Ziran Zhao
- Thoracic Surgery Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yibo Gao
- Thoracic Surgery Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Fengwei Tan
- Thoracic Surgery Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Qi Xue
- Thoracic Surgery Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Shugeng Gao
- Thoracic Surgery Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Jie He
- Thoracic Surgery Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
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Zhang X, Chen Q, He Y, Shi Q, Yin C, Xie Y, Yu H, Bao Y, Wang X, Tang C, Dong Z. STRIP2 motivates non-small cell lung cancer progression by modulating the TMBIM6 stability through IGF2BP3 dependent. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2023; 42:19. [PMID: 36639675 PMCID: PMC9837939 DOI: 10.1186/s13046-022-02573-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/15/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Striatin interacting protein 2 (STRIP2) is a core component of the striatin-interacting phosphatase and kinase (STRIPAK) complexes, which is involved in tumor initiation and progression via the regulation of cell contractile and metastasis. However, the underlying molecular mechanisms of STRIP2 in non-small cell lung cancer (NSCLC) progression remain largely unknown. METHODS The expressions of STRIP2 and IGF2BP3 in human NSCLC specimens and NSCLC cell lines were detected using quantitative RT-PCR, western blotting, and immunohistochemistry (IHC) analyses. The roles and molecular mechanisms of STRIP2 in promoting NSCLC progression were investigated in vitro and in vivo. RESULTS Here, we found that STRIP2 expression was significantly elevated in NSCLC tissues and high STRIP2 expression was associated with a poor prognosis. Knockdown of STRIP2 suppressed tumor growth and metastasis in vitro and in vivo, while STRIP2 overexpression obtained the opposite effect. Mechanistically, P300/CBP-mediated H3K27 acetylation activation in the promoter of STRIP2 induced STRIP2 transcription, which interacted with insulin-like growth factor 2 mRNA-binding protein 3 (IGF2BP3) and upregulated IGF2BP3 transcription. In addition, STRIP2-IGF2BP3 axis stimulated m6A modification of TMBIM6 mRNA and enhanced TMBIM6 stability. Consequently, TMBIM6 involved NSCLC cell proliferation, migration and invasion dependent on STRIP2 and IGF2BP3. In NSCLC patients, high co-expression of STRIP2, IGF2BP3 and TMBIM6 was associated with poor outcomes. CONCLUSIONS Our findings indicate that STRIP2 interacts with IGF2BP3 to regulate TMBIM6 mRNA stability in an m6A-dependent manner and may represent a potential prognostic biomarker and therapeutic target for NSCLC.
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Affiliation(s)
- Xilin Zhang
- grid.411440.40000 0001 0238 8414Huzhou Key Laboratory of Translational Medicine, First Affiliated Hospital of Huzhou University, Huzhou, 313000 Zhejiang China
| | - Qiuqiang Chen
- grid.411440.40000 0001 0238 8414Department of Cardiothoracic Surgery, First Affiliated Hospital of Huzhou University, Huzhou, 313000 Zhejiang China
| | - Ying He
- grid.411440.40000 0001 0238 8414Huzhou Key Laboratory of Translational Medicine, First Affiliated Hospital of Huzhou University, Huzhou, 313000 Zhejiang China
| | - Qian Shi
- grid.411440.40000 0001 0238 8414Huzhou Key Laboratory of Translational Medicine, First Affiliated Hospital of Huzhou University, Huzhou, 313000 Zhejiang China
| | - Chengyi Yin
- grid.411440.40000 0001 0238 8414Department of Cardiothoracic Surgery, First Affiliated Hospital of Huzhou University, Huzhou, 313000 Zhejiang China
| | - Yanping Xie
- grid.411440.40000 0001 0238 8414Department of Cardiothoracic Surgery, First Affiliated Hospital of Huzhou University, Huzhou, 313000 Zhejiang China
| | - Huanming Yu
- grid.411440.40000 0001 0238 8414Department of Cardiothoracic Surgery, First Affiliated Hospital of Huzhou University, Huzhou, 313000 Zhejiang China
| | - Ying Bao
- grid.411440.40000 0001 0238 8414Department of Cardiothoracic Surgery, First Affiliated Hospital of Huzhou University, Huzhou, 313000 Zhejiang China
| | - Xiang Wang
- grid.411440.40000 0001 0238 8414Huzhou Key Laboratory of Translational Medicine, First Affiliated Hospital of Huzhou University, Huzhou, 313000 Zhejiang China
| | - Chengwu Tang
- grid.411440.40000 0001 0238 8414Huzhou Key Laboratory of Translational Medicine, First Affiliated Hospital of Huzhou University, Huzhou, 313000 Zhejiang China
| | - Zhaohui Dong
- grid.411440.40000 0001 0238 8414Department of Cardiothoracic Surgery, First Affiliated Hospital of Huzhou University, Huzhou, 313000 Zhejiang China
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Tie X, Chen L, Li X, Zha W, Liu Y. A nomogram model of postoperative prognosis for metastatic lung adenocarcinoma: A study based on the SEER database. Medicine (Baltimore) 2022; 101:e31083. [PMID: 36254027 PMCID: PMC9575752 DOI: 10.1097/md.0000000000031083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
We have observed that patients with metastatic lung adenocarcinoma can obtain survival benefits from surgical resection of the primary tumor. A model was developed to evaluate the prognosis of patients. The patients with metastatic lung adenocarcinoma were identified in the Surveillance, Epidemiology, and End Results database and divided into surgery group and non-surgical group. Through Kaplan-Meier analysis, the survival rate of the non-surgical group was found to be significantly lower no matter before or after propensity score matching. One thousand one hundred and seventy surgical patients were divided into a training group and a verification group. In the training group, univariate and multivariate Cox models were used to explore the prognostic factors, and logistic regression was used to establish a nomogram based on significant predictors. In total, 12,228 patients with metastatic lung adenocarcinoma were recognized; primary tumor surgery accounted for 9.5%. After propensity score matching, the median survival time of 2 groups was significantly different. For the training group, univariate and multivariate COX analysis was conducted, and a nomogram was constructed. Acceptable agreement has been achieved between the predicted and observed survival rates, and the nomogram can divide patients with metastatic lung adenocarcinoma into different risk groups and predict their prognostic survival rate.
