Centrally located lung cancer and risk of occult nodal disease: an objective evaluation of multiple definitions of tumour centrality with dedicated imaging software

Introduction Current guidelines recommend invasive mediastinal staging in patients with centrally located radiographic stage T1N0M0 nonsmall cell lung cancer (NSCLC). The lack of a specific definition of a central tumour has resulted in discrepancies among guidelines and heterogeneity in practice patterns. Methods Our objective was to study specific definitions of tumour centrality and their association with occult nodal disease. Pre-operative chest computed tomography scans from patients with clinical (c) T1N0M0 NSCLC were processed with a dedicated software system that divides the lungs in thirds following vertical and concentric lines. This software accurately assigns tumours to a specific third based both on the location of the centre of the tumour and its most medial aspect, creating eight possible definitions of central tumours. Results 607 patients were included in our study. Surgery was performed for 596 tumours (98%). The overall pathological (p) N disease was: 504 (83%) N0, 56 (9%) N1, 47 (8%) N2 and no N3. The prevalence of N2 disease remained relatively low regardless of tumour location. Central tumours were associated with upstaging from cN0 to any N (pN1/pN2). Two definitions were associated with upstaging to any N: concentric lines, inner one-third, centre of the tumour (OR 3.91, 95% CI 1.85–8.26; p
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung imaging, Lung cancer Original Articles: Lung cancer Source Type: research

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Abstract PURPOSE: To provide evidence-based recommendations to practicing clinicians on radiographic imaging and biomarker surveillance strategies after definitive curative-intent therapy in patients with stage I-III non-small-cell lung cancer (NSCLC) and SCLC. METHODS: ASCO convened an Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary, radiology, primary care, and advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 2000...
Source: Ann Oncol - Category: Cancer & Oncology Authors: Tags: J Clin Oncol Source Type: research
The follow-up for radically treated non-small cell lung cancer (NSCLC) patients remains controversial. The aim of this study was to review the outcomes since the change in the local protocol in 2014 were CT scan follow-up introduced, in term of further radical treatment for recurrence as well as 3 years survival.243 patients with NSCLC who treated radically with surgical resection were retrospectively reviewed. Patients treated in 2012-2013 were followed-up by chest radiographs or no specific protocol (Group A), while patients treated in 2015 had CT-Scans follow-up at 6, 12 and 18 months (Group B).Out of 169 patients in gr...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung cancer Source Type: research
CONCLUSIONS: This study reveals the associations between CT imaging radiomics features and NSCLC co-expressed gene sets. The findings suggest that CT radiomics features can reflect important biological information of NSCLC patients, which may have a significant clinical impact as CT is routinely used in clinical practice, assisting in improving medical decision-support at low cost. PMID: 31450540 [PubMed - as supplied by publisher]
Source: Journal of X-Ray Science and Technology - Category: Radiology Tags: J Xray Sci Technol Source Type: research
Conclusions The recent, first randomized clinical trial demonstrated overall and progression free survival benefits after SBRT to oligometastatic disease which supports prior retrospective case series (6). The spine is a common site of metastatic bone disease, and as high quality data continue to mature, along with completion of additional randomized clinical trials, it is expected that utility of SBRT to the spine will increase in the future. Spine SBRT is unique due to the requirement of sharp dose falloff to prevent serious neurologic morbidity. With recent advances in radiotherapy planning, robotic patient positionin...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: The newly developed radiomic signature was a powerful predictor of LN metastasis and the radiomics nomogram could facilitate the preoperative individualized prediction of LN status. Introduction Gastric cancer (GC) is one of the most common malignant tumors and the second leading cause of cancer-related deaths worldwide (1). Accurate evaluation of lymph node metastasis (LNM) status in GC patients is vital for prognosis and treatment decisions (2–4). Some histopathologic factors and biomarkers (e.g., lymphatic invasion, matrix metalloproteinase-2) are found to be able to predict LNM in GC, but mos...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Mark E. Gray1,2*, James Meehan2,3, Paul Sullivan4, Jamie R. K. Marland4, Stephen N. Greenhalgh1, Rachael Gregson1, Richard Eddie Clutton1, Carol Ward2, Chris Cousens5, David J. Griffiths5, Alan Murray4 and David Argyle1 1The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom 2Cancer Research UK Edinburgh Centre and Division of Pathology Laboratories, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom 3School of Engineering and Physical Sciences, Institute of Sensors, Signals and Systems, Heriot-Watt Univer...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsA guideline-recommended strategy for invasive mediastinal staging selects all patients with true nodal disease and a majority of patients without nodal disease for invasive mediastinal staging. Our prediction model appears to maintain (within a margin of error) the sensitivity of a guideline-recommended invasive staging strategy and has the potential to reduce the use of invasive procedures.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Conclusion: An adequate interpretation of follow-up radiologic examinations is crucial not to miss a post-operative complication or even recurrenceDifferentiating recurrence from postsurgical changes could be challenging for radiologists; reviewing evolution of imaging patterns of previous exams may be helpful to distinguish them.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Imaging Source Type: research
ConclusionsGenerally, superior vena cava syndrome is the result of extrinsic compression of the superior vena cava by tumor. Our patient ’s case represents the development of superior vena cava syndrome after an excellent response of tumor with near-complete tumor response. We suspect chemoradiation therapy as a potential etiology for the precipitation of the superior vena cava syndrome, which is currently not well reported in the medical literature.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Conclusions The utility of FDG-PET in patients with NSCLC on immune blockade therapy appeared to be similar to what has been reported with conventional chemotherapeutic treatments, with early metabolic response predicting subsequent benefit. Baseline whole-body metabolic tumor volume was a strong negative prognostic factor for OS. Summary dual-time-point data did not provide incremental value.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Lung Cancer I Source Type: research
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