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1. Quality of life, psychological states, and personality traits in patients with pectus excavatumCentral MessagePerspective

Author

Kohei Matsuda, MD, Daisuke Fujisawa, MD, Kyohei Masai, MD, Naoki Miyazaki, Shigeki Suzuki, MD, Yu Okubo, MD, Kaoru Kaseda, MD, Keisuke Asakura, MD, Tomoyuki Hishida, MD, and Hisao Asamura, MD

Subjects
pectus excavatum, funnel chest, QOL, depression, social anxiety, Diseases of the circulatory (Cardiovascular) system, RC666-701, Surgery, RD1-811
Abstract

Objective: The quality of life (QOL) and psychological states of patients with pectus excavatum (PE) have yet to be well understood. This study aimed to evaluate the health-related QOL (HRQOL), psychological states, and personality traits of patients with PE, alongside the associations of these factors with the severity of PE. Methods: A cross-sectional evaluation was prospectively performed in patients scheduled to undergo PE repair surgery between July 2019 and April 2021. The primary outcome was the patients’ HRQOL, and the secondary outcomes were depression, social anxiety, self-efficacy, and personality traits. Results: In total, 129 patients were subjected to analyses. Patients' HRQOL had a lower role component summary score (mean ± standard deviation: 41.8 ± 12.8, P

Published
2024
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2. Prospective, Multi-Institutional Observational Study of Deterioration in Activities of Daily Living in Elderly Patients After Lung Cancer Surgery

Author

Hidefumi Takei, MD, Hideo Kunitoh, MD, Masashi Wakabayashi, MSc, Tomoko Kataoka, DDS, Yuta Sekino, MD, Tomonori Mizutani, MD, Masahiro Tsuboi, MD, Norihiko Ikeda, MD, Hisao Asamura, MD, Morihito Okada, MD, Makoto Takahama, MD, Yasuhisa Ohde, MD, Jiro Okami, MD, Satoshi Shiono, MD, Keijyu Aokage, MD, Shun-ichi Watanabe, MD, H. Fukuda, and T. Shibata

Subjects
Non–small cell, surgery, Elderly patients, Activities of daily living, Quality of life, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Introduction: To determine the rate of deteriorating activities of daily living (ADL) and to investigate predictive factors in elderly patients undergoing surgery for NSCLC. Methods: Patients with NSCLC aged 75 years or older who underwent curative surgical resection were evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence Instrumental ADL (TMIG-IADL) and the Japanese version of EuroQol 5-dimensions 5-level (EQ-5D-5L) quality-of-life scale administered at baseline and at 6 months postoperative. The primary end point was the rate of living patients without substantial deterioration of TMIG-IADL, defined as a decline greater than or equal to three points. Multivariable logistic regression was performed to determine risk factors for deteriorating ADL. Results: Between May 2019 and May 2020, 876 of the 986 screened patients enrolled from 47 institutions were eligible and included in the analysis. TMIG-IADL and EQ-5D-5L scores were obtained from 96.0% and 92.6% of the patients, respectively. At 6 months postoperative, 745 patients (85.1%, 95% confidence interval: 82.5%–87.3%) reported no significant ADL deterioration, and 96 of 841 patients (11.4%) with postoperative score data reported significant deterioration. The social domain was the most frequently affected activity. In multivariable analysis, poor performance status, low G8 geriatric screening score, segmentectomy (versus wedge resection), and surgery lasting less than 3 hours were associated with deteriorating ADL. Worsening EQ-5D-5L scores by minimally important difference or more were observed in 22.1% of the patients. Changes in TMIG-IADL and EQ-5D-5L scores were poorly correlated. Conclusions: Approximately 15% of elderly patients with NSCLC experienced significant ADL deterioration at 6 months postoperative.