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Affiliation(s)
- Xiaowei Tie
- Taixing People’s Hospital Affiliated with Bengbu Medical College, Bengbu, China
| | - Lianlian Chen
- Taixing People’s Hospital Affiliated with Bengbu Medical College, Bengbu, China
| | - Xiaomin Li
- Taixing People’s Hospital Affiliated with Bengbu Medical College, Bengbu, China
| | - Wenjuan Zha
- Taixing People’s Hospital Affiliated with Bengbu Medical College, Bengbu, China
| | - Yangchen Liu
- Taixing People’s Hospital Affiliated with Bengbu Medical College, Bengbu, China
- *Correspondence: Yang Chen Liu, Taixing People’s Hospital Affiliated with Bengbu Medical College, Bengbu, China (e-mail: )
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Yuan J, Cheng Z, Feng J, Xu C, Wang Y, Zou Z, Li Q, Guo S, Jin L, Jiang G, Shang Y, Wu J. Prognosis of lung cancer with simple brain metastasis patients and establishment of survival prediction models: a study based on real events. BMC Pulm Med 2022; 22:162. [PMID: 35477385 PMCID: PMC9047387 DOI: 10.1186/s12890-022-01936-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 03/31/2022] [Indexed: 12/11/2022] Open
Abstract
Objectives The aim of this study was to explore risk factors for the prognosis of lung cancer with simple brain metastasis (LCSBM) patients and to establish a prognostic predictive nomogram for LCSBM patients. Materials and methods Three thousand eight hundred and six cases of LCSBM were extracted from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015 using SEER Stat 8.3.5. Lung cancer patients only had brain metastasis with no other organ metastasis were defined as LCSBM patients. Prognostic factors of LCSBM were analyzed with log-rank method and Cox proportional hazards model. Independent risk and protective prognostic factors were used to construct nomogram with accelerated failure time model. C-index was used to evaluate the prediction effect of nomogram. Results and conclusion The younger patients (18–65 years old) accounted for 54.41%, while patients aged over 65 accounted for 45.59%.The ratio of male: female was 1:1. Lung cancer in the main bronchus, upper lobe, middle lobe and lower lobe were accounted for 4.91%, 62.80%, 4.47% and 27.82% respectively; and adenocarcinoma accounted for 57.83% of all lung cancer types. The overall median survival time was 12.2 months. Survival rates for 1-, 3- and 5-years were 28.2%, 8.7% and 4.7% respectively. We found female (HR = 0.81, 95% CI 0.75–0.87), the married (HR = 0.80; 95% CI 0.75–0.86), the White (HR = 0.90, 95% CI 0.84–0.95) and primary site (HR = 0.45, 95% CI 0.39–0.52) were independent protective factors while higher age (HR = 1.51, 95% CI 1.40–1.62), advanced grade (HR = 1.19, 95% CI 1.12–1.25) and advanced T stage (HR = 1.09, 95% CI 1.05–1.13) were independent risk prognostic factors affecting the survival of LCSBM patients. We constructed the nomogram with above independent factors, and the C-index value was 0.634 (95% CI 0.622–0.646). We developed a nomogram with seven significant LCSBM independent prognostic factors to provide prognosis prediction.
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Affiliation(s)
- Jiaying Yuan
- Department of Respiratory and Critical Care Medicine, Shanghai Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, China
| | - Zhiyuan Cheng
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200240, China
| | - Jian Feng
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, China
| | - Chang Xu
- Clinical College of Xiangnan University, Chenzhou, 423043, China
| | - Yi Wang
- School of Life Sciences, Fudan University, Shanghai, 200433, China
| | - Zixiu Zou
- School of Life Sciences, Fudan University, Shanghai, 200433, China
| | - Qiang Li
- Department of Respiratory and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, 200120, China
| | - Shicheng Guo
- School of Life Sciences, Fudan University, Shanghai, 200433, China
| | - Li Jin
- School of Life Sciences, Fudan University, Shanghai, 200433, China
| | - Gengxi Jiang
- Department of Thoracic Surgery, Shanghai Changhai Hospital, the First Affiliated Hospital of Naval Military Medical University, Shanghai, 200433, China.
| | - Yan Shang
- Department of Respiratory and Critical Care Medicine, Shanghai Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, China. .,Department of General Medicine, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, China.
| | - Junjie Wu
- Department of Pulmonary and Critical Care Medicine, Fudan University, Shanghai, 200032, China. .,Department of Pulmonary and Critical Care Medicine, Shanghai Geriatric Medical Center, Shanghai, 200032, China.
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Construction and validation of a nomogram for non small cell lung cancer patients with liver metastases based on a population analysis. Sci Rep 2022; 12:4011. [PMID: 35256719 PMCID: PMC8901853 DOI: 10.1038/s41598-022-07978-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 02/22/2022] [Indexed: 11/12/2022] Open
Abstract
Lung cancer is one of the most common malignancies in the United States, and the common metastatic sites in advanced non-small cell lung cancer (NSCLC) are bone, brain, adrenal gland, and liver, respectively, among which patients with liver metastases have the worst prognosis. We retrospectively analyzed 1963 patients diagnosed with NSCLC combined with liver metastases between 2010 and 2015. Independent prognostic factors for patients with liver metastases from NSCLC were identified by univariate and multivariate Cox regression analysis. Based on this, we developed a nomogram model via R software and evaluated the performance and clinical utility of the model by calibration curve, receiver operating characteristic curves, and decision curve analysis (DCA). The independent prognostic factors for NSCLC patients with liver metastases included age, race, gender, grade, T stage, N stage, brain metastases, bone metastases, surgery, chemotherapy, and tumor size. The area under the curve predicting OS at 6, 9, and 12 months was 0.793, 0.787, and 0.784 in the training cohort, and 0.767, 0.771, and 0.773 in the validation cohort, respectively. Calibration curves of the nomogram showed high agreement between the outcomes predicted by the nomogram and the actual observed outcomes, and the DCA further demonstrated the value of the clinical application of the nomogram. By analyzing the Surveillance, Epidemiology, and End Results database, we established and verified a prognostic nomogram for NSCLC patients with liver metastases, to personalize the prognosis of patients. At the same time, the prognostic nomogram has a satisfactory accuracy and the results are a guide for the development of patient treatment plans.
