Transformation from adenocarcinoma to squamous cell carcinoma associated with long‑term administration of EGFR‑TKIs

Haruki, Tomohiro; Nakanishi, Atsuyuki; Matsui, Shinji; Kidokoro, Yoshiteru; Kubouchi, Yasuaki; Takagi, Yasuaki; Taniguchi, Yoshihiro; Nakamura, Hiroshige

doi:10.3892/mco.2020.2152

Cited by 6 publications

(2 citation statements)

References 9 publications

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“…Şehitogullari et al also reported that robot-assisted surgery requires a significantly shorter hospital stay than conventional endoscopic surgery [19]. Artificial pneumothorax is widely used in robot-assisted surgery [18][19][20]. The less invasive nature of robot-assisted surgery is attributed not only to the advantages of the surgical technique, but also to the suppressive effect of artificial pneumothorax, as revealed in this study.…”

Section: Discussionsupporting

confidence: 54%

Artificial pneumothorax suppresses postoperative inflammatory reaction in mediastinal tumor surgery

Ito

Tsukioka

Izumi

et al. 2021

Gen Thorac Cardiovasc Surg

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Objective: The induction of artificial pneumothorax has many intraoperative advantages. However, few reports on the postoperative effects of artificial pneumothorax induction are available. In this study, we investigated the effect of artificial pneumothorax on postoperative clinical course in patients with mediastinal tumors. Methods:We retrospectively investigated the clinical courses of 89 patients who had undergone mediastinal tumor resection between January 2010 and December 2020.Sixty-five patients had undergone resection with artificial pneumothorax. Results:The tumor location significantly varied across patients. The proportion of patients in whom artificial pneumothorax was induced was higher among those having anterior mediastinal tumors. The number of ports and the total skin incision length were significantly higher in patients without artificial pneumothorax. The C-reactive protein level elevation on postoperative day2 and pleural effusion at 24 hours after surgery were significantly higher in patients without artificial pneumothorax. Furthermore, the albumin level reduction and hospital stay after surgery were significantly lower in patients with artificial pneumothorax. Multiple regression analysis showed that the use of artificial pneumothorax was an independent predictive factor of the C-reactive 4 protein level elevation on postoperative day 2 and pleural effusion at 24 hours after surgery. In patients without artificial pneumothorax, the operation time positively correlated with the C-reactive protein level (r=0.646, P<0.001).Conclusions: Artificial pneumothorax suppressed the postoperative inflammatory response, pleural effusion, and albumin reduction, and shortened the hospital stay in patients undergoing mediastinal tumor surgery.

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Section: Discussionsupporting

confidence: 54%

Artificial pneumothorax suppresses postoperative inflammatory reaction in mediastinal tumor surgery

Ito

Tsukioka

Izumi

et al. 2021

Gen Thorac Cardiovasc Surg

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“…As shown in Table 2, [10–31] a total of 27 cases of SQ transformation in EGFR mutated lung adenocarcinoma after treatment with EGFR TKIs have been reported. The ages of these patients were 40 to 80 years (median age was 62 years), and 18 patients (66.7%) were female.…”

Section: Discussionmentioning

confidence: 99%

T790M mutation positive squamous cell carcinoma transformation from EGFR-mutated lung adenocarcinoma after low dose erlotinib: A case report and literature review

Kusaba¹,

Takeda²,

Abe³

et al. 2022

Medicine

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Rationale: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are widely used for the treatment of EGFR mutation positive advanced nonsmall cell lung cancer (NSCLC); however, acquired resistance is known to develop during these treatments. Among these mechanisms, histological transformation is seldom encountered. Although platinum based chemotherapy has been reported to be effective in the treatment of patients with small cell lung cancer transformation, there is a lack of information on the treatment of patients with squamous cell carcinoma (SQ) transformation. Patient Concerns and Diagnosis: An 80-year-old nonsmoking woman was referred to our hospital because of an abnormal shadow on her chest radiograph. Diagnostic bronchoscopy was performed and pathological examination revealed adenocarcinoma. Mutation analysis of the EGFR gene revealed deletion of E746-A750 in exon 19. She refused both surgical treatment and radiation therapy, and preferred periodic radiologic follow-up. Unfortunately, approximately a year and a half after the initial diagnosis, the primary lesion enlarged, and many pleural nodules were newly detected (clinically T4N2M1a, stage IVA). Interventions and Outcomes: Based on EGFR mutation analysis, a reduced dose of daily erlotinib was prescribed, which achieved a partial response and 34 months of progression-free survival (PFS). A repeated biopsy with an endobronchial cryoprobe was performed on the enlarged primary lesion. Pathological examination revealed SQ harboring an identical EGFR mutation with a secondary EGFR T790M mutation. Osimertinib 80 mg once a day was started as second line therapy, which resulted in 8 months of PFS and 15 months of survival. Lesson: The literature review and our report suggest that osimertinib is a promising treatment for NSCLC regardless of histology if T790M is present as an acquired mutation.

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Gefitinib/osimertinib

2021

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Transformation from adenocarcinoma to squamous cell carcinoma associated with long‑term administration of EGFR‑TKIs

Cited by 6 publications

References 9 publications

Artificial pneumothorax suppresses postoperative inflammatory reaction in mediastinal tumor surgery

Artificial pneumothorax suppresses postoperative inflammatory reaction in mediastinal tumor surgery

T790M mutation positive squamous cell carcinoma transformation from EGFR-mutated lung adenocarcinoma after low dose erlotinib: A case report and literature review

Gefitinib/osimertinib

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