Trimodality Therapy for Lung Cancer With Chest Wall Invasion: Initial Results of a Phase II Study

Kawaguchi, Koji; Yokoi, Kohei; Niwa, Hiroshi; Ohde, Yasuhisa; Mori, Satoshi; Okumura, Sakae; Shiono, Satoshi; Ito, Hiroyuki; Yano, Motoki; Shigemitsu, Kikuo; Hiramatsu, Yoshihiro; Okami, Jiro; Saitô, Hiroshi

doi:10.1016/j.athoracsur.2014.05.022

Cited by 21 publications

(14 citation statements)

References 16 publications

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“…Thus, the ndings of the studies, including ours, suggest that the presence of systemic metastases affect the survival of patients with locally advanced NSCLC rather than the local control. However, intrathoracic recurrences after ICRT followed by surgery are reportedly few; intrathoracic recurrence was observed in only 5 of 51 patients (10%) with chest wall invasion in the study by Kawaguchi et al [4] and in 4 of 52 patients (8%) with stage IIIA in the study by Bharadwaj et al [17]. In the present study, intrathoracic recurrence was observed in only 3 of the 95 patients (3%).…”

Section: Discussioncontrasting

confidence: 52%

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Differences between Lung Adenocarcinoma and Squamous Cell Carcinoma in Tumor Response and Survival after Induction Chemoradiotherapy followed by Surgery

Shiraishi

Honma

Shoji

et al. 2020

Preprint

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Objectives: To examine the differences in clinical response, pathological response, recurrence, and survival between lung adenocarcinoma (AD) and squamous cell carcinoma (SQ) after induction chemoradiotherapy (ICRT) followed by surgery. Methods: Ninety-five patients with N1-2 or T3-4 non-small cell lung cancer were treated with ICRT followed by surgery between 2012 and 2018; 55 patients had AD and 40 had SQ. Differences in reductions of tumor size and fluorodeoxyglucose uptake on positron emission tomography after ICRT, as well as the pathological response, histological distribution of residual tumors, time to recurrence, and overall survival were compared between AD and SQ. Median follow-up period was 51 months. Results: After ICRT, SQ showed significantly more reduction in both the tumor size and fluorodeoxyglucose uptake than AD (p<0.001 for both). Of the 40 SQ, 22 (55%) showed the pathological complete remission, which was significantly more frequent than 8 of 55 AD (15%) (p<0.001). AD remained at the periphery of primary tumor in 39 of 55 patients (71%), which was more frequently than 6 of 40 patients (15%) in SQ (p<0.001). While there was no significant difference in the rate of conducting postoperative adjuvant chemotherapy between AD and SQ (47% vs. 40%, respectively) (p=0.48), the time to recurrence was significantly longer in SQ than in AD (p=0.026; 3-years recurrence-free rate: 77% vs. 52%). However, overall survival was not significantly different between the two (p=0.53; 3-years survival rate: 74% in both). Conclusion: While SQ showed better tumor response and longer time to recurrence after ICRT than AD, the overall survival was not different between the two. AD remained at the periphery of primary tumor more frequently than SQ after ICRT.

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Section: Discussioncontrasting

confidence: 52%

“…Induction chemoradiotherapy (ICRT) followed by surgery is a recently employed multimodal therapy for locally advanced non-small cell lung cancer (NSCLC), with satisfactory outcomes [1][2][3][4][5]. For survival prediction, the use of pathological response is better than the use of clinical response [6,7].…”

Section: Introductionmentioning

confidence: 99%

Differences between Lung Adenocarcinoma and Squamous Cell Carcinoma in Tumor Response and Survival after Induction Chemoradiotherapy followed by Surgery

Shiraishi

Honma

Shoji

et al. 2020

Preprint

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“…In a trial related to induction therapy for lung cancer, VTE was reported as an adverse event in 4% of cases. Given the above, the incidence of VTE in patients who undergo surgery after induction therapy is expected to be around 4-5% [6]. Chemotherapy with cisplatin has been reported to carry a significantly higher incidence of VTE than other platinum-based chemotherapy regimens, and all VTE cases were in the cisplatin combination group in the present study [7].…”

