Impact of Revised Stage Classification of Lung Cancer on Survival

Adebonojo, Samuel A.; Bowser, Andrew N.; Moritz, Dennis; Corcoran, Philip C.

doi:10.1378/chest.115.6.1507

Cited by 78 publications

(44 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The 1997 system has been reported to have no significant difference between stages IB and IIA in many reports. [16][17][18][19][20][21][22] The 5-year survival rate of patients with stage IB disease is inferior to that of patients with stage IIA disease in our series according to the 1997 system. Prognosis in stage IIA has not been evaluated properly because of small number of the patients.…”

Section: Discussioncontrasting

confidence: 63%

“…Prognosis in stage IIA has not been evaluated properly because of small number of the patients. [16][17][18][19][20][21][22] The proportion of patients with stage IIA disease in our series increases from 2.5% to 9.5% in the 2009 system, and the 5-year survival rate of patients with stage IB disease is slightly superior to that of patients with stage IIA disease, but there is no difference between stages IB and IIA. Similar results are reported in another report.…”

Section: Discussionmentioning

confidence: 50%

See 1 more Smart Citation

Unification of T2a and T2b Tumors to T2 Tumors in Non-Small Cell Lung Cancer Staging

Haraguchi

Koizumi

Akiyama

et al. 2011

ATCS

View full text Add to dashboard Cite

Section: Discussioncontrasting

confidence: 63%

Section: Discussionmentioning

confidence: 50%

Unification of T2a and T2b Tumors to T2 Tumors in Non-Small Cell Lung Cancer Staging

Haraguchi

Koizumi

Akiyama

et al. 2011

ATCS

View full text Add to dashboard Cite

“…The SUV max of the primary lesion was obtained and recorded. TLG of the primary lesion was also obtained using an SUV cutoff of 2.5; if the volume of interest was out of proportion to the lesion seen on CT, an isocontour with variable threshold levels was used to best fit the contour of the lesion on CT. TLG was calculated by multiplication of MTV (volume, cm 3 ) by mean SUV within the volume of interest. A representative example of measuring and calculating TLG is shown in Figure 1.…”

Section: F-fdg Pet/ct Protocolmentioning

confidence: 99%

“…TNM stage has been considered the primary prognostic factor in NSCLC. However, tumor-and patientspecific factors vary even within the same disease stage, creating a heterogeneous population of patients, each with an individual prognosis that requires consideration of patient-and tumor-specific factors for best estimation (2,3). Recently, the incidence of earlystage NSCLC has increased as a result of the use of low-dose CT for screening.…”

mentioning

confidence: 99%

Prognostic Value of Total Lesion Glycolysis by ¹⁸F-FDG PET/CT in Surgically Resected Stage IA Non–Small Cell Lung Cancer

Park

Cho

et al. 2014

J Nucl Med

View full text Add to dashboard Cite

Despite the favorable prognosis of stage IA non-small cell lung cancer (NSCLC), the disease recurs after complete surgical resection in 20%-30% of patients. This study determined the prognostic value of various metabolic parameters of 18 F-FDG PET/CT in surgically resected stage IA NSCLC. Methods: We retrospectively reviewed 248 patients with stage IA NSCLC who underwent lobectomy and complete lymph node dissection after PET/CT. A region of interest was drawn on the primary lesion, and metabolic indices such as metabolic tumor volume, maximum standardized uptake value (SUV max ), and total lesion glycolysis (TLG) were measured using an SUV cutoff of 2.5. Results: The patients included 134 men and 114 women, and the mean age was 63.03 ± 10.01 y; 129 were stage T1a (#2 cm) and 119 were T1b (.2 cm). The median follow-up period was 36.6 mo. Recurrence took place in 15 patients. The mean (±SD) SUV max , metabolic tumor volume, and TLG were 4.55 ± 3.75, 5.92 ± 5.57, and 14.42 ± 17.35, respectively. The cutoffs of SUV max and TLG were 3.7 and 13.76, respectively. The 5-y overall survival (OS) was 95.1% in low-SUV max patients and 82.2% in high-SUV max patients (P 5 0.02). The 5-y OS was 93.7% in low-TLG patients and 78.3% in high-TLG patients (P 5 0.01). On multivariate analysis, TLG was a risk factor for OS (hazard ratio, 3.159; P 5 0.040), but SUV max showed marginal significance (P 5 0.064). The concordance index of the TLG model was 0.676 (95% CI, 0.541-0.812). Conclusion: TLG was a significant prognostic factor for OS in patients with stage IA NSCLC. Lungcanceri s the second most common cancer in both men and women and the most common cause of cancer death in the world (1). Non-small cell lung cancer (NSCLC) accounts for 80%-85% of all lung cancer cases. Oncologic treatment options for NSCLC typically include surgery, radiation, and chemotherapy, either alone or in combination. TNM stage has been considered the primary prognostic factor in NSCLC. However, tumor-and patientspecific factors vary even within the same disease stage, creating a heterogeneous population of patients, each with an individual prognosis that requires consideration of patient-and tumor-specific factors for best estimation (2,3). Recently, the incidence of earlystage NSCLC has increased as a result of the use of low-dose CT for screening. However, despite having early-stage disease, up to 20%-30% of patients with stage IA NSCLC relapse after surgical treatment. Therefore, other prognostic factors besides TNM stages are needed to identify patients at high risk for recurrence, predict prognosis, and recommend individualized adjuvant therapy (4).18 F-FDG PET relies on the fact that most neoplasms are highly metabolically active and therefore can be detected on a background of relatively less active normal tissues. When performed in addition to qualitative evaluation by visual inspection, 18 F-FDG PET can provide several semiquantitative measurements of radioactivity concentration in each tissue compartment, such as standardized uptake value (SUV...

