Morbidity and Mortality of Major Pulmonary Resections in Patients With Early-Stage Lung Cancer: Initial Results of the Randomized, Prospective ACOSOG Z0030 Trial

Allen, Mark S.; Darling, Gail; Pechet, Taine T.; Mitchell, John D.; Herndon, James E.; Landreneau, Rodney J.; Inculet, Richard; Jones, David R.; Meyers, Bryan F.; Harpole, David H.; Putnam, Joe B.; Rusch, Valerie W.

doi:10.1016/j.athoracsur.2005.06.066

Cited by 594 publications

(339 citation statements)

References 11 publications

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“…In these patients, limited resections are usually indicated owing to the lower risk of postoperative respiratory failure, perioperative mortality, and long-term disability (24)(25)(26). Given the higher risk of recurrence associated with limited resection, we investigated whether PORT or adjuvant chemotherapy, individually or in combination, are associated with improved patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

Adjuvant Treatment for Elderly Patients with Early-Stage Lung Cancer Treated with Limited Resection

Mhango

Bonomi²,

Neugut

et al. 2013

Annals ATS

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Objectives: Limited resection is commonly used for treating older patients with early-stage non-small cell lung cancer (NSCLC) who cannot tolerate lobectomy. However, parenchymal-sparing procedures leave patients at increased risk of recurrence. The role of postoperative radiotherapy (PORT) and chemotherapy after limited resection is not established. Methods:We identified 1,929 patients with stage I-II (<5 cm in size) NSCLC who underwent limited resection (wedge or segmentectomy) from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Using propensity score methods, we compared toxicity and survival of patients treated with limited resection alone, PORT, adjuvant chemotherapy, or PORT and chemotherapy. We conducted secondary analysis stratifying the sample by size (.2-5 cm), stage (IA vs. IB/IIA), and type of limited resection (wedge resection vs. segmentectomy).Measurements and Main Results: Overall, 1,656 (85.8%), 159 (8.3%), 74 (3.8%), and 40 (2.1%) patients were treated with limited resection alone, PORT, adjuvant chemotherapy, or PORT and chemotherapy, respectively. Adjusted analysis using inverse probability weighting showed that PORT (hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.45-1.69), adjuvant chemotherapy (HR, 1.48; 95% CI, 1.36-1.61), and PORT and chemotherapy (HR, 1.73; 95% CI, 1.61-1.86) were associated with worse survival compared with limited resection alone. Similar results were obtained in secondary analyses. Compared with limited resection alone, the adjusted odds ratios for toxicity were 1.97 (95% CI, 1.6-2.4), 3.15 (95% CI, 2.58-3.85), 2.59 (95% CI, 2.0-3.4) for PORT, chemotherapy, and PORT and chemotherapy, respectively.Conclusions: PORT and adjuvant chemotherapy are not beneficial and appear to be associated with increased toxicity and worse survival after limited resection in elderly patients with early-stage NSCLC. Alternative strategies should be explored to improve local control.

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Section: Discussionmentioning

confidence: 99%

Adjuvant Treatment for Elderly Patients with Early-Stage Lung Cancer Treated with Limited Resection

Mhango

Bonomi²,

Neugut

et al. 2013

Annals ATS

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“…[18][19][20] In addition, high rates of postoperative complications accompany this procedure, with a bacterial pneumonia rate of 10-25% and increased systemic lipopolysaccharide release. 21,22 Several reports from clinical series have raised the possibility that inflammatory consequences resulting from postsurgical complications may influence cancer recurrence. [23][24][25] Evidence from studies of other malignancies such as colorectal carcinoma have shown that proinflammatory cytokines such as TNFa and IL-1b increase tumor cell adhesion to endothelial cells in vitro and in vivo, largely by upregulating the expression of cell adhesion molecules such as selectins on the endothelial surface.…”

mentioning

confidence: 99%

Systemic inflammation increases cancer cell adhesion to hepatic sinusoids by neutrophil mediated mechanisms