Section: Discussionmentioning

confidence: 59%

Venous thromboembolism in non-small cell lung cancer patients who underwent surgery after induction therapy

Kaminuma

Tanahashi

Suzuki

et al. 2020

Gen Thorac Cardiovasc Surg

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Objectives Lung cancer patients have been reported to have a high incidence of venous thromboembolism (VTE) and a high recurrence rate of VTE. However, there are no detailed reports of VTE in lung cancer patients who underwent surgery after induction therapy. We examined the incidence and clinical features of VTE in these patients. Methods We retrospectively evaluated 89 patients with non-small cell lung cancer who underwent surgery after induction therapy at our department between April 2009 and March 2018. The incidence of VTE, clinical features, and long-term prognosis were retrospectively examined. Results Among the 89 patients, 4 (4.5%) developed VTE, and there was no significant difference in the background characteristics between patients with and without VTE. All four patients developed VTE during preoperative treatment. In the patients with VTE, anticoagulant therapy with oral anticoagulants was administered after heparinization, and the median duration of anticoagulant therapy was 18.7 months. There were no cases of symptomatic VTE recurrence after surgery, regardless of lung cancer recurrence. Although the overall survival (OS) showed no significant difference between patients with and without VTE, the disease-free survival was significantly shorter in patients with VTE than in those without it (median 6.3 vs. 71.6 months, p < 0.01). Conclusions In induction cases, the incidence of VTE was 4.5%, and it can at least be stated that no symptomatic VTE developed or recurred after surgery. Patients with VTE in induction therapy had short progression-free survival and required careful follow-up after surgery.

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“…This study has the following limitations: (1) the study design was retrospective without a control group; (2) the single-center study design resulted in poor generalizability, especially with respect to the threshold obtained by ROC analysis; (3) there was a selection bias due to the dropout of patients who were not treated surgically; (4) the intention-to-treat population was clinical T3/T4 but not pathologic T3/T4, whereas the pathologic diagnosis of extrapulmonary involvement before ICRT is generally impossible; (5) although the values of whole-SUV were objective, those of site-SUV might not be because of the possible dependency on the measurement locations; and (6) although none of the 7 patients who avoided en bloc resection of neighboring structures suffered margin recurrences, the number of patients was too small to make a widespread recommendation for avoiding the combined resection.…”

Section: Commentmentioning

confidence: 99%

“…(Ann Thorac Surg 2020;109:255-61) Ó 2020 by The Society of Thoracic Surgeons I nduction chemoradiotherapy (ICRT) followed by surgery has resulted in satisfactory outcomes in patients with T3/T4 non-small cell lung cancer (NSCLC). [1][2][3][4][5][6] Although en bloc resection for the involved structures is standard surgical treatment for T3/T4 NSCLC even after ICRT, this surgery could be unnecessary if the extrapulmonary involvement is replaced by scar tissue. Opting to avoid en bloc resection after ICRT is especially crucial for high-risk combined resections involving structures such as great vessels, trachea, esophagus, and vertebrae.…”

mentioning

confidence: 99%

Positron Emission Tomography in T3/T4 Non-Small Cell Lung Cancer After Induction Chemoradiotherapy

Shiraishi

O’uchi

Honma

et al. 2020

The Annals of Thoracic Surgery

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Trimodality Therapy for Lung Cancer With Chest Wall Invasion: Initial Results of a Phase II Study

Cited by 21 publications

References 16 publications

Differences between Lung Adenocarcinoma and Squamous Cell Carcinoma in Tumor Response and Survival after Induction Chemoradiotherapy followed by Surgery

Differences between Lung Adenocarcinoma and Squamous Cell Carcinoma in Tumor Response and Survival after Induction Chemoradiotherapy followed by Surgery

Venous thromboembolism in non-small cell lung cancer patients who underwent surgery after induction therapy

Positron Emission Tomography in T3/T4 Non-Small Cell Lung Cancer After Induction Chemoradiotherapy

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