Morbidity, Survival, and Site of Recurrence After Mediastinal Lymph-Node Dissection Versus Systematic Sampling After Complete Resection for Non-Small Cell Lung Cancer

Lardinois, Didier; Suter, Hans; Hakki, H.; Rousson, Valentin; Betticher, Daniel; Ris, Hans‐Beat

doi:10.1016/j.athoracsur.2005.02.005

Cited by 162 publications

(113 citation statements)

References 26 publications

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…This is similar to other studies which report crude brain metastases rates ranging from 2% to 16% for stage I disease 12,18-26 and 3% to 19 % for stage II disease. 24,[26][27][28][29][30] Second, although the overall rate was low, brain metastases developed in 29% patients who failed at distant sites. Thus, future efforts to reduce the risk of distant recurrence will need to account for failures in the central nervous system.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the development of brain metastases

Hubbs

Boyd

Hollis

et al. 2010

Cancer

115

View full text Add to dashboard Cite

BACKGROUND The risk of developing brain metastases after definitive treatment of locally advanced nonsmall cell lung cancer (NSCLC) is approximately 30%-50%. The risk for patients with early stage disease is less defined. The authors sought to investigate this further and to study potential risk factors. METHODS The records of all patients who underwent surgery for T1-T2 N0-N1 NSCLC at Duke University between the years 1995 and 2005 were reviewed. The cumulative incidence of brain metastases and distant metastases was estimated by using the Kaplan-Meier method. A multivariate analysis assessed factors associated with the development of brain metastases. RESULTS Of 975 consecutive patients, 85% were stage I, and 15% were stage II. Adjuvant chemotherapy was given to 7%. The 5-year actuarial risk of developing brain metastases and distant metastases was 10%(95% confidence interval [CI], 8-13) and 34%(95% CI, 30-39), respectively. Of patients developing brain metastases, the brain was the sole site of failure in 43%. On multivariate analysis, younger age (hazard ratio [HR], 1.03 per year), larger tumor size (HR, 1.26 per cm), lymphovascular space invasion (HR, 1.87), and hilar lymph node involvement (HR, 1.18) were associated with an increased risk of developing brain metastases. CONCLUSIONS In this large series of patients treated surgically for early stage NSCLC, the 5-year actuarial risk of developing brain metastases was 10%. A better understanding of predictive factors and biological susceptibility is needed to identify the subset of patients with early stage NSCLC who are at particularly high risk. Cancer 2010;116:5038-46.

show abstract

Section: Discussionmentioning

confidence: 99%

Factors associated with the development of brain metastases

Hubbs

Boyd

Hollis

et al. 2010

Cancer

115

View full text Add to dashboard Cite

show abstract

“…3 There is substantial variation in the reported rate of local recurrence for patients with stage I disease (range, 6%-45%). [17][18][19][20][21][22][23] According to the Lung Cancer Study Group, crude rates of local failure for stage IA disease were 6% after lobectomy and 17% after sublobar resections. In patients with a previous history of lobectomy/pneumonectomy or poor pulmonary function, ''less'' surgery (ie, wedge resection or segmentectomy) has been used, and radioactive seeds have been added to the resection site to increase the chances of achieving local control.…”

Section: Discussionmentioning

confidence: 99%

Limited resection followed by intraoperative seed implantation is comparable to stereotactic body radiotherapy for solitary lung cancer

Parashar¹,

Patel²,

Monni³

et al. 2010

Cancer

View full text Add to dashboard Cite

BACKGROUND:The objective of this study was to compare the outcomes of patients who underwent wedge resection plus intraoperative brachytherapy versus patients who received stereotactic body radiotherapy (SBRT) for single malignant lung nodules. METHODS: A retrospective chart review included 55 patients who were treated for single lung nodules, and 47 of those patients who had adequate information were chosen for the current analysis. Twentyfive patients with single malignant lung nodules received SBRT. Twenty-two patients underwent limited surgical resection plus radioactive seed implantation for solitary malignant lung nodules. RESULTS: Univariate statistical analysis demonstrated a significance difference only for age in the 2 groups: The mean age in the radioactive seed group (66.6 years) was statistically significantly different from the mean of the age in the SBRT group (75.9 years; 2-sided P ¼ .04). No significant differences were observed between the 2 groups in terms of local control, distant metastasis, survival, or toxicity. CONCLUSIONS: The current results demonstrated comparable efficacy in outcome and toxicity between surgical resection with radioactive seed implantation and SBRT for the treatment of single malignant lung nodules in patients who were not candidates for lobectomy/pneumonectomy. Cancer 2010;116:5047-53.

show abstract

“…The risk of recurrence without ACT was derived from a study by Pepek et al, which reported the 5-year risk of cancer recurrence by stage (i.e., IA, IB, IIA, and IIB) [25]. Other studies were excluded because they did not report the results by stage at the level of granularity needed [26][27][28][29]. The risk of death after experiencing a cancer recurrence was pooled from two studies [30,31].…”

Section: Literature-derived Inputsmentioning

confidence: 99%

Cost-Utility of a Prognostic Test Guiding Adjuvant Chemotherapy Decisions in Early-Stage Non-Small Cell Lung Cancer

et al. 2015

View full text Add to dashboard Cite

Background. A prognostic test was developed to guide adjuvant chemotherapy (ACT) decisions in early-stage non-small cell lung cancer (NSCLC) adenocarcinomas.The objective of this study was to compare the cost-utility of the prognostic test to the current standard of care (SoC) in patients with early-stage NSCLC. Materials and Methods. Lifetime costs (2014 U.S. dollars) and effectiveness (quality-adjusted life-years [QALYs]) of ACT treatment decisions were examined using a Markov microsimulation model from a U.S. third-party payer perspective. Cancer stage distribution and probability of receiving ACT with the SoC were based on data from an academic cancer center. The probability of receiving ACT with the prognostic test was estimated from a physician survey. Risk classification was based on the 5-year predicted NSCLC-related mortality. Treatment benefit with ACT was based on the prognostic score. Discounting at a 3% annual rate was applied to costs and

show abstract

Morbidity, Survival, and Site of Recurrence After Mediastinal Lymph-Node Dissection Versus Systematic Sampling After Complete Resection for Non-Small Cell Lung Cancer

Cited by 162 publications

References 26 publications

Factors associated with the development of brain metastases

Factors associated with the development of brain metastases

Limited resection followed by intraoperative seed implantation is comparable to stereotactic body radiotherapy for solitary lung cancer

Cost-Utility of a Prognostic Test Guiding Adjuvant Chemotherapy Decisions in Early-Stage Non-Small Cell Lung Cancer

Contact Info

Product

Resources

About