Published
2023
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3. Separate evaluation of unilateral lung function using upright/supine CT in a patient with diaphragmatic paralysis

Author

Takahiro Suzuki, MD, Keisuke Asakura, MD, Yoshitake Yamada, MD, Minoru Yamada, PhD, Yoichi Yokoyama, MD, Yu Okubo, MD, Kyohei Masai, MD, Kaoru Kaseda, MD, Tomoyuki Hishida, MD, Hisao Asamura, MD, and Masahiro Jinzaki, MD

Subjects
CT, Diaphragm, Diagnostic Imaging, Lung function, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract

Background: Unilateral diaphragmatic paralysis is a condition in which the unilateral diaphragm is paralyzed and elevated. Orthopnea due to lung compression by an elevated diaphragm in the supine position is common in patients with unilateral diaphragmatic paralysis. Although its symptom is posture-dependent, the effect of posture on lung function in unilateral diaphragmatic paralysis has not been studied. Computed tomography (CT) can be used to assess lung volume. However, conventional CT cannot be performed in the upright position. A pulmonary function test can be performed in both upright and supine positions. However, it cannot evaluate the function of each lung separately. Case presentation: We report a case of a 79-year-old man with unilateral diaphragmatic paralysis. He presented with difficulty in inspiration, specifically in the supine position, and underwent both conventional supine CT and newly developed upright CT to assess the effect of posture on the function of each lung. The difference between expiratory and inspiratory lung volumes on CT in the supine position was less than that in the upright position by 46% and 4% on affected and healthy sides, respectively. We previously reported that the difference between expiratory and inspiratory lung volumes on CT correlated with inspiratory capacity on the pulmonary function test. A 46% decline in inspiratory capacity on the affected side in the supine position likely caused orthopnea in this patient. Conclusions: Supine/upright CT is helpful to assess the influence of posture on unilateral lung function in patients with unilateral diaphragmatic paralysis.

Published
2022
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4. Genotype-phenotype mapping of a patient-derived lung cancer organoid biobank identifies NKX2-1-defined Wnt dependency in lung adenocarcinoma

Author

Toshiki Ebisudani, Junko Hamamoto, Kazuhiro Togasaki, Akifumi Mitsuishi, Kai Sugihara, Taro Shinozaki, Takahiro Fukushima, Kenta Kawasaki, Takashi Seino, Mayumi Oda, Hikaru Hanyu, Kohta Toshimitsu, Katsura Emoto, Yuichiro Hayashi, Keisuke Asakura, Todd A. Johnson, Hideki Terai, Shinnosuke Ikemura, Ichiro Kawada, Makoto Ishii, Tomoyuki Hishida, Hisao Asamura, Kenzo Soejima, Hidewaki Nakagawa, Masayuki Fujii, Koichi Fukunaga, Hiroyuki Yasuda, and Toshiro Sato

Subjects
CP: Stem cell research, CP: Cancer, Biology (General), QH301-705.5
Abstract

Summary: Human lung cancer is a constellation of tumors with various histological and molecular properties. To build a preclinical platform that covers this broad disease spectrum, we obtained lung cancer specimens from multiple sources, including sputum and circulating tumor cells, and generated a living biobank consisting of 43 lines of patient-derived lung cancer organoids. The organoids recapitulated the histological and molecular hallmarks of the original tumors. Phenotypic screening of niche factor dependency revealed that EGFR mutations in lung adenocarcinoma are associated with the independence from Wnt ligands. Gene engineering of alveolar organoids reveals that constitutive activation of EGFR-RAS signaling provides Wnt independence. Loss of the alveolar identity gene NKX2-1 confers Wnt dependency, regardless of EGFR signal mutation. Sensitivity to Wnt-targeting therapy can be stratified by the expression status of NKX2-1. Our results highlight the potential of phenotype-driven organoid screening and engineering for the fabrication of therapeutic strategies to combat cancer.

Published
2023
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5. A phase III study of adjuvant chemotherapy in patients with completely resected, node-negative non–small cell lung cancer (JCOG 0707)Central MessagePerspective

Author

Hideo Kunitoh, MD, Masahiro Tsuboi, MD, Masashi Wakabayashi, MSc, Morihito Okada, MD, Kenji Suzuki, MD, Shun-ichi Watanabe, MD, Hisao Asamura, MD, H. Fukuda, T. Shibata, T. Kazato, T. Mizutani, and J. Eba

Subjects
non–small cell lung cancer, node-negative, adjuvant chemotherapy, tegafur/uracil, tegafur/gimeracil/oteracil, Diseases of the circulatory (Cardiovascular) system, RC666-701, Surgery, RD1-811
Abstract