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Chen H, Huang C, Ge H, Chen Q, Chen J, Li Y, Chen H, Luo S, Zhao L, Xu X. A novel LASSO-derived prognostic model predicting survival for non-small cell lung cancer patients with M1a diseases. Cancer Med 2022; 11:1561-1572. [PMID: 35128839 PMCID: PMC8921928 DOI: 10.1002/cam4.4560] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 11/16/2021] [Accepted: 11/30/2021] [Indexed: 11/12/2022] Open
Abstract
Introduction The current American Joint Committee on Cancer (AJCC) M1a staging of non‐small cell lung cancer (NSCLC) encompasses a wide disease spectrum, showing diverse prognosis. Methods Patients who diagnosed in an earlier period formed the training cohort, and those who diagnosed thereafter formed the validation cohort. Kaplan–Meier analysis was performed for the training cohort by dividing the M1a stage into three subgroups: (I) malignant pleural effusion (MPE) or malignant pericardial effusion (MPCE); (II) separate tumor nodules in contralateral lung (STCL); and (III) pleural tumor nodules on the ipsilateral lung (PTIL). Gender, age, histologic, N stage, grade, surgery for primary site, lymphadenectomy, M1a groups, and chemotherapy were selected as independent prognostic factors using the least absolute shrinkage and selection operator (LASSO) Cox regression analysis. And a nomogram was constructed using Cox hazard regression analysis. Accuracy and clinical practicability were separately tested by Harrell's concordance index, the receiver operating characteristic (ROC) curve, calibration plots, residual plot, the integrated discrimination improvement (IDI), net reclassification improvement (NRI), and decision curve analysis (DCA). Results The concordance index (0.661 for the training cohort and 0.688 for the validation cohort) and the area under the ROC curve (training cohort: 0.709 for 1‐year and 0.727 for 2‐year OS prediction; validation cohort: 0.737 for 1‐year and 0.734 for 2‐year OS prediction) indicated satisfactory discriminative ability of the nomogram. Calibration curve and DCA presented great prognostic accuracy, and clinical applicability. Its prognostic accuracy preceded the AJCC staging with evaluated NRI (1‐year: 0.327; 2‐year: 0.302) and IDI (1‐year: 0.138; 2‐year: 0.130). Conclusion Our study established a nomogram for the prediction of 1‐ and 2‐year OS in patients with NSCLC diagnosed with stage M1a, facilitating healthcare workers to accurately evaluate the individual survival of M1a NSCLC patients. The accuracy and clinical applicability of this nomogram were validated.
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Affiliation(s)
- Hongchao Chen
- Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli Clinical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Chen Huang
- Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli Clinical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Huiqing Ge
- Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli Clinical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Qianshun Chen
- Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli Clinical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Jing Chen
- Department of Pharmacy, Fujian Children's hospital, Fuzhou, Fujian, China
| | - Yuqiang Li
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Haiyong Chen
- Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli Clinical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Shiyin Luo
- Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli Clinical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Lilan Zhao
- Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli Clinical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Xunyu Xu
- Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli Clinical College of Fujian Medical University, Fuzhou, Fujian, China
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Zhu S, Ge T, Hu J, Jiang G, Zhang P. Prognostic value of surgical intervention in advanced lung adenocarcinoma: a population-based study. J Thorac Dis 2021; 13:5942-5953. [PMID: 34795942 PMCID: PMC8575796 DOI: 10.21037/jtd-21-997] [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: 06/17/2021] [Accepted: 08/19/2021] [Indexed: 12/24/2022]
Abstract
Background Surgical intervention is generally not considered as a treatment option in patients with advanced non-small cell lung cancer (NSCLC). Accumulating data suggest that surgery may have beneficial effects for these advanced patients. However, no evidence supports the significance of primary tumor resection (PTR) and metastatic tumor resection (MTR) in patients with stage IV lung adenocarcinoma (LUAD). Methods A total of 32,497 patients diagnosed with primary stage IV LUAD were selected through the Surveillance, Epidemiology, and End Results (SEER) database. Possible confounders were eliminated by propensity score matching (PSM). The overall survival (OS) and lung cancer-specific survival (LCSS) were estimated as the primary endpoints. Furthermore, the independent prognostic factors of patients with the surgical intervention were retrospectively analyzed. Results Patients underwent surgical intervention had better OS and LCSS than those who did not (P=0.001 for OS; P<0.001 for LCSS). Meanwhile, patients who underwent surgery combined with lymph node dissection had better survival outcomes (P<0.001 for OS and LCSS) in the K-M analysis. For different metastatic sites, PTR was beneficial to the survival of patients with isolated lung metastases (LUM) and multiple organ metastases (MOM) (LUM: P=0.041; MOM: P=0.003). As for metastatic surgery, no patients were found to benefit from resection of metastatic tumor [bone metastasis (BOM): P=0.696; brain metastasis (BRM): P=0.951; LUM: P=0.402; MOM: P=0.365]. Conclusions Surgical intervention strategies can prolong survival to some extent, depending on different sites of metastasis and highly selected patients.
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Affiliation(s)
- Shuncang Zhu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Tao Ge
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Junjie Hu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Gening Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Peng Zhang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
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12
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Differential role of residual metabolic tumor volume in inoperable stage III NSCLC after chemoradiotherapy ± immune checkpoint inhibition. Eur J Nucl Med Mol Imaging 2021; 49:1407-1416. [PMID: 34664091 PMCID: PMC8921088 DOI: 10.1007/s00259-021-05584-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/09/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND The PET-derived metabolic tumor volume (MTV) is an independent prognosticator in non-small cell lung cancer (NSCLC) patients. We analyzed the prognostic value of residual MTV (rMTV) after completion of chemoradiotherapy (CRT) in inoperable stage III NSCLC patients with and without immune checkpoint inhibition (ICI). METHODS Fifty-six inoperable stage III NSCLC patients (16 female, median 65.0 years) underwent 18F-FDG PET/CT after completion of standard CRT. rMTV was delineated on 18F-FDG PET/CT using a standard threshold (liver SUVmean + 2 × standard deviation). 21/56 patients underwent additional ICI (CRT-IO, 21/56 patients) thereafter. Patients were divided in volumetric subgroups using median split dichotomization (MTV ≤ 4.3 ml vs. > 4.3 ml). rMTV, clinical features, and ICI-application were correlated with clinical outcome parameters (progression-free survival (PFS), local PFS (LPFS), and overall survival (OS). RESULTS Overall, median follow-up was 52.0 months. Smaller rMTV was associated with longer median PFS (29.3 vs. 10.5 months, p = 0.015), LPFS (49.9 vs. 13.5 months, p = 0.001), and OS (63.0 vs. 23.0 months, p = 0.003). CRT-IO patients compared to CRT patients showed significantly longer median PFS (29.3 vs. 11.2 months, p = 0.034), LPFS (median not reached vs. 14.0 months, p = 0.016), and OS (median not reached vs. 25.2 months, p = 0.007). In the CRT subgroup, smaller rMTV was associated with longer median PFS (33.5 vs. 8.6 months, p = 0.001), LPFS (49.9 vs. 10.1 months, p = 0.001), and OS (63.0 vs. 16.3 months, p = 0.004). In the CRT-IO subgroup, neither PFS, LPFS, nor OS were associated with MTV (p > 0.05 each). The findings were confirmed in subsequent multivariate analyses. CONCLUSION In stage III NSCLC, smaller rMTV is highly associated with superior clinical outcome, especially in patients undergoing CRT without ICI. Patients with CRT-IO show significantly improved outcome compared to CRT patients. Of note, clinical outcome in CRT-IO patients is independent of residual MTV. Hence, even patients with large rMTV might profit from ICI despite extensive tumor load.
