Progress in the Treatment and Outcomes for Early-Stage Non-Small Cell Lung Cancer

Shin, Jeoung-Sook; Yoon, Ja Kyoung; Marwaha, G.

doi:10.1007/s00408-018-0110-1

Cited by 23 publications

(19 citation statements)

References 33 publications

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“…In particular, studies continue to report significantly lower surgery rates among Blacks compared with Whites for earlystage NSCLC (1-3, 15) and worse overall survival (4). In a recent study evaluating treatment trends for early-stage lung cancer, Shin and colleagues found that over an almost 30-year time period there has been an increasing proportion of older patients and patients receiving radiotherapy alone instead of surgery; however, overall survival has improved among early-stage NSCLC and race remains a prognostic factor (16). Although the landscape for treatment for stage I NSCLC may be changing due to increased utilization of stereotactic body radiotherapy (SBRT), it remains to be seen how this impacts treatment disparities.…”

Section: Discussionmentioning

confidence: 99%

Racial Differences in Treatment and Survival among Veterans and Non-Veterans with Stage I NSCLC: An Evaluation of Veterans Affairs and SEER-Medicare Populations

Williams

Alpert

Redding

et al. 2020

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Surgery is the preferred treatment for stage I nonsmall cell lung cancer (NSCLC), with radiation reserved for those not receiving surgery. Previous studies have shown lower rates of surgery among Blacks with stage I NSCLC than among Whites.Methods: Black and White men ages 65 years with stage I NSCLC diagnosed between 2001 and 2009 were identified in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database and Veterans Affairs (VA) cancer registry. Logistic regression and Cox proportional hazards models were used to examine associations between race, treatment, and survival.Results: Among the patients in the VA (n ¼ 7,895) and SEER (n ¼ 8,744), the proportion of Blacks was 13% and 7%, respectively. Overall, 16.2% of SEER patients (15.4% of Whites, 26.0% of Blacks) and 24.5% of VA patients received no treatment (23.4% of Whites, 31.4% of Blacks). In both cohorts, Blacks were less likely to receive any treatment compared with Whites [OR adj ¼ 0.57; 95% confidence interval (CI), 0.47-0.69 for SEER-Medicare; OR adj ¼ 0.68; 95% CI, 0.58-0.79 for VA]. Among treated patients, Blacks were less likely than Whites to receive surgery only (OR adj ¼ 0.57; 95% CI, 0.47-0.70 for SEER-Medicare; OR adj ¼ 0.73; 95% CI, 0.62-0.86 for VA), but more likely to receive chemotherapy only and radiation only. There were no racial differences in survival.Conclusions: Among VA and SEER-Medicare patients, Blacks were less likely to get surgical treatment. Blacks and Whites had similar survival outcomes when accounting for treatment.Impact: This supports the hypothesis that equal treatment correlates with equal outcomes and emphasizes the need to understand multilevel predictors of lung cancer treatment disparities.

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Section: Discussionmentioning

confidence: 99%

Racial Differences in Treatment and Survival among Veterans and Non-Veterans with Stage I NSCLC: An Evaluation of Veterans Affairs and SEER-Medicare Populations

Williams

Alpert

Redding

et al. 2020

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Anatomical lung resection (lobectomy and segmentectomy) is the mainstay treatment for early-stage non-small cell lung cancer (NSCLC) [ 1 ]. Owing to several advantages, such as less surgical trauma, a lower complication rate and improved postoperative rehabilitation, a majority of the aforementioned operations are currently performed through the video-assisted thoracic surgery (VATS) approach [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Short- and long-term outcomes of thoracoscopic pneumonectomy - single center experience.

