Integral mediastinal staging in patients with NON-SMALL cell lung cancer and risk factors for occult N2 disease

Lucena, Carmen M.; Martín-Deleon, Roberto; Boada, Marc; Marrades, Ramón M.; Sánchez, David; Sánchez, Marcelo; Vollmer, Iván; Martı́nez, Daniel; Fontana, Ainhoa; Reguart, Noemı́; Molins, Laureano; Agustı́, Carlos

doi:10.1016/j.rmed.2023.107132

Cited by 3 publications

(5 citation statements)

References 24 publications

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“…One study reported long-term oncological outcomes but was not included for analysis as complete resection in the full cohort was not obtained [ 10 ]. All studies were retrospective, except for one [ 11 ]. All included studies were labeled as having a low risk of bias (≥6).…”

Section: Resultsmentioning

confidence: 99%

True Prevalence of Unforeseen N2 Disease in NSCLC: A Systematic Review + Meta-Analysis

Hui

Charaf²,

Hendriks

et al. 2023

Cancers

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Patients with unforeseen N2 (uN2) disease are traditionally considered to have an unfavorable prognosis. As preoperative and intraoperative mediastinal staging improved over time, the prevalence of uN2 changed. In this review, the current evidence on uN2 disease and its prevalence will be evaluated. A systematic literature search was performed to identify all studies or completed, published trials that included uN2 disease until 6 April 2023, without language restrictions. The Newcastle-Ottawa Scale (NOS) was used to score the included papers. A total of 512 articles were initially identified, of which a total of 22 studies met the predefined inclusion criteria. Despite adequate mediastinal staging, the pooled prevalence of true unforeseen pN2 (9387 patients) was 7.97% (95% CI 6.67–9.27%), with a pooled OS after five years (892 patients) of 44% (95% CI 31–58%). Substantial heterogeneity regarding the characteristics of uN2 disease limited our meta-analysis considerably. However, it seems patients with uN2 disease represent a subcategory with a similar prognosis to stage IIb if complete surgical resection can be achieved, and the contribution of adjuvant therapy is to be further explored.

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Section: Resultsmentioning

confidence: 99%

True Prevalence of Unforeseen N2 Disease in NSCLC: A Systematic Review + Meta-Analysis

Hui

Charaf²,

Hendriks

et al. 2023

Cancers

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Section: Multi-station Sampling In the Era Of Immunotherapymentioning

confidence: 99%

“…Lucena et al [5 ▪ ] prospectively evaluated the added benefit of video-assisted mediastinoscopy after endobronchial ultrasound (EBUS) staging in patients with a radiologically normal mediastinum and risk factors for occult mediastinal metastases (OMM). The overall prevalence of OMM was 10% with a 6 and 4.4% risk of missing the diagnosis with EBUS and the combined approach, respectively [5 ▪ ]. Proceeding with mediastinoscopy after negative EBUS staging in these patients was not recommended, but future research is required to determine the potential benefit in those patients with clinical N1 disease.…”

Section: Multi-station Sampling In the Era Of Immunotherapymentioning

confidence: 99%

“…Green þ purple lymph node stations (2R, 2L, 4R, 4L, 7, 8, 9) are reachable by EUS-FNA or EUS-B FNA; the right-sided paratracheal lymph nodes are often difficult to access in this manner, however, given the interposition of the trachea and loss of ultrasound visualization. Yellow lymph node stations(5,6) are typically out of reach for EBUS and cervical mediastinoscopy; these stations may be reachable by EUS or EUS-B on occasion, but often require a left thoracoscopic intervention or Chamberlain procedure for access.…”

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confidence: 99%

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What is new in mediastinal staging?

Schwalk,

Niroula,

Schimmel

2023

Current Opinion in Pulmonary Medicine

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Purpose of review Appropriate staging is of utmost importance in nonsmall cell lung cancer (NSCLC), as the pathologic stage dictates both overall prognosis and appropriate therapeutic pathways. This article seeks to review the current recommendations for mediastinal staging of NSCLC and available modalities to achieve this. Landmark publications pertaining to recent advancements in NSCLC treatments are also highlighted and the role of specific bronchoscopic modalities for tissue acquisition are reviewed. Recent findings Recent advancements in the treatment of NSCLC have made accurate mediastinal staging more important than ever. Guidelines and recommendations outlining patients that warrant invasive mediastinal staging are available and a systematic approach should be utilized when sampling is performed. Ensuring the adequacy of tissue for the growing number of molecular biomarkers that must be tested has been the focus of many recent studies. Summary Appropriate mediastinal staging is crucial for the management of patients with NSCLC as is obtaining adequate tissue for diagnostic and therapeutic purposes. EBUS-TBNA is sufficient for the diagnosis of nonsmall cell and small cell lung carcinomas, but EBUS-guided intranodal forceps and cryobiopsy may provide more optimal specimen for patients with benign disease, such as sarcoidosis, or in cases of lymphoma. Further studies are necessary to better delineate the role of these techniques in the diagnosis and staging of mediastinal diseases before they become the primary diagnostic modalities.

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“…Lung carcinoma is one of the cruelest life-changing illnesses in human society. Exact disease identification is vital for effective cancer therapy; every carcinoma needs a specific treatment strategy [1][2][3][4]. The usual treatments like surgery, radiotherapy, chemotherapy, hormonal treatments, and biological therapies are highly toxic and expensive.…”

Section: Introductionmentioning

confidence: 99%

Natural compound chaetocin induced DNA damage and apoptosis through reactive oxygen species‐dependent pathways in A549 lung cancer cells and in vitro evaluations

Zhang

Ruan

Yang³

et al. 2023

IET Nanobiotechnology

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There is an urgent need for potential pharmaceutics for lung cancer treatment due to the increased number of lung cancer deaths and the resistance of cancer cells to present therapeutics. The present work aims to discover the anticancer potential of the natural compound chaetocin as a therapeutic for lung cancer treatment. Results showed the significance of chaetocin-induced cell growth inhibition by the expression of G 2 /M phase arrest and reactive oxygen species (ROS) dependent apoptosis in A549 lung cancer cells. Results concluded that chaetocin could produce ROS and nuclear damage against A549 lung cancer cells. Interestingly, chaetocin exhibits a significant level of CD47 that downregulates the expression of CD47 at mRNA levels. PBMC biocompatibility study revealed that chaetocin is non-toxic to normal cells. Overall, experimental results suggested that chaetocin induces A549 cell apoptosis, by causing ROS and nuclear damage activation pathways. In the future, chaetocin might be an effective bio-safe anticancer agent for lung cancer treatments.

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Integral mediastinal staging in patients with NON-SMALL cell lung cancer and risk factors for occult N2 disease

Cited by 3 publications

References 24 publications

True Prevalence of Unforeseen N2 Disease in NSCLC: A Systematic Review + Meta-Analysis

True Prevalence of Unforeseen N2 Disease in NSCLC: A Systematic Review + Meta-Analysis

What is new in mediastinal staging?

Natural compound chaetocin induced DNA damage and apoptosis through reactive oxygen species‐dependent pathways in A549 lung cancer cells and in vitro evaluations

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