McDonald

Spicer

Giannais

et al. 2009

Intl Journal of Cancer

197

150

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Interactions between endothelial selectins and selectin ligands expressed on tumor cells have been implicated in the binding of circulating metastatic cancer cells to the vascular endothelium during extravasation. Moreover, there is mounting evidence that inflammatory environments can accelerate the progression of metastasis by neutrophil mediated mechanisms. In this study, a physiologically relevant in vivo model of early metastasis coupled with intravital microscopy was used to visualize the trafficking of tumor cells within the liver vasculature in real time. Using GFPlabeled Lewis lung carcinoma subline H-59 cells, we show here that disrupting the interactions between endothelial selectins and tumor cell selectin ligands diminished tumor cell recruitment to the liver. Furthermore, systemic inflammation induced by intravenous injection of lipopolysaccharide significantly enhanced the metastatic potential of these lung carcinoma cells by increasing their propensity to adhere to the liver sinusoidal endothelium. Confocal microscopy revealed frequent colocalization of cancer cells with neutrophils and neutrophil depletion in vivo significantly attenuated the lipopolysaccharide-induced increase in H-59 cell adhesion. Although direct selectin-selectin ligand interactions contributed significantly to tumor cell adhesion to sinusoidal endothelial cells, we show here that in addition, interactions between adherent neutrophils within the inflamed sinusoids and circulating tumor cells may further increase tumor cell arrest in the liver. ' 2009 UICC Key words: cancer; metastasis; lung; rodent; adhesion molecules; e-selectin; neutrophil; sialyl Lewis X Lung cancer is the leading cause of cancer-related deaths worldwide. 1 A high proportion of patients harbor metastasis to regional lymph nodes upon presentation, and over half of all patients who undergo curative intent surgical resection of the lung will develop metastatic recurrence. 2 The liver is a common site of metastasis for lung cancer, with autopsy studies showing hepatic metastases in over 50% of lung cancer patients. 3 The hematogenous dissemination of cancer cells from a primary tumor to distant organs involves a cascade of sequential steps (reviewed in Refs. 4,5). The adhesion of circulating tumor cells to the vascular endothelium of distant organs is a key step in the metastatic cascade that may determine the organ tropism and extent of metastasis. Interactions between endothelial selectins and tumor cell selectin ligands have been implicated in the metastatic process. [5][6][7][8] Selectins are a family of transmembrane glycoproteins possessing an extracellular lectin domain that binds to carbohydrate moieties present on their ligands. 9 The three known selectins that function as cell adhesion molecules are expressed on the surface of endothelial cells (E-selectin and P-selectin), platelets (P-selectin) and leukocytes (L-selectin). E-selectin has been shown to contribute to the metastatic spread of multiple cancers, including lung and colon carcinoma, and m...

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“…Torasik cerrahi işlemlerinden sonra postoperatif pulmoner komplikasyon görülme sıklığı (%19-59) , üst abdominal cerrahi (%16-17) veya alt abdominal cerrahiye (% 0-5) oranla daha yüksektir. 10,11 Oranlar cerrahinin yerine, risk faktörlerinin varlığına ve bir postoperatif pulmoner komplikasyonu belirlemede kullanılan kriterlere göre değişir.…”

Section: Giriş Ve Amaçunclassified

“…Her iki grup arasında demografik özellikler açısından istatistiksel olarak farklılık bulunmadı. Hastaların ortalama yoğun bakım kalış süresi iki gün (1-7), hastane kalış süresi ortalama sekiz gün (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) Komplikasyonlar: İS grubundaki hastalarda postoperatif birinci gün, iki hastada lober atelektazi, bir hastada segmental atelektazi, dört hastada ise plevral efüzyon görüldü (Tablo 6). CPAP grubundaki hastalarda, postoperatif birinci gün üç hastada lober atelektazi, bir hastada ise plevral efüzyon görüldü.…”

Section: Bulgularunclassified

“…Solunum fonksiyon testleri parametrelerinde gerçekleşen bu azalmaları düzeltmek ve ciddi sağlık problemlerine yol açabilen bu komplikasyonların önlenmesi için çeşitli fizyoterapi yöntemlerini kullanan farklı çalışmalar yapılmıştır. [8][9][10] Postoperatif pulmoner komplikasyonların önlenmesinde pek çok fizyoterapi yaklaşımı söz konusudur. Bunlar; ekspiratuar manevralar, IPPB, aktif solunum teknikleri döngüsü, İS, CPAP, PEP (Positive Expiratory Pressure) gibi yöntemlerdir.…”

Section: Grup (Is) (N=15)unclassified

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Torasik cerrahi sonrası postoperatif pulmoner komplikasyonların önlenmesinde İnsentif spirometre ve Continous Positive Airway Pressure (CPAP)'ın karşılaştırılması

Kostanoğlu

Tarakçı

Dayıoğlu

et al. 2014

HSP

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Morbidity and Mortality of Major Pulmonary Resections in Patients With Early-Stage Lung Cancer: Initial Results of the Randomized, Prospective ACOSOG Z0030 Trial

Cited by 594 publications

References 11 publications

Adjuvant Treatment for Elderly Patients with Early-Stage Lung Cancer Treated with Limited Resection

Adjuvant Treatment for Elderly Patients with Early-Stage Lung Cancer Treated with Limited Resection

Systemic inflammation increases cancer cell adhesion to hepatic sinusoids by neutrophil mediated mechanisms

Torasik cerrahi sonrası postoperatif pulmoner komplikasyonların önlenmesinde İnsentif spirometre ve Continous Positive Airway Pressure (CPAP)'ın karşılaştırılması

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