Outcome of Surgery for Small Cell Lung Cancer - Response to Induction Chemotherapy Predicts Survival

Nakamura, Hiroki; Kato, Yuichi; Kato, Harubumi

doi:10.1055/s-2004-821075

Cited by 37 publications

(19 citation statements)

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“…One Japanese multi-institutional phase II study (JCOG9101) has reported that recurrence after surgery occurred in 43% (26/61) of patients overall, in 29% (10/35) of patients with p-stage I disease, in 50% (4/8) of patients with p-stage II, and in 67% (12/18) of patients with p-stage III, and that the incidence of brain metastasis was 15% (9/61) in patients overall, 11% (4/35) in patients with p-stage I disease, 38% (3/8) in patients with p-stage II, and 11% (2/18) in patients with p-stage III [20]. Another Japanese study showed that relapse after surgery occurred in 34 of 69 (49%) patients who underwent complete resection of SCLC and in 27% (8/30) of patients with p-stage I disease, 58% (7/12) of patients with p-stage II, 69% (18/26) of patients with p-stage III, and 100% (1/1) of patients with p-stage IV [19].…”

Section: Discussionmentioning

confidence: 99%

“…However, use of PCI after combined-modality treatment with surgery for resectable LS-SCLC has not yet been investigated sufficiently. As far as we are aware, only 2 Japanese studies have reported the frequency of brain relapse after surgery for LS-SCLC [19,20]. One Japanese multi-institutional phase II study (JCOG9101) has reported that recurrence after surgery occurred in 43% (26/61) of patients overall, in 29% (10/35) of patients with p-stage I disease, in 50% (4/8) of patients with p-stage II, and in 67% (12/18) of patients with p-stage III, and that the incidence of brain metastasis was 15% (9/61) in patients overall, 11% (4/35) in patients with p-stage I disease, 38% (3/8) in patients with p-stage II, and 11% (2/18) in patients with p-stage III [20].…”

Section: Discussionmentioning

confidence: 99%

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Patterns of recurrence and outcome in patients with surgically resected small cell lung cancer

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Patterns of recurrence and outcome in patients with surgically resected small cell lung cancer

et al. 2011

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“…One Japanese multi-institutional phase II study (JCOG9101) has reported that the overall incidence of BM was 15% (9/61) in patients with surgically resected SCLC, but only 11% (4/35) in patients with p-stage I disease compared to 19.2% in patients with p-stage II or stage III disease [ 15 ]. Nakamura et al analyzed the frequency of BM as a first relapse site and found a 7% (2/30) BM rate for patients with p-stage I disease, 25% (3/12) for patients with p-stage II SCLC, and 27% (7/26) for patients with p-stage III [ 21 ]. Ogawa et al also reported the frequency of BM, but only 28 patients were included in the study [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for brain metastases in completely resected small cell lung cancer: a retrospective study to identify patients most likely to benefit from prophylactic cranial irradiation

et al. 2014

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BackgroundThe role of prophylactic cranial irradiation (PCI) on small cell lung cancer (SCLC) has been established based on the two-stage system of limited versus extensive disease and the treatment modality of chemoradiotherapy. However, the use of PCI after combined-modality treatment with surgery for resectable limited-stage SCLC has not been investigated sufficiently. We conducted a retrospective study to evaluate risk factors for brain metastasis (BM) in patients with surgically resected SCLC to identify those most likely to benefit from PCI.Patients and methodsThe records of 126 patients with completely resected SCLC and definitive TNM stage based on histological examination between 2003 and 2009 were reviewed. The cumulative incidence of BM was estimated using the Kaplan–Meier method and differences between the groups were analyzed using the log-rank test. Multivariate Cox regression analysis was applied to assess the risk factors of BM.ResultsTwenty-eight patients (22.2%) developed BM at some point during their clinical course. The actuarial risk of developing BM at 3 years was 9.7% in patients with p-stage I disease, 18.5% in patients with p-stage II disease, and 35.4% in patients with p-stage III disease (p = 0.013). The actuarial risk of developing BM at 3 years in patients with LVI was 39.9% compared to 17.5% in patients without LVI (p = 0.003). Multivariate analysis identified pathologic stage (hazard ratio [HR] = 2.013, p = 0.017) and LVI (HR = 1.924, p = 0.039) as independent factors related to increased risk of developing BM.ConclusionPatients with completely resected p-stage II-III SCLC and LVI are at the highest risk for BM.

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“…The importance of response to chemotherapy on outcome in patients has been demonstrated in the setting of multiple tumors, including rectal, lung, and esophageal, and more recently, with colorectal cancer metastatic to the liver [19][20][21]. In a study by Adam et al the response to chemotherapy was evaluated through imaging studies of abdominopelvic and chest CT scan and abdominopelvic ultrasound utilizing the World Health Organization criteria (WHO) [22].…”

Section: Discussionmentioning

confidence: 99%

Response to chemotherapy predicts survival following resection of hepatic colo‐rectal metastases in patients treated with neoadjuvant therapy

Small¹,

Lubezky²,

Shmueli³

et al. 2008

Journal of Surgical Oncology

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Background: Prognosis of patients following resection of CRC metastases to the liver has traditionally been predicted by clinical risk factors. In the era of neoadjuvant chemotherapy, determination of new prognostic indicators of outcome are necessary. Methods: This retrospective study includes patients with CRC liver metastases, who received oxaliplatin or irinotecan based neoadjuvant chemotherapy and underwent R0 resection. Patients were followed by CT and PET-CT, before, during and after chemotherapy and surgery. The predictive value of the Memorial Sloan-Kettering Cancer Center Clinical Score (MSKCC-CS) and degree of response to chemotherapy (measured by CT and PET-CT), were analyzed by univariate and multivariate COX regression. Results: Included are 54 patients. Overall 1-, 2-, 3-year survival rates 88%, 70%, and 39%. Response to chemotherapy on CT was a significant predictor of survival on univariate (P ¼ 0.03) and multivariate analysis (P ¼ 0.03), whereas MSKCC-CS and response to chemotherapy on PET-CT were not. Multivariate analysis demonstrated response to chemotherapy as a predictor of time to recurrence on CT (P ¼ 0.02) and PET-CT (P ¼ 0.03), while the MSKCC-CS (P ¼ 0.64) was not. Conclusions: In this cohort of patients treated by neoadjuvant chemotherapy, the outcome was not predicted by the traditional clinical scoring system, but rather by response to chemotherapy as evaluated by CT and PET-CT.

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Outcome of Surgery for Small Cell Lung Cancer - Response to Induction Chemotherapy Predicts Survival

Abstract: Surgery combined with chemotherapy is a therapeutic option in selected patients with SCLC. Pathologic nodal status and response to induction chemotherapy are predictors of survival.

Cited by 37 publications

References 9 publications

Patterns of recurrence and outcome in patients with surgically resected small cell lung cancer

Patterns of recurrence and outcome in patients with surgically resected small cell lung cancer

Risk factors for brain metastases in completely resected small cell lung cancer: a retrospective study to identify patients most likely to benefit from prophylactic cranial irradiation

Response to chemotherapy predicts survival following resection of hepatic colo‐rectal metastases in patients treated with neoadjuvant therapy

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