Objective: To evaluate efficacy of S-1 (tegafur/gimeracil/oteracil), an active novel fluoropyrimidine, as compared to UFT (tegafur/uracil) as a postoperative adjuvant therapy in patients with node-negative non–small cell lung cancer (NSCLC). Methods: Eligible patients had undergone complete resection of p-stage I (T1 with tumor diameter >2 cm or T2-N0M0 by 5th edition Union for International Cancer Control TNM) NSCLC, and were randomized to receive oral UFT 250 mg/m2/day for 2 years (Arm A) or oral S-1 80 mg/m2/day for 2 weeks with a 1-week rest period, for 1 year (Arm B). The primary end point was relapse-free survival (RFS), with 80% power and a one-sided type I error of 0.05. Results: From November 2008 to December 2013, 963 patients were enrolled (Arm A: 482, Arm B: 481). Toxicities (hematologic/nonhematologic) of grade 3 or more were observed in 15.9 (1.5/14.7)% in Arm A, and in 14.9 (3.6/12.1)% in Arm B, respectively. At data cut-off in December 2018, the hazard ratio for RFS was 1.06 (95% confidence interval, 0.82-1.36), showing no superiority of S-1 over UFT. The hazard ratio of overall survival (OS) was 1.10 (95% confidence interval, 0.81-1.50). The 5-year RFS/OS were 79.4%/88.8% in Arm A and 79.5%/89.7% in Arm B, respectively. The original NSCLC accounted for 58%/53%, respectively, of the Arm A/Arm B OS events. Secondary malignancies were observed in 85 (17.8%) and 84 (17.8%) individuals in Arm A and Arm B, respectively. Conclusions: S-1 was not superior to UFT as postoperative adjuvant therapy in node-negative NSCLC. Future investigation should incorporate identification of high-risk populations for recurrence.

Published
2020
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6. Histological and prognostic data on surgically resected early-stage lung adenocarcinoma

Author

Masaya Yotsukura, MD, Hisao Asamura, MD, Shigeki Suzuki, MD, Keisuke Asakura, MD, Yukihiro Yoshida, MD, Kazuo Nakagawa, MD, Hiroyuki Sakurai, MD, Shun-ichi Watanabe, MD, and Noriko Motoi, MD

Subjects
Lung adenocarcinoma, histological subtype, cancer-associated active fibroblast, recurrence, Computer applications to medicine. Medical informatics, R858-859.7, Science (General), Q1-390
Abstract

This article presents supplementary data for the research article by Yotsukura et al. entitled “Prognostic impact of cancer-associated active fibroblasts and invasive architectural patterns on early-stage lung adenocarcinoma” [1], which presented the postoperative prognosis for early-stage lung adenocarcinoma categorized according to histological findings. We included data of 1,032 resected cases of lung adenocarcinoma, which consisted of pathological stage IA invasive cancer and adenocarcinoma in situ resected at National Cancer Center Hospital, Tokyo, Japan, between 2007 and 2012. A pathological review was performed to assess total tumor size, size of invasion, histological subtype, lymphovascular invasion, and presence of cancer-associated active fibroblast (CAF). Tumor recurrence and overall survival were retrospectively recorded. Of the included cases, 166 (16.1%), and 866 (83.9%) were adenocarcinoma in situ and pathological stage IA, respectively. Pathological stage IA adenocarcinoma was further classified based on the histologial subtype and the presence of CAF. This data set may be useful for analyzing the postoperative prognosis of early-stage lung adenocarcinoma, in combination with detailed pathological findings including size of invasion, histological subtype, and presence of CAF.

Published
2020
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8. Contributors

