Benefits of surgery in the multimodality treatment of stage IIB-IIIC small cell lung cancer

Yang, Yong; Yuan, Guangda; Zhan, Cheng; Huang, Yiwei; Zhao, Mengnan; Yang, Xiaodong; Wang, Shuai; Lin, Zongwu; Zheng, Shaojiang; Lu, Tao; Guo, Wei; Wang, Qun

doi:10.7150/jca.31202

Cited by 13 publications

(19 citation statements)

References 41 publications

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“…In patients with lymph node metastasis, concurrent chemoradiation is the cornerstone of treatment. Although some retrospective studies found that surgery combined with chemoradiation can enhance survival in stage II/III SCLC [ 5 , 11 – 14 ], this has not been demonstrated in clinical trials.…”

Section: Introductionmentioning

confidence: 99%

Effect of surgery on survival in patients with stage III N2 small cell lung cancer: propensity score matching analysis and nomogram development and validation

Chai

Feng

et al. 2021

World J Surg Onc

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Background The standard treatment of stage III N2 small cell lung cancer (SCLC) is concurrent chemoradiation, and surgery is not recommended. This study was aimed to evaluate whether surgery has survival benefits in patients with stage III N2 SCLC and investigate the factors influencing survival of surgery. Methods Patients diagnosed with stage T1-4N2M0 SCLC from 2004 to 2015 were selected from the Surveillance Epidemiology End Results database. Propensity score matching (PSM) was used to balance confounders between patients who underwent surgery and those treated with radiation and/or chemotherapy. We compared overall survival (OS) of the two groups using Kaplan-Meier curves and a Cox proportional hazard model. We also identified prognostic factors in patients with surgical resection, and a nomogram was developed and validated for predicting postoperative OS. Results −A total of 5576 patients were included in the analysis; of these, 211 patients underwent surgery. PSM balanced the differences between the two groups. The median OS was longer in the surgery group than in the non-surgery group (20 vs. 15 months; p = 0.0024). Surgery was an independent prognostic factor for longer OS in the multivariate Cox regression analysis, and subgroup analysis revealed a higher survival rate in T1 stage patients treated with surgery (hazard ratio = 0.565, 95% confidence interval: 0.401–0.798; p = 0.001). In patients who underwent surgery, four prognostic factors, including age, T stage, number of positive lymph nodes, and radiation, were selected into nomogram development for predicting postoperative OS. C-index, decision curve analyses, integrated discrimination improvement, and time-dependent receiver operating characteristics showed better performance in nomogram than in the tumor-node-metastasis staging system. Calibration plots demonstrated good consistency between nomogram predicted survival and actual observed survival. The patients were stratified into three different risk groups by prognostic scores and Kaplan-Meier curves showed significant difference between these groups. Conclusions These results indicate that surgery can prolong survival in patients with operable stage III N2 SCLC, particularly those with T1 disease. A nomogram that includes age, T stage, number of positive lymph nodes, and radiation can be used to predict their long-term postoperative survival.

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Section: Introductionmentioning

confidence: 99%

Effect of surgery on survival in patients with stage III N2 small cell lung cancer: propensity score matching analysis and nomogram development and validation

Chai

Feng

et al. 2021

World J Surg Onc

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“…At present, video-assisted thoracoscopic surgical treatment is a main choice [5][6][7]. In the past two years, robot-assisted pneumonectomy has gradually been carried out clinically [8]. However, less than 40% of patients are still diagnosed when the lesion is confined to the lungs, which is still a problem for patients [9].…”

Section: Introductionmentioning

confidence: 99%

MRPL42 is activated by YY1 to promote lung adenocarcinoma progression

Jiang¹,

Zhang²,

Kang³

et al. 2021

J. Cancer

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Mammalian mitochondrial ribosomal proteins are a group of protein factors encoded by nuclear genes, responsible for the synthesis of proteins in mitochondria. As a member of mitochondrial ribosomal proteins, MRPL42 (mitochondrial ribosomal protein L42) belongs to 28S and 39S subunits. The current literature showed that its role in lung adenocarcinoma (LUAD) was not clear. We found that MRPL42 was highly expressed in early-stage LUAD tissues and cell lines, and remarkably related to the prognosis of patients. Knockdown of MRPL42 could reduce the proliferation and colonization, promote cell cycle arrest in G1/S phase, and weaken the migration and invasion ability of LUAD cells in vitro. Moreover, depletion of MRPL42 also inhibited tumor growth in vivo. Bioinformatics analysis found that YY1 may bind to the promoter region upstream of the MRPL42 gene to promote the transcription of MRPL42, which was verified by the ChIP and Dual luciferase reporter assay. QRT-PCR confirmed that knocking down YY1 could attenuate the expression of MRPL42. In summary, MRPL42 acts as an oncogene in LUAD, and its expression level is regulated by YY1.

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“… 6 Surgical treatment is therefore rarely possible, but in the last few years it has been recommended for certain patients with early-stage disease. 7 Before the introduction of platinum-based antineoplastic drugs for the treatment of malignant disease, the median survival of patients diagnosed with small cell lung cancer was two to three months. 8 , 9 The survival rate has increased four to five times with chemotherapy, but for most patients with extensive-stage disease it does not exceed ten months.…”

Section: Introductionmentioning

confidence: 99%

Neutrophil-to-lymphocyte ratio can predict outcome in extensive-stage small cell lung cancer

Drpa

Šutić

Baranašić

et al. 2020

Radiology and Oncology

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BackgroundThe neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were analyzed in various carcinomas and their potential prognostic significance was determined. The objective of present study was to determine the correlation between these parameters and the survival of patients with small cell lung cancer (SCLC), since very few studies have been published on this type of carcinoma.Patients and methodsOne hundred and forty patients diagnosed with SCLC at University Hospital Center Zagreb, between 2012 and 2016 were retrospectively analyzed. Extensive-stage disease (ED) was verified in 80 patients and limited-stage disease (LD) in 60 patients. We analyzed the potential prognostic significance of various laboratory parameters, including NLR, PLR, and LMR, measured before the start of treatment.ResultsDisease extension, response to therapy, chest irradiation and prophylactic cranial irradiation (PCI), as well as hemoglobin, monocyte count, C-reactive protein (CRP), and lactate dehydrogenase (LDH) showed a prognostic significance in all patients. When we analyzed the patients separately, depending on the disease extension, we found that only skin metastases as well as LDH and NLR values, regardless of the cut-off value, had a prognostic significance in ED. Meanwhile, the ECOG performance status, chest irradiation, PCI, and hemoglobin and creatinine values had a prognostic significance in LD.ConclusionsNLR calculated before the start of the treatment had a prognostic significance for ED, while PLR and LMR had no prognostic significance in any of the analyzed groups of patients.

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Benefits of surgery in the multimodality treatment of stage IIB-IIIC small cell lung cancer

Cited by 13 publications

References 41 publications

Effect of surgery on survival in patients with stage III N2 small cell lung cancer: propensity score matching analysis and nomogram development and validation

Effect of surgery on survival in patients with stage III N2 small cell lung cancer: propensity score matching analysis and nomogram development and validation

MRPL42 is activated by YY1 to promote lung adenocarcinoma progression

Neutrophil-to-lymphocyte ratio can predict outcome in extensive-stage small cell lung cancer

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