Executive Summary

Detterbeck, Frank C.; Lewis, Sandra Zelman; Diekemper, Rebecca L.; Addrizzo-Harris, Doreen; Alberts, W. Michael

doi:10.1378/chest.12-2377

Cited by 399 publications

(121 citation statements)

References 5 publications

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“…RT can be performed as conventionally fractionated radiotherapy (CFRT) or as stereotactic ablative body radiation (SABR), which was formerly referred to as stereotactic body radiation therapy. SABR enables highly focal treatment of cancer with single or few fractions of high-dose radiation and is preferred to CFRT [3]. RFA is a minimally invasive method that involves image-guided percutaneous placement of an electrode into a tumor and generation of heat to cause complete tumor destruction.…”

Section: Introductionmentioning

confidence: 99%

Sublobar Resection, Radiofrequency Ablation or Radiotherapy in Stage I Non-Small Cell Lung Cancer

et al. 2015

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Background: The best therapy for patients with stage I non-small cell lung cancer (NSCLC) who are medically unfit for lobectomy or prefer not to undergo surgery has not yet been demonstrated. Objectives: We analyzed data from our prospective database to evaluate the recurrence and survival rates and assess the extent to which the type of treatment explains outcome differences. Methods: This study included 116 patients with histologically proven clinical stage I NSCLC who were treated with sublobar resection (SLR; n = 42), radiofrequency ablation (RFA; n = 25) or radiotherapy (RT; n = 49) between 2009 and 2013. The primary end point was the time to primary tumor recurrence (PR). Kaplan-Meier curves and Cox regression were used to compare the recurrence patterns and survivals after adjustments for potential confounders. Results: The SLR patients were younger and exhibited better performance status. The RT patients had larger tumors. After adjusting for age and tumor size, there were differences between the different treatments in terms of the PR rate, but no differences were observed in overall (OS) or disease-free survival. The hazard ratio for PR comparing SLR versus RT adjusted for age and tumor size was 2.73 (95% confidence interval, CI, 0.72-10.27) and that for SLR versus RFA was 7.57 (95% CI 1.94-29.47). Conclusions: Our study suggests that SLR was associated with a higher primary tumor control rate compared to RFA or RT, although the OSs were not different. These results should be confirmed in prospective trials.

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Section: Introductionmentioning

confidence: 99%

Sublobar Resection, Radiofrequency Ablation or Radiotherapy in Stage I Non-Small Cell Lung Cancer

et al. 2015

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“…Furthermore, our data show that we follow the ACCP and BTS guidelines recommendation of early mediastinal staging before surgery (3, 10). A recent US report found that this was performed only in 21% of patients (23, 24).…”

Section: Discussionmentioning

confidence: 59%

“…TNM stage was assessed (9), and patients were referred to relevant therapy according to cytology, TNM, and performance status (10). …”

Section: Methodsmentioning

confidence: 99%

Accuracy and consequences of same-day, invasive lung cancer workup – a retrospective study in patients treated with surgical resection

Madsen

Høegholm

Bødtger

2016

European Clinical Respiratory Journal

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BackgroundThough widely used, little is known about accuracy and efficacy of same-day, invasive workup of suspected lung cancer.ObjectiveTo evaluate the accuracy and efficacy of same-day, invasive lung cancer workup (diagnosis and mediastinal staging), and to identify differences between patients without (Group A) or with (Group B) need for resampling.MethodsA retrospective study was performed on all consecutive patients referred for surgical treatment for localised lung cancer after invasive diagnostic and staging workup at our unit. Data were extracted from electronic medical files. Surgical specimens served as gold standard for correct diagnosis and stage.ResultsA total of 129 patients (peripheral lesion: 84%; mediastinal staging: 97%) were included. After same-day, invasive workup, 71% had no need for further invasive workup (Group A), while 29% had (Group B). Group A differed significantly from Group B in fewer invasive tests, fewer days from referral to surgery, and lower pneumothorax incidence, while no differences were observed in diagnostic accuracy, cancer subtype, tumour size, tumour stage, peripheral lesion, nodal involvement, gender, or presence of chronic obstructive pulmonary disease. Tumour located in right upper lobe was associated with need for resampling.DiscussionOur retrospective study suggests that same-day, invasive workup for lung cancer is safe, accurate, and efficacious in reducing time to therapy, even in patients with small lesions and low tumour burden.

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“…An initial chest radiograph showed a mass-like lesion in the right lower lung zone, and a subsequent chest computed tomography (CT) scan confirmed a 5.1-cm-sized right lung mass with enlarged lymph nodes at the right hilar, subcarinal, and right lower paratracheal area, which was highly suspected to be primary lung cancer (Figure 1A, B). Positron emission tomography and magnetic resonance imaging of the brain detected no distant metastasis; therefore, EBUS-TBNA (BF-UC260F-OL8; Olympus, Tokyo, Japan) was performed for both pathologic diagnosis and nodal staging of the suspected lung cancer according to the American College of Chest Physicians evidence-based clinical practice guidelines (Figure 1C, D)5. Ultrasound findings showed that the subcarinal and right lower paratracheal lymph nodes were enlarged (19×21 mm and 10×16 mm, respectively) with discrete margins and central hypoechogenicity.…”

Section: Case Reportmentioning

confidence: 99%

New-Onset Malignant Pleural Effusion after Abscess Formation of a Subcarinal Lymph Node Associated with Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

et al. 2014

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We present a case of an unusual infectious complication of a ruptured mediastinal abscess after endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), which led to malignant pleural effusion in a patient with stage IIIA non-small-cell lung cancer. EBUS-TBNA was performed in a 48-year-old previously healthy male, and a mediastinal abscess developed at 4 days post-procedure. Video-assisted thoracoscopic surgery was performed for debridement and drainage, and the intraoperative findings revealed a large volume pleural effusion that was not detected on the initial radiographic evaluation. Malignant cells were unexpectedly detected in the aspirated pleural fluid, which was possibly due to increased pleural permeability and transport of malignant cells originating in a ruptured subcarinal lymph node from the mediastinum to the pleural space. Hence, the patient was confirmed to have squamous cell lung carcinoma with malignant pleural effusion and his TNM staging was changed from stage IIIA to IV.

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Executive Summary

Cited by 399 publications

References 5 publications

Sublobar Resection, Radiofrequency Ablation or Radiotherapy in Stage I Non-Small Cell Lung Cancer

Sublobar Resection, Radiofrequency Ablation or Radiotherapy in Stage I Non-Small Cell Lung Cancer

Accuracy and consequences of same-day, invasive lung cancer workup – a retrospective study in patients treated with surgical resection

New-Onset Malignant Pleural Effusion after Abscess Formation of a Subcarinal Lymph Node Associated with Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

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