Smoking Habit and Respiratory Function Predict Patients’ Outcome after Surgery for Lung Cancer, Irrespective of Histotype and Disease Stage

Abstract

Background. Growing evidence suggests that sublobar resections offer more favorable outcomes than lobectomy in early-stage lung cancer surgery. However, a percentage of cases that cannot be ignored develops disease recurrence irrespective of the surgery performed with curative intent. The goal of this work is thus to compare different surgical approaches, namely, lobectomy and segmentectomy (typical and atypical) to derive prognostic and predictive markers. Patients and Methods. Here we analyzed a cohort of 153 NSCLC patients in clinical stage TNM I who underwent pulmonary resection surgery with a mediastinal hilar lymphadenectomy from January 2017 to December 2021, with an average follow-up of 25.5 months. Partition analysis was also applied to the dataset to detect outcome predictors. Results. The results of this work showed similar OS between lobectomy and typical and atypical segmentectomy for patients with stage I NSCLC. In contrast, lobectomy was associated with a significant improvement in DFS compared with typical segmentectomy in stage IA, while in stage IB and overall, the two treatments were similar. Atypical segmentectomy showed the worst performance, especially in 3-year DFS. Quite unexpectedly, outcome predictor ranking analysis suggests a prominent role of smoking habits and respiratory function, irrespective of the tumor histotype and the patient’s gender. Conclusions. Although the limited follow-up interval cannot allow conclusive remarks about prognosis, the results of this study suggest that both lung volumes and the degree of emphysema-related parenchymal damage are the strongest predictors of poor survival in lung cancer patients. Overall, these data point out that greater attention should be addressed to the therapeutic intervention for co-existing respiratory diseases to obtain optimal control of early lung cancer.

Smart Sensors and Microtechnologies in the Precision Medicine Approach against Lung Cancer

“…With respect to cancer, several strategies have been investigated in recent decades with the main objective of reducing the systemic toxicity of chemotherapy and also increase the therapeutic effect on the malignant mass [ 258 , 259 , 260 , 261 ]. Lung cancer is a disease difficult to locally treat, with high rates of disease recurrence even after surgery is performed with curative intent [ 262 , 263 ]. Micro and nanoparticles loaded with chemotherapy agents have been tested in several preclinical and clinical trials [ 264 , 265 , 266 ].…”

A study on lung cancer using nabla discrete fractional-order model

“…Surgery, on the other hand, is a common treatment for lung cancer that involves the removal of the tumor and surrounding tissue. Surgery is typically used for early-stage lung cancer and can be curative if all the cancer cells are removed [9]. However, surgery alone may not be effective in cases where the cancer has spread to other parts of the body.…”

A fractional-order mathematical model for lung cancer incorporating integrated therapeutic approaches

“…Although immunotherapy is a promising treatment, prolonged administration could lead to immune-related adverse events (irAEs), including endocrine adverse events (eAEs) 7,8 . On the other hand, surgery involves the removal of the tumor and surrounding tissue and is often curative for early-stage lung cancer, but may not be effective for advanced cases 9 . Combining these therapies may enhance treatment efficacy while reducing adverse effects 10 .…”