Author

Alex A. Adjei, Mjung-Ju Ahn, Chris I. Amos, Alberto Antonicelli, Hisao Asamura, Todd Atwood, Paul Baas, Joan E. Bailey-Wilson, David Ball, Fabrice Barlesi, Jose G. Bazan, José Belderbos, Andrea Bezjak, Lucinda J. Billingham, Paolo Boffetta, Martina Bonifazi, Julie R. Brahmer, Elisabeth Brambilla, Fraser Brims, Alessandro Brunelli, Ayesha Bryant, Nicholas Campbell, Brett W. Carter, Robert Cerfolio, Byoung Chul Cho, William C.S. Cho, Hak Choy, Chia-Yu Chu, Glenda Colburn, Henri Colt, Rafael Rosell Costa, Gail E. Darling, Mellar Davis, Patricia M. de Groot, Harry J. de Koning, Paul De Leyn, Dirk De Ruysscher, Ayşe Nur Demiral, Jules Derks, Frank C. Detterbeck, Siddhartha Devarakonda, Anne-Marie C. Dingemans, Jessica S. Donington, Carolyn M. Dresler, Steven M. Dubinett, Grace K. Dy, Jeremy J. Erasmus, Alysa Fairchild, Dean A. Fennell, Hiran C. Fernando, Pier Luigi Filosso, Raja Flores, Kwun Fong, Jesme Fox, David R. Gandara, Leena Gandhi, Laurie Gaspar, Stefano Gasparini, Adi F. Gazdar, Giuseppe Giaccone, Nicolas Girard, Peter Goldstraw, Elizabeth M. Gore, Glenwood Goss, Ramaswamy Govindan, Alissa K. Greenberg, Dominique Grunenwald, Matthias Guckenberger, Swati Gulati, Raffit Hassan, Christopher Hazzard, Fiona Hegi, Thomas Hensing, Roy Herbst, Fred R. Hirsch, Nanda Horeweg, David M. Jablons, James R. Jett, Andrew Kaufman, Paul Keall, Karen Kelly, Feng-Ming (Spring) Kong, Kaoru Kubota, Ite A. Laird-Offringa, Primo N. Lara, Janessa Laskin, Quynh-Thu Le, Cécile Le Péchoux, Elvira L. Liclican, Yolande Lievens, Chia-Chi (Josh) Lin, Billy W. Loo, Michael Mac Manus, Homer A. Macapinlac, Fergus Macbeth, William J. Mackillop, Christopher Maher, Isa Mambetsariev, Sumithra J. Mandrekar, Aaron S. Mansfield, Lawrence B. Marks, Céline Mascaux, Pierre P. Massion, Julien Mazieres, Annette McWilliams, Tetsuya Mitsudomi, Tony Mok, Daniel Morgensztern, Francoise Mornex, James L. Mulshine, Reginald F. Munden, Kristiaan Nackaerts, Shinji Nakamichi, Masayuki Noguchi, Krista Noonan, Silvia Novello, Anna K. Nowak, Kenneth J. O’Byrne, Nisha Ohri, Morihito Okada, Jamie S. Ostroff, Mamta Parikh, Elyse R. Park, Keunchil Park, Harvey I. Pass, Nicholas Pastis, Luis Paz-Ares, Nathan Pennell, Maurice Perol, Rathi N. Pillai, Pieter E. Postmus, Suresh S. Ramalingham, Sara Ramella, Ramón Rami-Porta, Martin Reck, Mary W. Redman, Niels Reinmuth, Umberto Ricardi, David Rice, Carole A. Ridge, William N. Rom, Kenneth E. Rosenzweig, Enrico Ruffini, Valerie W. Rusch, Ravi Salgia, Montse Sanchez-Cespedes, Anjali Saqi, Giorgio V. Scagliotti, Selma Schimmel, Ann G. Schwartz, Suresh Senan, Francis A. Shepherd, Jill M. Siegfried, Gerard A. Silvestri, George R. Simon, Egbert F. Smit, Stephen B. Solomon, Laura P. Stabile, Matthew A. Steliga, Thomas E. Stinchcombe, Nicholas S. Stollenwerk, Jong-Mu Sun, Anish Thomas, Ming-Sound Tsao, Jun-Chieh J. Tsay, Paul Van Houtte, Paul E. Van Schil, Nico van Zandwijk, J.F. Vansteenkiste, Marileila Varella-Garcia, Giulia Veronesi, Shalini K. Vinod, Everett E. Vokes, Heather Wakelee, Tonya C. Walser, Shun-ichi Watanabe, Walter Weder, Benjamin Wei, Ignacio I. Wistuba, James Chih-Hsin Yang, David F. Yankelevitz, Kazuhiro Yasufuku, Ken Y. Yoneda, Gérard Zalcman, Caicun Zhou, Yang Zhou, and Daniel Zips

Published
2018
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9. The IASLC Lung Cancer Staging Project: Methodology and Validation Used in the Development of Proposals for Revision of the Stage Classification of NSCLC in the Forthcoming (Eighth) Edition of the TNM Classification of Lung Cancer

