Lung Cancer in Nepal

Shilpakar, Ramila; Paudel, Bishnu Dutta; Sharma, Rajeev; Silwal, Sudhir Raj; Sapkota, Ranjan; Shrestha, Prajowl; Dulal, Soniya; Piya, Madan Kumar; Tuladhar, Sampurna; Neupane, Prakash; Dhimal, Meghnath; Niroula, Abesh; Uprety, Dipesh

doi:10.1016/j.jtho.2021.10.020

Cited by 5 publications

(6 citation statements)

References 17 publications

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“…Kamigaichi Atsushi et al found that the number and length of incisions were closely related to muscle, nerve, and vascular injuries in patients [ 18 ] because small incisions are less liable to chest muscles injury, which can reduce the stimulation of surgical operations on muscles and nerves. Moreover, the single-port operation allows for more effective hemostasis and less fluctuation of the patient's cellular and humoral immunity [ 13 , 20 , 21 ]; thus, single-port operation avoids collateral damages to the adjacent tissues, reduces the stress response, and alleviates postoperative pain.…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Single-Port Thoracoscopic Lobectomy versus Three-Port Thoracoscopic Lobectomy for Lung Cancer

Zhou

et al. 2022

Journal of Oncology

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Objective. To evaluate the clinical efficacy of single-port thoracoscopic lobectomy versus three-port thoracoscopic lobectomy for lung cancer. Methods. From February 2020 to February 2021, 200 lung cancer patients treated in our institution assessed for eligibility were enrolled and randomly assigned (1 : 1) to either the experimental group (single-port thoracoscopic lobectomy) or the control group (three-port thoracoscopic lobectomy). The outcomes were the eligible patients’ surgical indices, pain stress indexes, and postoperative complications. Results. The experimental group outperformed the control group in terms of incision length, postoperative drainage time, extubation time, time to get out of bed, time to analgesics administration, and postoperative pain score ( P < 0.001 ). Compared with the control group, the experimental group reduced the intraoperative bleeding ( 161.98 ± 10.65 versus 179.65 ± 14.20 , P < 0.001 ) and length of hospital stay ( 7.98 ± 0.56 versus 10.46 ± 1.23 , P < 0.001 ). The operative time of the single-port thoracoscopic lobectomy was longer than that of the three-port thoracoscopic lobectomy ( P < 0.001 ). There was no statistical difference between the two groups in the intraoperative conversion to thoracotomy and the number of lymph node dissections ( P > 0.05 ). Postoperative pain stress indices and complication rates of the experimental group were significantly lower than those of the control group ( P < 0.001 ). Conclusion. Single-port thoracoscopic lobectomy can improve the perioperative indices of lung cancer patients, reduce their pain stress response, and accelerate postoperative recovery. However, its operation is difficult and time-consuming, requiring experienced surgeons for improved surgical outcomes in practice.

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Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Single-Port Thoracoscopic Lobectomy versus Three-Port Thoracoscopic Lobectomy for Lung Cancer

Zhou

et al. 2022

Journal of Oncology

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“…Even though there are multiple drugs in each class targeting an oncogene product, in-class competition does not appear to put a downward pressure on prices as happens in other areas of the economy, and prices continue to remain high [ 135 , 136 ]. Since global pricing follows the United States pricing, targeted drugs for oncogene-addicted NSCLC remain high globally and, in most countries, these agents are unaffordable to the majority of the NSCLC population [ 136 , 137 ].…”

Section: Cost and Accessmentioning

confidence: 99%

Challenges in the Use of Targeted Therapies in Non–Small Cell Lung Cancer

2022

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Precision oncology has fundamentally changed how we diagnose and treat cancer. In recent years, there has been a significant change in the management of patients with oncogeneaddicted advanced-stage NSCLC. Increasing amounts of identifiable oncogene drivers have led to the development of molecularly targeted drugs. Undoubtedly, the future of thoracic oncology is shifting toward increased molecular testing and the use of targeted therapies. For the most part, these novel drugs have proven to be safe and effective. As with all great innovations, targeted therapies pose unique challenges. Drug toxicities, resistance, access, and costs are some of the expected obstacles that will need to be addressed. This review highlights some of the major challenges in the use of targeted therapies in NSCLC and provides guidance for the future strategies.

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“…24,25 In countries with a high incidence of pulmonary infections, like India and Nepal, there is a concern for increased lung fibrosis and pleural adhesions making minimally invasive surgical resection less feasible. 26 The availability of skilled surgical oncologists or thoracic surgeons and post-operative rehabilitation resources differ widely throughout the world. The disparities in resource availability results in lower surgical resection rates; however, the overall post-operative outcomes are similar to high-income countries.…”

Section: Management Of Non-metastatic Lung Cancermentioning

confidence: 99%

Lung cancer management in low and middle-income countries - current challenges and potential solutions

Uprety

Surapaneni

2023

International Journal of Cancer Care and Delivery

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Lung cancer is the second-most prevalent cancer and, the most common cause of cancer-related mortality throughout the world. Evidence-based strategies to decrease its incidence and mortality are being implemented in different parts of the world. Smoking cessation policies are being actively publicized to decrease the incidence of tobacco related cancers including lung cancer. Screening program for early detection of localized lung cancer which can then be targeted by a multimodality approach utilizing surgery, radiation, chemoimmunotherapy to achieve cure is now becoming the standard in several high-income countries. Precision medicine in lung cancer is booming with metastatic non-curative cancers targeted with small molecule tyrosine kinase inhibitors. However, these advancements are not available all around the world. Inequalities exist in the management of lung cancer, mostly driven by the economic differences between the countries. Raising awareness to these international barriers is pivotal for improving lung cancer related incidence and mortality.

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Lung Cancer in Nepal

Cited by 5 publications

References 17 publications

Clinical Efficacy of Single-Port Thoracoscopic Lobectomy versus Three-Port Thoracoscopic Lobectomy for Lung Cancer

Clinical Efficacy of Single-Port Thoracoscopic Lobectomy versus Three-Port Thoracoscopic Lobectomy for Lung Cancer

Challenges in the Use of Targeted Therapies in Non–Small Cell Lung Cancer

Lung cancer management in low and middle-income countries - current challenges and potential solutions

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