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Calvo V, Aliaga C, Carracedo C, Provencio M. Prognostic factors in potentially resectable stage III non-small cell lung cancer receiving neoadjuvant treatment-a narrative review. Transl Lung Cancer Res 2021; 10:581-589. [PMID: 33569338 PMCID: PMC7867763 DOI: 10.21037/tlcr-20-515] [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
Lung cancer is the leading cause of cancer-related death in worldwide. The most important treatment for patients with stage I and II non-small cell lung cancer (NSCLC) is surgery. Resected stage II and III NSCLC patients should be offered adjuvant chemotherapy and in patients with resected stage IB disease and with a primary tumor >4 cm this treatment could be considered. The treatment of resectable locally advanced NSCLC should be evaluated within an experienced multidisciplinary team. Neoadjuvant chemotherapy can be considered in patients with resectable disease and clear candidates for complementary chemotherapy. Neoadjuvant chemotherapy has similar impact on overall survival (OS) than adjuvant chemotherapy, however postoperative chemotherapy has more evidence-based support. Immunotherapy is being studied in early and locally advanced NSCLC as a neoadjuvant or adjuvant treatment. Different prognostic factors have been described in patients with stage III who have received neoadjuvant treatment, which we intend to review in this article.
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Affiliation(s)
- Virginia Calvo
- Medical Oncology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Carlos Aliaga
- Medical Oncology Department, Aliada Contra el Cáncer, Lima, Perú
| | - Carlos Carracedo
- Medical Oncology Department, Aliada Contra el Cáncer, Lima, Perú
| | - Mariano Provencio
- Medical Oncology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
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Wu CY, Lee CL, Wu CF, Fu JY, Yang CT, Wen CT, Liu YH, Liu HP, Hsieh JCH. Circulating Tumor Cells as a Tool of Minimal Residual Disease Can Predict Lung Cancer Recurrence: A longitudinal, Prospective Trial. Diagnostics (Basel) 2020; 10:diagnostics10030144. [PMID: 32155787 PMCID: PMC7151004 DOI: 10.3390/diagnostics10030144] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/27/2020] [Accepted: 03/05/2020] [Indexed: 12/01/2022] Open
Abstract
Background: The role of circulating tumor cells (CTCs) for predicting the recurrence of cancer in lung cancer patients after surgery remains unclear. Methods: A negatively selected protocol of CTC identification was applied. For all the enrolled patients, CTC testing was performed before and after surgery on the operation day (day 0), postoperative day 1, and day 3. The daily decline and trend of CTCs were analyzed to correlate with cancer relapse. The mixed model repeated measures (MMRM) adjusted by cancer characteristics was applied for statistical significance. Results: Fifty patients with lung mass undergoing surgery were enrolled. Among 41 primary lung cancers, 26 (63.4%) were pathological stage Tis and I. A total of 200 CTC tests were performed. MMRM analysis indicated that surgery could contribute to a CTC decline after surgery in all patients with statistical significance (p = 0.0005). The daily decrease of CTCs was statistically different between patients with and without recurrence (p = 0.0068). An early rebound of CTC counts on postoperative days 1 and 3 was associated with recurrence months later. Conclusion: CTC testing can potentially serve as a tool for minimal residual disease detection in early-staged lung cancer after curative surgery.
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Affiliation(s)
- Ching-Yang Wu
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou 333423, Taiwan; (C.-Y.W.); (C.-F.W.); (C.-T.W.); (Y.-H.L.); (H.-P.L.)
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan; (J.-Y.F.); (C.-T.Y.)
| | - Chia-Lin Lee
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei 112304, Taiwan;
- Department of Medical Research, Taichung Veterans General Hospital, Taichung 407752, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407752, Taiwan
| | - Ching-Feng Wu
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou 333423, Taiwan; (C.-Y.W.); (C.-F.W.); (C.-T.W.); (Y.-H.L.); (H.-P.L.)
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan; (J.-Y.F.); (C.-T.Y.)
| | - Jui-Ying Fu
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan; (J.-Y.F.); (C.-T.Y.)
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou 333423, Taiwan
| | - Cheng-Ta Yang
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan; (J.-Y.F.); (C.-T.Y.)
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou 333423, Taiwan
| | - Chi-Tsung Wen
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou 333423, Taiwan; (C.-Y.W.); (C.-F.W.); (C.-T.W.); (Y.-H.L.); (H.-P.L.)