Author

Frank C. Detterbeck, Kari Chansky, Patti Groome, Vanessa Bolejack, John Crowley, Lynn Shemanski, Catherine Kennedy, Mark Krasnik, Michael Peake, Ramón Rami-Porta, Peter Goldstraw, Hisao Asamura, David Ball, David G. Beer, Ricardo Beyruti, Frank Detterbeck, Wilfried Ernst Erich Eberhardt, John Edwards, Françoise Galateau-Sallé, Dorothy Giroux, Fergus Gleeson, James Huang, Jhingook Kim, Young Tae Kim, Laura Kingsbury, Haruhiko Kondo, Kaoru Kubota, Antoon Lerut, Gustavo Lyons, Mirella Marino, Edith M. Marom, Jan van Meerbeeck, Alan Mitchell, Takashi Nakano, Andrew G. Nicholson, Anna Nowak, Thomas Rice, Kenneth Rosenzweig, Enrico Ruffini, Valerie Rusch, Nagahiro Saijo, Paul Van Schil, Jean-Paul Sculier, Kelly Stratton, Kenji Suzuki, Yuji Tachimori, Charles F. Thomas, William Travis, Ming S. Tsao, Andrew Turrisi, Johan Vansteenkiste, Hirokazu Watanabe, Yi-Long Wu, Paul Baas, Jeremy Erasmus, Seiki Hasegawa, Kouki Inai, Kemp Kernstine, Hedy Kindler, Lee Krug, Kristiaan Nackaerts, Harvey Pass, David Rice, Conrad Falkson, Pier Luigi Filosso, Giuseppe Giaccone, Kazuya Kondo, Marco Lucchi, Meinoshin Okumura, Eugene Blackstone, F. Abad Cavaco, E. Ansótegui Barrera, J. Abal Arca, I. Parente Lamelas, A. Arnau Obrer, R. Guijarro Jorge, D. Ball, G.K. Bascom, A. I. Blanco Orozco, M. A. González Castro, M.G. Blum, D. Chimondeguy, V. Cvijanovic, S. Defranchi, B. de Olaiz Navarro, I. Escobar Campuzano, I. Macía Vidueira, E. Fernández Araujo, F. Andreo García, K.M. Fong, G. Francisco Corral, S. Cerezo González, J. Freixinet Gilart, L. García Arangüena, S. García Barajas, P. Girard, T. Goksel, M. T. González Budiño, G. González Casaurrán, J. A. Gullón Blanco, J. Hernández Hernández, H. Hernández Rodríguez, J. Herrero Collantes, M. Iglesias Heras, J. M. Izquierdo Elena, E. Jakobsen, S. Kostas, P. León Atance, A. Núñez Ares, M. Liao, M. Losanovscky, G. Lyons, R. Magaroles, L. De Esteban Júlvez, M. Mariñán Gorospe, B. McCaughan, C. Kennedy, R. Melchor Íñiguez, L. Miravet Sorribes, S. Naranjo Gozalo, C. Álvarez de Arriba, M. Núñez Delgado, J. Padilla Alarcón, J. C. Peñalver Cuesta, J.S. Park, M. J. Pavón Fernández, M. Rosenberg, E. Ruffini, V. Rusch, J. Sánchez de Cos Escuín, A. Saura Vinuesa, M. Serra Mitjans, T.E. Strand, D. Subotic, S. Swisher, R. Terra, C. Thomas, K. Tournoy, P. Van Schil, M. Velasquez, Y.L. Wu, K. Yokoi, Ramon Rami-Porta, Dorothy J. Giroux, William D. Travis, Paul van Schil, Marcin Zielinski, Wilfried Eberhardt, Jan van Meeerbeeck, Andrew Nicholson, Kouru Kubota, Alex Bankier, Mary Beth Beasley, Douglas B. Flieder, Jin Mo Goo, Heber MacMahon, David Naidich, Charles A. Powell, Mathias Prokop, Yasushi Yatabe, Douglas A. Arenberg, Jessica S. Donington, Wilbur A. Franklin, Nicolas Girard, Peter J. Mazzone, Valerie W. Rusch, Lynn T. Tanoue, and Eberhardt, Wilfried (Beitragende*r)