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The role of surgery in the treatment of oligoprogression after systemic treatment for advanced non-small cell lung cancer. Lung Cancer 2021; 161:141-151. [PMID: 34600405 DOI: 10.1016/j.lungcan.2021.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 09/08/2021] [Accepted: 09/21/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Patients with advanced stage non-small cell lung cancer (NSCLC) are generally considered incurable. The mainstay of treatment for these patients is systemic therapy. The addition of local treatment, including surgery, remains controversial. Oligoprogression is defined as advanced stage NSCLC with limited progression of disease after a period of prolonged disease stabilisation or after a partial or complete response on systemic therapy. In this retrospective study we evaluated outcome and survival of patients who underwent a resection for oligoprogression after systemic therapy for advanced stage NSCLC. MATERIALS AND METHODS Patients with oligoprogression after systemic treatment for advanced NSCLC who were operated in the Antoni van Leeuwenhoek Hospital were included. Patient and treatment characteristics were collected in relation to progression free survival (PFS) and overall survival (OS). RESULTS Between January 2015 and December 2019, 28 patients underwent surgery for an oligoprogressive lesion (primary tumor lung (n = 12), other metastatic site (n = 16)). Median age at time of resection was 60 years (39-86) and 57% were female. Postoperative complications were observed in 2 patients (7%). Progression of disease after resection of the oligoprogressive site was observed in 17 patients (61%). Median PFS was 7 months since date of resection (95% CI 6.0-25.0) and median OS was not reached. Seven patients (25%) died during follow-up. Age was predictive for OS and clinical T4 stage was predictive for PFS. M1 disease at initial presentation was predictive for better PFS compared to patients who were diagnosed with M0 disease initially. Patients who underwent resection because of oligoprogression of the primary lung tumour had a better PFS, when compared to oligoprogression of another metastastic site. CONCLUSION Surgical resection of an oligoprogressive lesion in patients with advanced NSCLC treated with systemic treatment is feasible and might be considered in order to achieve long term survival.
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Wang F, Gao J, Ren Y, Su H, She Y, Xie D, Chen C. Predicted outcomes of subdividing M1-stage metastatic lung cancer based on the prognosis and the response to local consolidative therapy. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1293. [PMID: 34532430 PMCID: PMC8422121 DOI: 10.21037/atm-21-1383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/01/2021] [Indexed: 11/06/2022]
Abstract
Background For stage IV non-small cell lung cancer (NSCLC) patients, systemic therapy is the main strategy, and local consolidative therapy tends to be performed for patients with oligometastases. The porpose of this article is to evaluate the prognostic effects of local consolidative therapy for patients with stage IV NSCLC and divide these patients into different subcategories to stratify the prognoses. Methods A total of 30,583 patients with stage IV NSCLC were identified in the Surveillance, Epidemiology, and End Results (SEER) database. To identify factors related to high cancer-specific mortality (CSM) rates and compare the prognostic effects of different treatment strategies, a competing risk model was developed. Furthermore, independent prognostic factors identified through multivariable analysis were employed to supplement the current M1 subcategory. Cumulative incidence curves were estimated using the Kaplan-Meier method, and the log-rank test was used to compare prognostic differences. Results The CSM rates of M1a, M1b, and M1c patients were significantly different [M1b versus M1a: subdistribution hazard ratio (SHR), 1.38; 95% confidence interval (CI), 1.31-1.45; P<0.001; M1c vs. M1a: SHR, 1.76; 95% CI, 1.67-1.85; P<0.001]. Patients were divided into five groups depending on the M1 subcategory and liver involvement (Group A, M1c NSCLC with liver involvement; Group B, M1c NSCLC without liver involvement; Group C, M1b NSCLC with liver involvement; Group D, M1b NSCLC without liver involvement; and Group E, M1a NSCLC). Univariable analysis showed that liver involvement was associated with increased cancer-specific mortality (CSM) rates in both M1b and M1c patients (A vs. B: SHR, 1.36; 95% CI, 1.30-1.43; P<0.001; C vs. D: SHR, 1.27; 95% CI, 1.20-1.35; P<0.001). Primary tumor surgery plus chemotherapy may substantially benefit patients, especially M1b patients (surgery alone: SHR, 0.425; 95% CI, 0.361-0.500; P<0.001 vs. chemotherapy alone: SHR, 0.366; 95% CI, 0.352-0.382; P<0.001 vs. chemotherapy plus surgery: SHR, 0.194; 95% CI, 0.165-0.228; P<0.001; no treatment used as reference). Conclusions Subdivision of M1 disease and awareness of liver involvement may help to inform the prognosis of stage IV NSCLC patients and facilitate treatment planning.