show abstract

“…For patients with early-stage disease, the survival rate after surgery is 40% to 55% (1,2), raising the need to accurately identify subgroups who might benefit from adjuvant chemotherapy (3). The utility of adjuvant chemotherapy for the stage IB tumors, however, remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Prediction of Clinical Outcome in Multiple Lung Cancer Cohorts by Integrative Genomics: Implications for Chemotherapy Selection

et al. 2009

View full text Add to dashboard Cite

The role of adjuvant chemotherapy in patients with stage IB non-small-cell lung cancer (NSCLC) is controversial. Identifying patient subgroups with the greatest risk of relapse and, consequently, most likely to benefit from adjuvant treatment thus remains an important clinical challenge. Here, we hypothesized that recurrent patterns of genomic amplifications and deletions in lung tumors could be integrated with gene expression information to establish a robust predictor of clinical outcome in stage IB NSCLC. Using high-resolution microarrays, we generated tandem DNA copy number and gene expression profiles for 85 stage IB lung adenocarcinomas/large cell carcinomas. We identified specific copy number alterations linked to relapse-free survival and selected genes within these regions exhibiting copy number-driven expression to construct a novel integrated signature (IS) capable of predicting clinical outcome in this series (P = 0.02). Importantly, the IS also significantly predicted clinical outcome in two other independent stage I NSCLC cohorts (P = 0.003 and P = 0.025), showing its robustness. In contrast, a more conventional molecular predictor based solely on gene expression, while capable of predicting outcome in the initial series, failed to significantly predict outcome in the two independent data sets. Our results suggest that recurrent copy number alterations, when combined with gene expression information, can be successfully used to create robust predictors of clinical outcome in early-stage NSCLC. The utility of the IS in identifying early-stage NSCLC patients as candidates for adjuvant treatment should be further evaluated in a clinical trial. [Cancer Res 2009;69(3):1055-62]

show abstract

Impact of Revised Stage Classification of Lung Cancer on Survival

Cited by 78 publications

References 17 publications

Unification of T2a and T2b Tumors to T2 Tumors in Non-Small Cell Lung Cancer Staging

Unification of T2a and T2b Tumors to T2 Tumors in Non-Small Cell Lung Cancer Staging

Prognostic Value of Total Lesion Glycolysis by ¹⁸F-FDG PET/CT in Surgically Resected Stage IA Non–Small Cell Lung Cancer

Prediction of Clinical Outcome in Multiple Lung Cancer Cohorts by Integrative Genomics: Implications for Chemotherapy Selection

Contact Info

Product

Resources

About

Impact of Revised Stage Classification of Lung Cancer on Survival

Cited by 78 publications

References 17 publications

Unification of T2a and T2b Tumors to T2 Tumors in Non-Small Cell Lung Cancer Staging

Unification of T2a and T2b Tumors to T2 Tumors in Non-Small Cell Lung Cancer Staging

Prognostic Value of Total Lesion Glycolysis by 18F-FDG PET/CT in Surgically Resected Stage IA Non–Small Cell Lung Cancer

Prediction of Clinical Outcome in Multiple Lung Cancer Cohorts by Integrative Genomics: Implications for Chemotherapy Selection

Contact Info

Product

Resources

About

Prognostic Value of Total Lesion Glycolysis by ¹⁸F-FDG PET/CT in Surgically Resected Stage IA Non–Small Cell Lung Cancer