Subjects
0301 basic medicine, Pulmonary and Respiratory Medicine, Oncology, Stage classification, medicine.medical_specialty, Lung Neoplasms, Databases, Factual, Medizin, 1102 Cardiovascular Medicine And Haematology, Metastasis, 03 medical and health sciences, 0302 clinical medicine, International database, Internal medicine, medicine, Histologic type, Humans, Oncology & Carcinogenesis, Stage (cooking), Lung cancer, Neoplasm Staging, business.industry, External validation, 1103 Clinical Sciences, medicine.disease, Prognosis, Surgery, 030104 developmental biology, 030220 oncology & carcinogenesis, Lung cancer staging, business
Abstract

Introduction Stage classification provides a consistent language to describe the anatomic extent of disease and is therefore a critical tool in caring for patients. The Staging and Prognostic Factors Committee of the International Association for the Study of Lung Cancer developed proposals for revision of the classification of lung cancer for the eighth edition of the tumor, node, and metastasis (TNM) classification, which takes effect in 2017. Methods An international database of 94,708 patients with lung cancer diagnosed in 1999–2010 was assembled. This article describes the process and statistical methods used to refine the lung cancer stage classification. Results Extensive analysis allowed definition of tumor, node, and metastasis categories and stage groupings that demonstrated consistent discrimination overall and within multiple different patient cohorts (e.g., clinical or pathologic stage, R0 or R-any resection status, geographic region). Additional analyses provided evidence of applicability over time, across a spectrum of geographic regions, histologic types, evaluative approaches, and follow-up intervals. Conclusions An extensive analysis has produced stage classification proposals for lung cancer with a robust degree of discriminatory consistency and general applicability. Nevertheless, external validation is encouraged to identify areas of strength and weakness; a sound validation should have discriminatory ability and be based on an independent data set of adequate size and sufficient follow-up with enough patients for each subgroup.

Published
2016

10. The IASLC Lung Cancer Staging Project: Background Data and Proposed Criteria to Distinguish Separate Primary Lung Cancers from Metastatic Foci in Patients with Two Lung Tumors in the Forthcoming Eighth Edition of the TNM Classification for Lung Cancer

Author

Frank C. Detterbeck, Wilbur A. Franklin, Andrew G. Nicholson, Nicolas Girard, Douglas A. Arenberg, William D. Travis, Peter J. Mazzone, Edith M. Marom, Jessica S. Donington, Lynn T. Tanoue, Valerie W. Rusch, Hisao Asamura, Ramón Rami-Porta, Peter Goldstraw, David Ball, David G. Beer, Ricardo Beyruti, Vanessa Bolejack, Kari Chansky, John Crowley, Frank Detterbeck, Wilfried Ernst Erich Eberhardt, John Edwards, Françoise Galateau-Sallé, Dorothy Giroux, Fergus Gleeson, Patti Groome, James Huang, Catherine Kennedy, Jhingook Kim, Young Tae Kim, Laura Kingsbury, Haruhiko Kondo, Mark Krasnik, Kaoru Kubota, Antoon Lerut, Gustavo Lyons, Mirella Marino, Jan van Meerbeeck, Alan Mitchell, Takashi Nakano, Anna Nowak, Michael Peake, Thomas Rice, Kenneth Rosenzweig, Enrico Ruffini, Valerie Rusch, Nagahiro Saijo, Paul Van Schil, Jean-Paul Sculier, Lynn Shemanski, Kelly Stratton, Kenji Suzuki, Yuji Tachimori, Charles F. Thomas, William Travis, Ming S. Tsao, Andrew Turrisi, Johan Vansteenkiste, Hirokazu Watanabe, Yi-Long Wu, Paul Baas, Jeremy Erasmus, Seiki Hasegawa, Kouki Inai, Kemp Kernstine, Hedy Kindler, Lee Krug, Kristiaan Nackaerts, Harvey Pass, David Rice, Conrad Falkson, Pier Luigi Filosso, Giuseppe Giaccone, Kazuya Kondo, Marco Lucchi, Meinoshin Okumura, Eugene Blackstone, Douglas Flieder, Myrna Godoy, Jin Mo Goo, Lawrence R. Goodman, Jim Jett, Paul de Leyn, Alberto Marchevsky, Heber MacMahon, David Naidich, Morohito Okada, Marina Perlman, Charles Powell, Paul van Schil, Arne Warth, and Nackaerts, Kristiaan