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Affiliation(s)
- Fang Wang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jiani Gao
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yijiu Ren
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Hang Su
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yunlang She
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Dong Xie
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Chang Chen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
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Bungaro M, Paratore C, Bironzo P, Novello S. Local for advanced, is this a paradox? Transl Lung Cancer Res 2021; 10:3324-3328. [PMID: 34430369 PMCID: PMC8350073 DOI: 10.21037/tlcr-20-771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 03/05/2021] [Indexed: 01/09/2023]
Affiliation(s)
- Maristella Bungaro
- Medical Oncology Department, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Chiara Paratore
- Medical Oncology Department, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Paolo Bironzo
- Medical Oncology Department, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Silvia Novello
- Medical Oncology Department, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
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Hao Z, Liang H, Zhang Y, Wei W, Lan Y, Qiu S, Lin G, Wang R, Liu Y, Chen Y, Huang J, Wang W, Cui F, Goto T, Jeong JY, Veronesi G, Lopez-Pastorini A, Igai H, Liang W, He J, Liu J. Surgery for advanced-stage non-small cell lung cancer: lobectomy or sub-lobar resection? Transl Lung Cancer Res 2021; 10:1408-1423. [PMID: 33889519 PMCID: PMC8044485 DOI: 10.21037/tlcr-21-39] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Metastatic non-small cell lung cancer (NSCLC) has many comorbidities, such as chronic obstructive pulmonary disease, coronary heart disease, and older age-related comorbidities. A survival benefit was observed in such patients who underwent surgery for selected oligometastatic disease. However, to the best of our knowledge, there is no evidence to support whether lobectomy (compared with sub-lobar resection) would further prolong these patients' lives. Methods Patients with metastatic NSCLC who underwent primary tumor resection were identified from the Surveillance, Epidemiology, and End Results (SEER) database and then divided into lobectomy and sub-lobar resection groups. Propensity score matching (PSM, 1:1) was performed to match the baseline characteristics of the two groups. Cancer-specific survival (CSS) was estimated. Results In total, 24,268 patients with metastatic NSCLC were identified; 4,114 (16.95%) underwent primary tumor surgery, and of these, 2,045 (49.71%) underwent lobectomy and 1,766 (42.93%) underwent sub-lobar resection. After PSM, 644 patients in each group were included. Lobectomy was independently correlated with longer median CSS time [hazards ratio (HR): 0.70, 95% confidence interval (CI): 0.61-0.80, P<0.001]. The 1, 2, and 3-year survival rates after PSM also favored the lobectomy group. However, no significant survival difference was found for wedge resection and segmentectomy (HR: 0.96, 95% CI: 0.70-1.31, P=0.490). The 1-, 2-, and 3-year survival rates after PSM also exhibited no difference within the sub-lobar group. We explored whether lymph node dissection would provide additional survival benefits for stage IV NSCLC patients. According to the multivariate Cox analysis of the matched population, lymph node dissection was independently associated with better CSS (HR: 0.76, 95% CI: 0.66-0.88, P<0.001) and overall survival (OS) (HR: 0.74, 95% CI: 0.65-0.86, P<0.001). We confirmed this result in the different types of surgery and found that the lymph node dissection group consistently had better survival outcomes both in the lobectomy group and sub-lobar resection population. According to the subgroup analysis, with the exception of stage T4 and brain metastatic patients, all of the patient subtypes exhibited greater benefit from lobectomy than sub-lobar resection. Conclusions Lobectomy has a greater survival benefit in metastatic NSCLC patients compared with sub-lobar resection when radical treatment of primary site was indicated.
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Affiliation(s)
- Zhexue Hao
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Hengrui Liang
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Yichi Zhang
- Department of Clinical Medicine, Guangzhou Medical University, Guangzhou, China
| | - Wei Wei
- Department of Thoracic Surgery, Huizhou Municipal Central Hospital, Huizhou, China
| | - Yuting Lan
- Department of Clinical Medicine, Guangzhou Medical University, Guangzhou, China
| | - Shuxian Qiu
- Department of Clinical Medicine, Guangzhou Medical University, Guangzhou, China
| | - Guo Lin
- Department of Clinical Medicine, Guangzhou Medical University, Guangzhou, China
| | - Runchen Wang
- Department of Clinical Medicine, Guangzhou Medical University, Guangzhou, China
| | - Yulin Liu
- Department of Clinical Medicine, Guangzhou Medical University, Guangzhou, China
| | - Yingying Chen
- Department of Clinical Medicine, Guangzhou Medical University, Guangzhou, China
| | - Jun Huang
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Wei Wang
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Fei Cui
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Taichiro Goto
- Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, Yamanashi, Japan
| | - Jin Yong Jeong
- Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Giulia Veronesi
- Division of Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy.,School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Alberto Lopez-Pastorini
- Department of Thoracic Surgery, Lung Clinic, Hospital of the City of Cologne, University of Witten-Herdecke, Cologne, Germany
| | - Hitoshi Igai
- Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan
| | - Wenhua Liang
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Jianxing He
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Jun Liu
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
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Liang H, Liu Z, Huang J, Liu J, Wang W, Li J, Xiong S, Li C, Cheng B, Zhao Y, Cui F, He J, Liang W. Identifying optimal candidates for primary tumor resection among metastatic non-small cell lung cancer patients: a population-based predictive model. Transl Lung Cancer Res 2021; 10:279-291. [PMID: 33569312 PMCID: PMC7867775 DOI: 10.21037/tlcr-20-709] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background A survival benefit was observed in metastatic non-small cell lung cancer (NSCLC) patients that underwent surgical resection of the primary tumor. We developed a model testing the hypothesis that only certain stage IV patients would benefit from surgery and the potential benefit would vary based on primary tumor characteristics. Methods Patients with stage IV NSCLC were identified in the Surveillance, Epidemiology and End Results (SEER) database and then divided into surgery and non-surgery groups. A 1:1 Propensity score matching (PSM) was performed to balance characters. We assumed that patients received primary tumor surgery that lived longer than median cancer specific survival (CSS) time of those who didn't underwent surgery could benefit from the operation. Multivariable Cox model was used to explore the independent factors of CSS in two groups (beneficial and non-beneficial group). Logistic regression was used to build a nomogram based on the significant predictive factors. Results A total of 30,342 patients with stage IV NSCLC were identified; 8.03% (2,436) received primary tumor surgery. After PSM, surgical intervention was independently correlated with longer median CSS time (19 vs. 9 months, P<0.001). Among the surgery cohort, 1,374 (56.40%) patients lived longer than 9 months (beneficial group). Differentiated characters (beneficial and non-beneficial group) included age, gender, TNM stage, histologic type, tumor position and differentiation grade, which were integrated as predictors to build a nomogram. Conclusions A practical predictive model was created and might be used to identify the optimal candidates for surgical resection of the primary tumor among stage IV NSCLC patients.