Piwkowski¹,

Gabryel²,

Roszak³

et al. 2021

Videosurgery and Other Miniinvasive Techniques

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Introduction The video-assisted thoracic surgery (VATS) approach is widely used for pulmonary lobectomy, but its application for pneumonectomy is much less common and outcomes are ambiguous. Aim To evaluate the feasibility and outcomes of VATS pneumonectomy. Material and methods This retrospective study included 19 patients with the mean age of 62.6 ±5.5 years who were qualified for VATS pneumonectomy between September 1, 2010, and January 31, 2020. Indications and technical aspects were analyzed. Moreover, short- and long-term outcomes were assessed. Results There were no intraoperative deaths. Conversion to thoracotomy was necessary in 2 (10.5%) patients, because of bleeding in 1 patient and technical reasons in another. One patient died during the in-hospital period due to multi-organ failure as a result of bronchopleural fistula. Five other subjects developed postoperative complications, most often atrial fibrillation (n = 3). One patient was readmitted for empyema of the postpneumonectomy space without bronchopleural fistula. Histopathological examination revealed that the resection was complete (R0) in all cases and the most common type of cancer was squamous cell carcinoma (79%). Seven patients died during the follow-up: 1 because of surgical complications, 4 as a result of cancer progression, and 2 for non-cancer related reasons. Median survival was 47 months. One- and five-year probability of survival estimated by means of the Kaplan-Meier method was 0.88 ±0.07 and 0.43 ±0.15, respectively. Conclusions VATS pneumonectomy can be performed safely, without increased risk of intraoperative and postoperative complications. It enables a complete lung cancer resection and is likely to provide good short- and long-term outcomes.

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“…Lung cancer is not only the most commonly diagnosed cancer, but also the leading cause of cancer-associated death globally, with a predicted 2,28,150 novel cases and 1,47,510 deaths annually ( 1 , 2 ). Non-small cell lung cancer (NSCLC) is the most prevalent pathological subtype of lung cancer and accounts for 80–85% of all lung cancer cases ( 3 ). NSCLC is classified into lung squamous cell carcinoma, lung adenocarcinoma and large-cell lung cancer, and all three pathological classifications manifest similar biological behaviors and gene mutations ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Long noncoding RNA CBR3 antisense RNA 1 promotes the aggressive phenotypes of non‑small‑cell lung cancer by sponging microRNA‑509‑3p and competitively upregulating HDAC9 expression

et al. 2020

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Long noncoding RNA CBR3 antisense RNA 1 (CBR3-AS1) plays significant roles in the initiation and progression of osteosarcoma. The aim of the present study was to investigate the involvement of CBR3-AS1 in the development of non-small cell lung cancer (NSCLC). Reverse transcription-quantitative PCR was performed to detect CBR3-AS1 expression in NSCLC tissues and cell lines. The impacts of CBR3-AS1 on cellular proliferation, apoptosis, migration and invasiveness in vitro , and tumor growth in vivo , were investigated using the Cell Counting Kit-8 assay, flow cytometry, Transwell migration and invasion assays, and tumor xenograft model-based analysis, respectively. The results indicated that CBR3-AS1 was markedly upregulated in NSCLC tissues and cell lines. High CBR3-AS1 expression was correlated with larger tumor size, advanced TNM stage, increased incidence of lymph node metastasis and shorter overall survival times in patients with NSCLC. Furthermore, CBR3-AS1-knockdown notably suppressed cellular proliferation, migration and invasiveness in vitro , and also promoted apoptosis and suppressed tumorigenicity in vivo . Mechanistic investigation demonstrated that CBR3-AS1 functions as a competing endogenous RNA for microRNA-509-3p (miR-509-3p) in NSCLC cells. Furthermore, miR-509-3p exerted tumor-suppressive effects in NSCLC, and histone deacetylase 9 (HDAC9) was identified as a direct target of miR-509-3p. HDAC9 expression was suppressed by CBR3-AS1 depletion, which was abolished by miR-509-3p inhibition. Further rescue experiments revealed that increasing the output of the miR-509-3p/HDAC9 axis counteracted the CBR3-AS1 depletion-induced inhibitory effects on NSCLC cells. Collectively, the results of the present study indicate that the CBR3-AS1/miR-509-3p/HDAC9 pathway exerts tumor-promoting actions in NSCLC oncogenesis and progression, suggesting that this pathway is an effective target for the management of NSCLC.

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Progress in the Treatment and Outcomes for Early-Stage Non-Small Cell Lung Cancer

Abstract: Overall survival for early-stage NSCLC has significantly improved over the recent decades despite an increasing proportion of older patients and those undergoing sublobar resection or SBRT. This finding may be limited to those with adenocarcinoma.

Cited by 23 publications

References 33 publications

Racial Differences in Treatment and Survival among Veterans and Non-Veterans with Stage I NSCLC: An Evaluation of Veterans Affairs and SEER-Medicare Populations

Racial Differences in Treatment and Survival among Veterans and Non-Veterans with Stage I NSCLC: An Evaluation of Veterans Affairs and SEER-Medicare Populations

Short- and long-term outcomes of thoracoscopic pneumonectomy - single center experience.

Long noncoding RNA CBR3 antisense RNA 1 promotes the aggressive phenotypes of non‑small‑cell lung cancer by sponging microRNA‑509‑3p and competitively upregulating HDAC9 expression

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