Subjects
0301 basic medicine, Pulmonary and Respiratory Medicine, Oncology, medicine.medical_specialty, Lung Neoplasms, Medizin, Adenocarcinoma, 1102 Cardiovascular Medicine And Haematology, Metastasis, 03 medical and health sciences, 0302 clinical medicine, Meta-Analysis as Topic, Non-small cell lung cancer, Internal medicine, medicine, Humans, Non–small cell lung cancer, IASLC Staging and Prognostic Factors Committee Advisory Boards and the Multiple Pulmonary Sites Workgroup, In patient, Oncology & Carcinogenesis, Lung cancer staging, Lung cancer, Neoplasm Staging, Lung, business.industry, Background data, Cancer, Neoplasms, Second Primary, 1103 Clinical Sciences, medicine.disease, Prognosis, TNM classification, 030104 developmental biology, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Multiple tumors, business, IASLC Staging and Prognostic Factors Committee, Advisory Boards and the Multiple Pulmonary Sites Workgroup
Abstract

Introduction It can be difficult to distinguish between a second primary and a metastasis in patients with lung cancer who have more than one pulmonary site of cancer. Methods A systematic review of the literature was conducted by a subcommittee of the International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee to develop recommendations to identify second primary lung cancers. The process entailed review of knowledge relating to the mechanism of metastasis, determination of clonality, and outcomes of patients with resected tumors. Results It is easier to determine that two tumors are different than that they are the same; finding similarities does not establish that they are the same. For example, most second primary lung cancers are of the same histotype. Few criteria are reliable by themselves; these include different histologic cancer types or matching DNA breakpoints by sequencing and a comprehensive histologic assessment of resected specimens. Characteristics that are suggestive but associated with potential misclassification include the presence or absence of biomarkers, imaging characteristics, and the presence or absence of nodal involvement. Conclusions Clinical and pathologic (i.e., after resection) criteria are presented to identify two foci as separate primary lung cancers versus a metastasis. Few features are definitive; many commonly used characteristics are suggestive but associated with a substantial rate of misclassification. Careful review by a multidisciplinary tumor board, considering all available information, is recommended.

Published
2016

11. The IASLC Lung Cancer Staging Project: Background Data and Proposals for the Classification of Lung Cancer with Separate Tumor Nodules in the Forthcoming Eighth Edition of the TNM Classification for Lung Cancer

Author

Frank C. Detterbeck, Vanessa Bolejack, Douglas A. Arenberg, John Crowley, Jessica S. Donington, Wilbur A. Franklin, Nicolas Girard, Edith M. Marom, Peter J. Mazzone, Andrew G. Nicholson, Valerie W. Rusch, Lynn T. Tanoue, William D. Travis, Hisao Asamura, Ramón Rami-Porta, Peter Goldstraw, David Ball, David G. Beer, Ricardo Beyruti, Kari Chansky, Frank Detterbeck, Wilfried Ernst Erich Eberhardt, John Edwards, Françoise Galateau-Sallé, Dorothy Giroux, Fergus Gleeson, Patti Groome, James Huang, Catherine Kennedy, Jhingook Kim, Young Tae Kim, Laura Kingsbury, Haruhiko Kondo, Mark Krasnik, Kaoru Kubota, Antoon Lerut, Gustavo Lyons, Mirella Marino, Jan van Meerbeeck, Alan Mitchell, Takashi Nakano, Anna Nowak, Michael Peake, Thomas Rice, Kenneth Rosenzweig, Enrico Ruffini, Valerie Rusch, Nagahiro Saijo, Paul Van Schil, Jean-Paul Sculier, Lynn Shemanski, Kelly Stratton, Kenji Suzuki, Yuji Tachimori, Charles F. Thomas, William Travis, Ming S. Tsao, Andrew Turrisi, Johan Vansteenkiste, Hirokazu Watanabe, Yi-Long Wu, Paul Baas, Jeremy Erasmus, Seiki Hasegawa, Kouki Inai, Kemp Kernstine, Hedy Kindler, Lee Krug, Kristiaan Nackaerts, Harvey Pass, David Rice, Conrad Falkson, Pier Luigi Filosso, Giuseppe Giaccone, Kazuya Kondo, Marco Lucchi, Meinoshin Okumura, Eugene Blackstone, Douglas Flieder, Myrna Godoy, Jin Mo Goo, Lawrence R. Goodman, Jim Jett, Paul de Leyn, Alberto Marchevsky, Heber MacMahon, David Naidich, Morohito Okada, Marina Perlman, Charles Powell, Paul van Schil, Arne Warth, F. Abad Cavaco, E. Ansótegui Barrera, J. Abal Arca, I. Parente Lamelas, A. Arnau Obrer, R. Guijarro Jorge, D. Ball, G.K. Bascom, A.I. Blanco Orozco, M.A. González Castro, M.G. Blum, D. Chimondeguy, V. Cvijanovic, S. Defranchi, B. de Olaiz Navarro, I. Escobar Campuzano, I. Macía Vidueira, E. Fernández Araujo, F. Andreo García, K.M. Fong, G. Francisco Corral, S. Cerezo González, J. Freixinet Gilart, L. García Arangüena, S. García Barajas, P. Girard, T. Goksel, M.T. González Budiño, G. González Casaurrán, J.A. Gullón Blanco, J. Hernández Hernández, H. Hernández Rodríguez, J. Herrero Collantes, M. Iglesias Heras, J.M. Izquierdo Elena, E. Jakobsen, S. Kostas, P. León Atance, A. Núñez Ares, M. Liao, M. Losanovscky, G. Lyons, R. Magaroles, L. De Esteban Júlvez, M. Mariñán Gorospe, B. McCaughan, C. Kennedy, R. Melchor Íñiguez, L. Miravet Sorribes, S. Naranjo Gozalo, C. Álvarez de Arriba, M. Núñez Delgado, J. Padilla Alarcón, J.C. Peñalver Cuesta, J.S. Park, H. Pass, M.J. Pavón Fernández, M. Rosenberg, E. Ruffini, V. Rusch, J. Sánchez de Cos Escuín, A. Saura Vinuesa, M. Serra Mitjans, T.E. Strand, D. Subotic, S. Swisher, R. Terra, C. Thomas, K. Tournoy, P. Van Schil, M. Velasquez, Y.L. Wu, and K. Yokoi