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Affiliation(s)
- Hengrui Liang
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Zhichao Liu
- Nanshan School, Guangzhou Medical University, Guangzhou, China.,Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Huang
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Jun Liu
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Wei Wang
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Jianfu Li
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Shan Xiong
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Caichen Li
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Bo Cheng
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Yi Zhao
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Fei Cui
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Jianxing He
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Wenhua Liang
- Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
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Huang Z, Hu C, Tong Y, Fan Z, Zhao C. Construction of a nomogram to predict the prognosis of non-small-cell lung cancer with brain metastases. Medicine (Baltimore) 2020; 99:e21339. [PMID: 32756121 PMCID: PMC7402728 DOI: 10.1097/md.0000000000021339] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/11/2020] [Accepted: 06/17/2020] [Indexed: 12/24/2022] Open
Abstract
Patients with non-small-cell lung cancer (NSCLC) often have a poor prognosis when brain metastases (BM) occur. This study aimed to evaluate the prognostic factors of BM in newly diagnosed NSCLC patients and construct a nomogram to predict the overall survival (OS).We included NSCLC patients with BM newly diagnosed from 2010 to 2015 in Surveillance, Epidemiology, and End Results database. The independent prognostic factors for NSCLC with BM were determined by Cox proportional hazards regression analysis. We then constructed and validated a nomogram to predict the OS of NSCLC with BM.We finally included 4129 NSCLC patients with BM for analysis. Age, race, sex, liver metastasis, primary site, histologic type, grade, bone metastasis, T stage, N stage, surgery, chemotherapy, and lung metastasis were identified as the prognostic factors for NSCLC with BM and integrated to establish the nomogram. The calibration, receiver operating characteristic curve, and decision curve analyses also showed that the clinical prediction model performed satisfactorily in predicting prognosis.A clinical prediction model was constructed and validated to predict individual OS for NSCLC with BM. The establishment of this clinical prediction model has great significance for clinicians and individuals.
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Affiliation(s)
- Zhangheng Huang
- Department of Minimally Invasive Spine Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei
| | - Chuan Hu
- Department of Minimally Invasive Spine Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei
- Department of Orthopedic, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yuexin Tong
- Department of Minimally Invasive Spine Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei
| | - Zhiyi Fan
- Department of Minimally Invasive Spine Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei
| | - Chengliang Zhao
- Department of Minimally Invasive Spine Surgery, Affiliated Hospital of Chengde Medical University, Chengde, Hebei
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Käsmann L, Eze C, Taugner J, Roengvoraphoj O, Dantes M, Schmidt-Hegemann NS, Schiopu S, Belka C, Manapov F. Chemoradioimmunotherapy of inoperable stage III non-small cell lung cancer: immunological rationale and current clinical trials establishing a novel multimodal strategy. Radiat Oncol 2020; 15:167. [PMID: 32646443 PMCID: PMC7350600 DOI: 10.1186/s13014-020-01595-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 06/09/2020] [Indexed: 02/06/2023] Open
Abstract
Immune-checkpoint inhibitors (ICI) have dramatically changed the landscape of lung cancer treatment. Preclinical studies investigating combination of ICI with radiation show a synergistic improvement of tumor control probability and have resulted in the development of novel therapeutic strategies. For advanced non-small cell lung cancer (NSCLC), targeting immune checkpoint pathways has proven to be less toxic with more durable treatment response than conventional chemotherapy. In inoperable Stage III NSCLC, consolidation immune checkpoint inhibition with the PD-L1 inhibitor durvalumab after completion of concurrent platinum-based chemoradiotherapy resulted in remarkable improvement of progression-free and overall survival. This new tri-modal therapy has become a new treatment standard. Development of predictive biomarkers and improvement of patient selection and monitoring is the next step in order to identify patients most likely to derive maximal benefit from this new multimodal approach. In this review, we discuss the immunological rationale and current trials investigating chemoradioimmunotherapy for inoperable stage III NSCLC.
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Affiliation(s)
- Lukas Käsmann
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Chukwuka Eze
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.
| | - Julian Taugner
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Olarn Roengvoraphoj
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Maurice Dantes
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Nina-Sophie Schmidt-Hegemann
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Sanziana Schiopu
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
- Department of Internal Medicine V, Ludwig-Maximilians-University, Munich, Germany
| | - Claus Belka
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Farkhad Manapov
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
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Yin G, Xiao H, Liao Y, Huang C, Fan X. Construction of a Nomogram After Using Propensity Score Matching to Reveal the Prognostic Benefit of Tumor Resection of Stage IV M1a Nonsmall Cell Lung Cancer Patients. Cancer Invest 2020; 38:277-288. [PMID: 32267175 DOI: 10.1080/07357907.2020.1753761] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The aim of this work was to determine whether tumor resection could improve the prognosis of M1a nonsmall-cell lung cancer (NSCLC) patients. We obtained patient data from the Surveillance, Epidemiology, and End Results (SEER) database and used propensity score matching (PSM) to reduce the influence of confounding variables. Univariate and multivariate Cox regression analyses were used to identify independent prognostic factors, and the prediction results were visualized using the nomogram. A total of 772 patients with and without tumor resection were enrolled after PSM, and the nomogram combined with independent prognostic factors including age, sex, histological type, grade, T stage, N stage, chemotherapy, and surgery showed great prediction and discriminatory ability. Tumor resection is possibly a better choice for these patients.
