Evidence for Expanding Invasive Mediastinal Staging for Peripheral T1 Lung Tumors

DuComb, Emily A.; Tonelli, Benjamin A.; Tuo, Ya; Cole, Bernard F.; Mori, Vitor; Bates, Jason H. T.; Washko, George R.; Estépar, Raúl San Jośe; Kinsey, C. Matthew

doi:10.1016/j.chest.2020.05.607

Cited by 18 publications

(14 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…DuComb et al retrospectively studied 332 patients with T1 non-small cell lung cancer and showed that among patients with LNM, the most common pathological type was adenocarcinoma, which was consistent with the results of this study (56/58). In addition, they found that neither tumor diameter nor location was a risk factor for LNM [30]. In this study, location was also not shown to be a signi cant factor for metastases, but in contrast, mean diameter was an independent risk factor for the occurrence of LNM, possibly due to different inclusion and exclusion criteria: Our study included no restriction on tumor size, while they enrolled patients with T1 (8-30mm).…”

Section: Discussionmentioning

confidence: 55%

Preoperative CT semantic features predict lymph node metastasis of part-solid nodules in non-small cell lung cancer: a multicenter retrospective study

Yang

Wang

Niu

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Lymph node metastasis (LNM) is the most common way of metastasis of lung cancer, and it is an independent risk factor for long-term survival and recurrence of non-small cell lung cancer (NSCLC) patients. The purpose of this study was to explore the value of preoperative computed tomography (CT) semantic features in differential diagnosis of LNM in part-solid nodules of NSCLC.Methods A total of 955 NSCLC patients confirmed by postoperative pathology were retrospectively enrolled from January 2019 to March 2023. The clinical, pathological data and preoperative CT images of these patients were investigated and statistically analyzed in order to explore the risk factors of LNM. Multivariate logistic regression was used to select independent risk factors and establish different prediction models. 10-fold cross-validation was used for model training and validation. The area under the curve (AUC) of receiver operating characteristic curve (ROC) was calculated and the Delong test was performed to compare the predictive performance between models.Results LNM occurred in 68 of 955 patients. After univariate analysis and adjustment for confounding factors, smoking history, pulmonary disease, solid component proportion, pleural contact type, and mean diameter were screened as independent risk factors for differential LNM. The image predictors model established by four independent factors of CT semantic features except smoking history showed a good diagnostic efficiency for LNM. Its AUC in the validation group was 0.857, and the sensitivity, specificity and accuracy of the model were all 77.6%.Conclusions Preoperative CT semantic features have good diagnostic value for LNM of NSCLC. The image predictors model based on pulmonary disease, solid component proportion, pleural contact type and mean diameter has excellent diagnostic efficacy, and can provide non-invasive evaluation for clinical practice.

show abstract

Section: Discussionmentioning

confidence: 55%

Preoperative CT semantic features predict lymph node metastasis of part-solid nodules in non-small cell lung cancer: a multicenter retrospective study

Yang

Wang

Niu

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…5 This may be particularly important with the indications for mediastinal staging increasing as lymphadenopathy is possible regardless of primary tumor size or location. 29 Future investigations should build on the findings determined through this study. A detailed examination of postoperative care for male patients treated with salvage lobectomy should be considered, given its association with worsened OS.…”

Section: Discussionmentioning

confidence: 81%

Trends and Outcomes of Salvage Lobectomy for Early-stage Non–Small Cell Lung Cancer

Afshari

Anker

Kooperkamp

et al. 2023

American Journal of Clinical Oncology

View full text Add to dashboard Cite

Objectives: There is little data describing the outcomes for patients who develop local recurrences after stereotactic body radiation therapy (SBRT), a standard-of-care treatment for patients with early-stage non–small cell lung cancer. One emerging option is salvage lobectomy. We investigated trends in the use of salvage lobectomy after SBRT and described patient outcomes using a nationally representative sample. Methods: This is a retrospective study using the National Cancer Database of patients with non–small cell lung cancer diagnosed from 2004 to 2017. We used descriptive statistics to describe patients who underwent salvage lobectomy. Kaplan-Meier analysis was used to estimate overall survival (OS). Cox proportional modeling was used to identify factors associated with OS. Results: We identified 276 patients who underwent salvage lobectomy. Ninety-day mortality was 0%. The median survival time for the cohort was 50 months (95% CI, 44 to 58). Median follow-up was 65 months (Interquartile Range: 39 to 96). The factors associated with decreased OS include squamous cell histology (hazard ratio (HR)=1.72, P=0.005) and high grade (1.50, P=0.038). Increased OS was associated with lobectomy performed between 3 and 6 months after SBRT (HR=0.53, P=0.021), lobectomy performed >6 months after SBRT (HR=0.59, P=0.015), and female sex (HR=0.56, P=0.004). Conclusions: Salvage lobectomy after local failures of SBRT was associated with no perioperative mortality and favorable long-term outcomes. Our data suggest that lobectomy performed within 3 months of SBRT is associated with worse OS.

show abstract

“…Blinded quantitative analysis of tumour size as a predictor of lymph nodes metastasis in T1 lung tumours discovered that even among tiny tumours, a high prevalence of N2 or N3 metastasis persists, and there is no clear definition of central lesion that mitigates this risk (10).…”

Section: Discussionmentioning

confidence: 99%

In EBUS Signo Vinces: New Indications in Thoracic Oncology for Mediastinal Lymph Node Staging Using Endobronchial Ultrasound

2022

View full text Add to dashboard Cite

Evidence for Expanding Invasive Mediastinal Staging for Peripheral T1 Lung Tumors

Cited by 18 publications

References 37 publications

Preoperative CT semantic features predict lymph node metastasis of part-solid nodules in non-small cell lung cancer: a multicenter retrospective study

Preoperative CT semantic features predict lymph node metastasis of part-solid nodules in non-small cell lung cancer: a multicenter retrospective study

Trends and Outcomes of Salvage Lobectomy for Early-stage Non–Small Cell Lung Cancer

In EBUS Signo Vinces: New Indications in Thoracic Oncology for Mediastinal Lymph Node Staging Using Endobronchial Ultrasound

Contact Info

Product

Resources

About