Subjects
Pulmonary and Respiratory Medicine, Pathology, medicine.medical_specialty, Lung Neoplasms, Medizin, Adenocarcinoma, 1102 Cardiovascular Medicine And Haematology, Lung cancer, Lung cancer staging, Multiple tumors, Non-small cell lung cancer, TNM classification, Oncology, 03 medical and health sciences, 0302 clinical medicine, Meta-Analysis as Topic, medicine, Humans, Non–small cell lung cancer, Oncology & Carcinogenesis, Survival rate, Neoplasm Staging, business.industry, Background data, Nodule (medicine), Neoplasms, Second Primary, 1103 Clinical Sciences, Second primary cancer, medicine.disease, Prognosis, Survival Rate, 030228 respiratory system, 030220 oncology & carcinogenesis, IASLC Staging and Prognostic Factors Committee, Advisory Boards, Multiple Pulmonary Sites Workgroup and Participating Institutions, IASLC Staging and Prognostic Factors Committee Advisory Boards Multiple Pulmonary Sites Workgroup and Participating Institutions, Neoplasm staging, medicine.symptom, business
Abstract

Introduction Separate tumor nodules with the same histologic appearance occur in the lungs in a small proportion of patients with primary lung cancer. This article addresses how such tumors can be classified to inform the eighth edition of the anatomic classification of lung cancer. Separate tumor nodules should be distinguished from second primary lung cancer, multifocal ground glass/lepidic tumors, and pneumonic-type lung cancer, which are addressed in separate analyses. Methods Survival of patients with separate tumor nodules in the International Association for the Study of Lung Cancer database were analyzed. This was compared with a systematic literature review. Results Survival of clinically staged patients decreased according to the location of the separate tumor nodule relative to the index tumor (same lobe > same side > other side) in N0 and N-any cohorts (all M0 except possible other-side nodules). However, there was also a decrease in the proportion of patients resected; among only surgically resected or among nonresected patients no survival differences were noted. There were no survival differences between patients with same-lobe nodules and those with other T3 tumors, between patients with same-side nodules and those with T4 tumors, and patients with other-side nodules and those with other M1a tumors. The data correlated with those identified in a literature review. Conclusions Tumors with same-lobe separate tumor nodules (with the same histologic appearance) are recommended to be classified as T3, same-side nodules as T4, and other-side nodules as M1a. Thus, there is no recommended change between the seventh and eighth edition of the TNM classification of lung cancer.

Published
2015

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