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Affiliation(s)
- Guofang Yin
- Department of Respiratory and Critical Care Medicine II, The Affiliated Hospital of Southwest Medical University, Luzhuo, Sichuan Province, People's Republic of China
| | - Hua Xiao
- Department of Respiratory and Critical Care Medicine II, The Affiliated Hospital of Southwest Medical University, Luzhuo, Sichuan Province, People's Republic of China
| | - Yi Liao
- Department of Respiratory and Critical Care Medicine II, The Affiliated Hospital of Southwest Medical University, Luzhuo, Sichuan Province, People's Republic of China
| | - Chengliang Huang
- Department of Respiratory and Critical Care Medicine II, The Affiliated Hospital of Southwest Medical University, Luzhuo, Sichuan Province, People's Republic of China
| | - Xianming Fan
- Department of Respiratory and Critical Care Medicine II, The Affiliated Hospital of Southwest Medical University, Luzhuo, Sichuan Province, People's Republic of China
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Oligometastatic Disease in NSCLC - Not Just Wishful Thinking? J Thorac Oncol 2020; 14:2042-2045. [PMID: 31757373 DOI: 10.1016/j.jtho.2019.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 10/15/2019] [Indexed: 01/13/2023]
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Commentary: Surgery expanding to stage IV non-small cell lung cancer treatment?! J Thorac Cardiovasc Surg 2020; 161:1508-1509. [PMID: 32386755 DOI: 10.1016/j.jtcvs.2020.03.054] [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: 03/09/2020] [Revised: 03/09/2020] [Accepted: 03/10/2020] [Indexed: 11/22/2022]
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Käsmann L, Abdo R, Eze C, Dantes M, Taugner J, Gennen K, Roengvoraphoj O, Rades D, Belka C, Manapov F. External Validation of a Survival Score for Limited-Stage Small Cell Lung Cancer Patients Treated with Chemoradiotherapy. Lung 2020; 198:201-206. [PMID: 31897594 DOI: 10.1007/s00408-019-00312-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/17/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE In order to personalize multimodal treatment regimens in limited-stage small cell lung cancer (LS-SCLC), a survival score for these patients was proposed. The aim of this study is to validate the score in an independent external patient cohort. METHODS We collected data of 78 patients treated with chemoradiotherapy for LS-SCLC between 2004 and 2015. The survival score was calculated by independent prognostic factors: gender, Karnofsky performance status, tumor substage, and hemoglobin level before treatment. Scoring points were derived from 2-year survival rates divided by 10 and the values for each prognostic factor were tallied. Three risk subgroups were defined (high, intermediate, low risk: 9-13, 14-18, 19-26 points). The 2-year survival rate of each subgroup from the original study was compared to its corresponding subgroup from the validation cohort. RESULTS Median survival time in the entire validation cohort was 17 months (range: 1-123 months). The 2-year survival rates were 0% in the 9-13, 35% in the 14-18, and 43% in the 19-26 points group, respectively (p = 0.018). The difference in 2-year survival between the 9-13 points and the 14-18 points group was significant in the validation cohort (p = 0.007) as well after stratification of concurrent chemoradiotherapy (p < 0.001), whereas the difference between the 14 and 18 points and the 19-26 points group was not significant (p = 0.602, p = 0.770). CONCLUSION The score was reproducible to estimate the 2-year survival rate of patients with LS-SCLC, especially in the high- and intermediate-risk subgroups. In order to improve the differentiation between patients with an intermediate and favorable survival prognosis, the scoring system needs further development.
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Affiliation(s)
- Lukas Käsmann
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany.
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany.
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany.
| | - Reem Abdo
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany
| | - Chukwuka Eze
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany
| | - Maurice Dantes
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany
| | - Julian Taugner
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany
| | - Kathrin Gennen
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany
| | - Olarn Roengvoraphoj
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany
| | - Dirk Rades
- Department of Radiation Oncology, University of Luebeck, Luebeck, Germany
| | - Claus Belka
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Farkhad Manapov
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
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Gennen K, Käsmann L, Taugner J, Eze C, Karin M, Roengvoraphoj O, Neumann J, Tufman A, Orth M, Reu S, Belka C, Manapov F. Prognostic value of PD-L1 expression on tumor cells combined with CD8+ TIL density in patients with locally advanced non-small cell lung cancer treated with concurrent chemoradiotherapy. Radiat Oncol 2020; 15:5. [PMID: 31898519 PMCID: PMC6941268 DOI: 10.1186/s13014-019-1453-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 12/23/2019] [Indexed: 12/25/2022] Open
Abstract
Background/aim mmune checkpoint inhibition (CPI) has an increasing impact in the multimodal treatment of locally advanced non-small cell lung cancer (LA-NSCLC). Increasing evidence suggests treatment outcome depending on tumor cell PD-L1 expression. The purpose of this retrospective study was to investigate the prognostic value of PD-L1 expression on tumor cells in combination with CD8+ tumor stroma-infiltrating lymphocyte (TIL) density in inoperable LA-NSCLC treated with concurrent chemoradiotherapy (CRT). Patients and method We retrospectively assessed clinical characteristics and initial tumor biopsy samples of 31 inoperable LA-NSCLC patients treated with concurrent CRT. Prognostic impact of tumor cell PD-L1 expression (0% versus ≥1%) and CD8+ TIL density (0–40% vs. 41–100%) for local control, progression-free (PFS) and overall survival (OS) as well as correlations with clinicopathological features were evaluated. Results Median OS was 14 months (range: 3–167 months). The OS rates at 1- and 2 years were 68 and 20%. Local control of the entire cohort at 1 and 2 years were 74 and 61%. Median PFS, 1-year and 2-year PFS were 13 ± 1.4 months, 58 and 19%. PD-L1 expression < 1% on tumor cells was associated with improved OS, PFS and local control in patients treated with concurrent CRT. Univariate analysis showed a trend towards improved OS and local control in patients with low CD8+ TIL density. Evaluation of Tumor Immunity in the MicroEnvironment (TIME) appears to be an independent prognostic factor for local control, PFS and OS. The longest and shortest OS were achieved in patients with type I (PD-L1neg/CD8low) and type IV (PD-L1pos/CD8low) tumors (median OS: 57 ± 37 vs. 10 ± 5 months, p = 0.05), respectively. Conclusion Assessment of PD-L1 expression on tumor cells in combination with CD8+ TIL density can be a predictive biomarker in patients with inoperable LA-NSCLC treated with concurrent CRT.
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Affiliation(s)
- Kathrin Gennen
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Lukas Käsmann
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany. .,Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany. .,German Cancer Consortium (DKTK), partner site Munich, Munich, Germany.