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan; (J.-Y.F.); (C.-T.Y.)
| | - Yun-Hen Liu
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou 333423, Taiwan; (C.-Y.W.); (C.-F.W.); (C.-T.W.); (Y.-H.L.); (H.-P.L.)
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan; (J.-Y.F.); (C.-T.Y.)
| | - Hui-Ping Liu
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou 333423, Taiwan; (C.-Y.W.); (C.-F.W.); (C.-T.W.); (Y.-H.L.); (H.-P.L.)
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan; (J.-Y.F.); (C.-T.Y.)
| | - Jason Chia-Hsun Hsieh
- College of Medicine, Chang Gung University, Taoyuan 333323, Taiwan; (J.-Y.F.); (C.-T.Y.)
- Circulating Tumor Cell Lab., Division of Hematology and Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou 333423, Taiwan
- Correspondence: ; Tel.: +886-3-3281200 (ext. 2118)
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Zhang Y, Li Y, Zhang R, Zhang Y, Ma H. RNSCLC-PRSP software to predict the prognostic risk and survival in patients with resected T 1-3N 0-2 M 0 non-small cell lung cancer. BioData Min 2019; 12:17. [PMID: 31462928 PMCID: PMC6708148 DOI: 10.1186/s13040-019-0205-0] [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: 03/07/2019] [Accepted: 08/14/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The clinical outcomes of patients with resected T1-3N0-2M0 non-small cell lung cancer (NSCLC) with the same tumor-node-metastasis (TNM) stage are diverse. Although other prognostic factors and prognostic prediction tools have been reported in many published studies, a convenient, accurate and specific prognostic prediction software for clinicians has not been developed. The purpose of our research was to develop this type of software that can analyze subdivided T and N staging and additional factors to predict prognostic risk and the corresponding mean and median survival time and 1-5-year survival rates of patients with resected T1-3N0-2M0 NSCLC. RESULTS Using a Cox proportional hazard regression model, we determined the independent prognostic factors and obtained a prognostic index (PI) eq. PI = ∑βixi.=0.379X1-0.403X2-0.267X51-0.167X61-0.298X62 + 0.460X71 + 0.617X72-0.344X81-0.105X91-0.243X92 + 0.305X101 + 0.508X102 + 0.754X103 + 0.143X111 + 0.170X112 + 0.434X113-0.327X122-0.247X123 + 0.517X133 + 0.340X134 + 0.457X143 + 0.419X144 + 0.407X145. Using the PI equation, we determined the PI value of every patient. According to the quantile of the PI value, patients were divided into three risk groups: low-, intermediate-, and high-risk groups with significantly different survival rates. Meanwhile, we obtained the mean and median survival times and 1-5-year survival rates of the three groups. We developed the RNSCLC-PRSP software which is freely available on the web at http://www.rnsclcpps.com with all major browsers supported to determine the prognostic risk and associated survival of patients with resected T1-3N0-2 M0 non-small cell lung cancer. CONCLUSIONS After prognostic factor analysis, prognostic risk grouping and corresponding survival assessment, we developed a novel software program. It is practical and convenient for clinicians to evaluate the prognostic risk and corresponding survival of patients with resected T1-3N0-2M0 NSCLC. Additionally, it has guiding significance for clinicians to make decisions about complementary treatment for patients.
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Affiliation(s)
- Yunkui Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, No. 899 Pinghai Road, Suzhou, 215006 China
- Department of Thoracic Surgery, Shanxi Tumor Hospital, No. 3 Zhigongxin Street, Taiyuan, 030013 China
| | - YaoChen Li
- The Central Laboratory of Cancer Hospital of Shantou University Medical College, Guangdong Provincial Key Laboratory on Breast Cancer Diagnosis and Treatment Research, No. 7 Raoping Road, Shantou, 515031 China
| | - Rongsheng Zhang
- Department of Thoracic Surgery, Shanxi Tumor Hospital, No. 3 Zhigongxin Street, Taiyuan, 030013 China
| | - Yujie Zhang
- Department of Thoracic Surgery, Shanxi Tumor Hospital, No. 3 Zhigongxin Street, Taiyuan, 030013 China
| | - Haitao Ma
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, No. 899 Pinghai Road, Suzhou, 215006 China
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