| | - Julian Taugner
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Chukwuka Eze
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Monika Karin
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Olarn Roengvoraphoj
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Jens Neumann
- Institute of Pathology, Faculty of Medicine, LMU, Munich, Germany
| | - Amanda Tufman
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany.,Department of Internal Medicine V, Thoracic Oncology Centre Munich, Division of Respiratory Medicine and Thoracic Oncology, LMU, Munich, Germany
| | - Michael Orth
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Simone Reu
- Department of Pathology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Claus Belka
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.,Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany.,German Cancer Consortium (DKTK), partner site Munich, Munich, Germany
| | - Farkhad Manapov
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.,Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany.,German Cancer Consortium (DKTK), partner site Munich, Munich, Germany
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Tang H, Han X, Li M, Li T, Hao Y. Linc00221 modulates cisplatin resistance in non-small-cell lung cancer via sponging miR-519a. Biochimie 2019; 162:134-143. [DOI: 10.1016/j.biochi.2019.04.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 04/24/2019] [Indexed: 10/27/2022]
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Liao Y, Fan X, Wang X. Effects of different metastasis patterns, surgery and other factors on the prognosis of patients with stage IV non-small cell lung cancer: A Surveillance, Epidemiology, and End Results (SEER) linked database analysis. Oncol Lett 2019; 18:581-592. [PMID: 31289530 PMCID: PMC6546983 DOI: 10.3892/ol.2019.10373] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 04/10/2019] [Indexed: 12/26/2022] Open
Abstract
The surgical treatment of patients with advanced lung cancer remains controversial. The current study aimed to identify the factors affecting the prognosis of patients with stage IV non-small cell lung cancer (NSCLC) and to clarify the surgery guidelines. A total of 27,725 patients diagnosed with stage IV NSCLC were selected from the Surveillance, Epidemiology, and End Results program between 2010 and 2013. The sex, age, ethnicity, marital status, Tumor-Node-Metastasis stage, radiation therapy received and surgical status of each patient were recorded. Patients were followed up to November 2015. Survival rates were estimated by the Kaplan-Meier method. Single- and multi-factor analyses were performed using the log-rank test and multivariate Cox regression analysis respectively. In the isolated organ metastasis cohort, patients with liver metastasis alone had the worst prognosis, with a median overall survival (OS) of 4 months (liver metastasis vs. other organ metastases; P<0.001). Patients with lung metastasis only had the best prognosis, with a median OS of 8 months (lung metastasis vs. other organ metastases; P<0.001). Furthermore, patients with only one metastasis had the best prognosis, with a median OS of 6 months (single metastasis vs. multiple-organ metastases; P<0.001). The multivariate Cox regression analysis of the isolated-organ metastasis cohort and the multiple-organ metastases cohort revealed that patients who were ≤60 years, female, married, Asian, with N0 stage, had only bone metastasis, accepted wedge resection or lobectomy of the primary tumor, had surgical procedure to distant lymph node(s), and received beam radiation had an improved prognosis compared with the other patients. Age, sex, tumor type, ethnicity, N stage, number and type of metastatic lesions, surgical treatment of primary and metastatic lesions and radiation therapy are factors which influence the prognosis of patients with stage IV NSCLC. Furthermore, surgery may still benefit these patients.
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Affiliation(s)
- Yi Liao
- Department of Respiratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Xianming Fan
- Department of Respiratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Xue Wang
- Department of Respiratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
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Deng C, Wu SG, Tian Y. Lung Large Cell Neuroendocrine Carcinoma: An Analysis of Patients from the Surveillance, Epidemiology, and End-Results (SEER) Database. Med Sci Monit 2019; 25:3636-3646. [PMID: 31095532 PMCID: PMC6537662 DOI: 10.12659/msm.914541] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The aim of this study was to assess the incidence, clinicopathologic characteristics, prognostic factors, and treatment outcomes in lung large cell neuroendocrine carcinoma (LCNEC). Material/Methods Patients diagnosed with lung LCNEC between 2000 and 2013 were identified using the Surveillance, Epidemiology, and End-Results database. Kaplan–Meier methods and univariate and multivariate analyses were used for statistical analysis. Results A total of 2097 patients were identified. The total age-adjusted incidence rate of lung LCNEC was 0.3/100 000, with a rise in incidence over the study period. The 5-year lung cancer-specific survival (LCSS) and overall survival (OS) were 20.7% and 16.7%, respectively. Multivariate analysis indicated that age ≥65 years, male sex, advanced tumor stage, advanced nodal stage, not undergoing surgery. and not undergoing chemotherapy were independent adverse indicators for survival outcomes. After stratification by tumor stage, undergoing surgery was associated with more favorable LCSS and OS compared with those without surgery, regardless of tumor stage. Conclusions LCNEC is a rare lung cancer subtype with a dismal prognosis. Primary surgical treatment has significant survival benefits, even for stage IV patients. The optimal treatment strategies for lung LCNEC require further investigation.
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Affiliation(s)
- Chong Deng
- Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University, Institute of Radiotherapy and Oncology, Soochow University, Suzhou, Jiangsu, China (mainland)
| | - San-Gang Wu
- Department of Radiation Oncology, Cancer Hospital, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, Fujian, China (mainland)
| | - Ye Tian
- Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University, Institute of Radiotherapy and Oncology, Soochow University, Suzhou, Jiangsu, China (mainland)
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Deng J, Ren Z, Wen J, Wang B, Hou X, Xue Z, Chu X. Construction of a nomogram predicting the overall survival of patients with distantly metastatic non-small-cell lung cancer. Cancer Manag Res 2018; 10:6143-6156. [PMID: 30538562 PMCID: PMC6257075 DOI: 10.2147/cmar.s183878] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose This study aimed to establish a nomogram to predict the overall survival (OS) of the general non-small-cell lung cancer (NSCLC) patients with distant metastasis. Patients and methods We investigated Surveillance, Epidemiology, and End Results database for NSCLC patients with distant metastasis diagnosed between 2010 and 2014. Statistically significant prognostic factors were identified using uni- and multivariable Cox regression analyses. A nomogram incorporating these prognostic factors was developed and evaluated by the Harrell's concordance index (C-index), calibration plots, and risk group stratifications. Results We finally included 18,209 patients for analysis. These patients were divided into two groups, 14,567 cases for the training cohort and 3,642 for the validation cohort. Marital status, sex, race, age, histology, T stage, N stage, histological differentiation, bone metastasis, brain metastasis, liver metastasis, with M1a disease, surgery of primary cancer, and chemotherapy were identified as the prognostic factors of the OS and integrated to construct the nomogram. The nomogram had a C-index of 0.704 (95% CI: 0.699-0.709) in the training set and 0.699 (95% CI: 0.689-0.709) in the validation set. The calibration curves for 1- and 2-year OS in the training and validation sets showed acceptable agreement between the predicted and observed survival. Also, the nomogram was capable of stratifying patients into different risk groups within the patients who presented with bone, liver, or brain metastasis, as well as in each T, N stage, respectively. Conclusion A nomogram was established and validated to predict individual prognosis for the general patients with distantly metastatic NSCLC. Global prospective data with the latest TNM classification and more comprehensive prognostic factors are needed to improve this model.
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Affiliation(s)
- Jianqing Deng
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China,
| | - Zhipeng Ren
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China,
| | - Jiaxin Wen
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China,
| | - Bo Wang
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China,
| | - Xiaobin Hou
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China,
| | - Zhiqiang Xue
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China,
| | - Xiangyang Chu
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, People's Republic of China,
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