301 results found
Huang J, Osarogiagbon RU, Giroux DJ, et al., 2023, The IASLC Lung Cancer Staging Project: Proposals for the Revision of the N Descriptors in the Forthcoming 9th Edition of the TNM Classification for Lung Cancer., J Thorac Oncol
INTRODUCTION: The accurate assessment of nodal (N) status is crucial to the management and prognostication of non-metastatic non-small cell lung cancer. We sought to determine whether the current N descriptors should be maintained or revised for the upcoming 9th edition of the international Tumor Node Metastasis (TNM) lung cancer staging system. METHODS: Data was assembled by the International Association for the Study of Lung Cancer on patients with non-small cell lung cancer, detailing both clinical and pathologic N status, with information about anatomic location and individual station-level identification. Survival was calculated by the Kaplan-Meier method and prognostic groups were assessed by a Cox regression analysis. RESULTS: Data for clinical N and pathologic N status were available in 45,032 and 35,009 patients, respectively. The current N0 to N3 descriptors for both clinical N and pathologic N categories demonstrated prognostically distinct groups. Furthermore, single station N2 involvement (N2a) demonstrated better prognosis than multistation N2 involvement (N2b) in both clinical and pathologic classifications, and the differences between all neighboring nodal subcategories were highly significant. The prognostic differences between N2a and N2b were robust and consistent across resection status, histologic type, T category, and geographic region. CONCLUSIONS: The current N descriptors should be maintained, with the addition of new sub-descriptors to N2 for single station involvement (N2a) and multiple station involvement (N2b).
Cardillo G, Petersen RH, Ricciardi S, et al., 2023, European guidelines for the surgical management of pure ground-glass opacities and part-solid nodules: Task Force of the European Association of Cardio-Thoracic Surgery and the European Society of Thoracic Surgeons., Eur J Cardiothorac Surg, Vol: 64
Roberts ME, Rahman NM, Maskell NA, et al., 2023, British Thoracic Society Guideline for pleural disease, THORAX, ISSN: 0040-6376
Khader AA, Pons A, Palmares A, et al., 2023, Outcomes of chest drain management using only air leak (without fluid) criteria for removal after general thoracic surgery-a drainology study, JOURNAL OF THORACIC DISEASE, Vol: 15, Pages: 3776-+, ISSN: 2072-1439
Roberts ME, Rahman NM, Maskell NA, et al., 2023, British Thoracic Society Guideline for pleural disease, THORAX, Vol: 78, Pages: s1-s42, ISSN: 0040-6376
Donington JS, Gitlitz B, Lim E, et al., 2023, Integration of New Systemic Adjuvant Therapies for Non-small Cell Lung Cancer: Role of the Surgeon, ANNALS OF THORACIC SURGERY, Vol: 115, Pages: 1544-1555, ISSN: 0003-4975
Im S-A, Gennari A, Park YH, et al., 2023, Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, staging and treatment of patients with metastatic breast cancer., ESMO Open, Vol: 8
The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, staging and treatment of patients with metastatic breast cancer (MBC) was published in 2021. A special, hybrid guidelines meeting was convened by ESMO and the Korean Society of Medical Oncology (KSMO) in collaboration with nine other Asian national oncology societies in May 2022 in order to adapt the ESMO 2021 guidelines to take into account the differences associated with the treatment of MBC in Asia. These guidelines represent the consensus opinions reached by a panel of Asian experts in the treatment of patients with MBC representing the oncological societies of China (CSCO), India (ISMPO), Indonesia (ISHMO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), the Philippines (PSMO), Singapore (SSO), Taiwan (TOS) and Thailand (TSCO). The voting was based on the best available scientific evidence and was independent of drug access or practice restrictions in the different Asian countries. The latter were discussed when appropriate. The aim of these guidelines is to provide guidance for the harmonisation of the management of patients with MBC across the different regions of Asia, drawing from data provided by global and Asian trials whilst at the same time integrating the differences in genetics, demographics and scientific evidence, together with restricted access to certain therapeutic strategies.
Ng K, Boumelha J, Enfield KSS, et al., 2023, Antibodies against endogenous retroviruses promote lung cancer immunotherapy, NATURE, Vol: 616, Pages: 563-+, ISSN: 0028-0836
Frankell AM, Dietzen M, Al Bakir M, et al., 2023, The evolution of lung cancer and impact of subclonal selection in TRACERx, NATURE, Vol: 616, Pages: 525-+, ISSN: 0028-0836
Abbosh C, Frankell AM, Harrison T, et al., 2023, Tracking early lung cancer metastatic dissemination in TRACERx using ctDNA, Nature, Vol: 616, Pages: 553-562, ISSN: 0028-0836
Circulating tumour DNA (ctDNA) can be used to detect and profile residual tumour cells persisting after curative intent therapy1. The study of large patient cohorts incorporating longitudinal plasma sampling and extended follow-up is required to determine the role of ctDNA as a phylogenetic biomarker of relapse in early-stage non-small-cell lung cancer (NSCLC). Here we developed ctDNA methods tracking a median of 200 mutations identified in resected NSCLC tissue across 1,069 plasma samples collected from 197 patients enrolled in the TRACERx study2. A lack of preoperative ctDNA detection distinguished biologically indolent lung adenocarcinoma with good clinical outcome. Postoperative plasma analyses were interpreted within the context of standard-of-care radiological surveillance and administration of cytotoxic adjuvant therapy. Landmark analyses of plasma samples collected within 120 days after surgery revealed ctDNA detection in 25% of patients, including 49% of all patients who experienced clinical relapse; 3 to 6 monthly ctDNA surveillance identified impending disease relapse in an additional 20% of landmark-negative patients. We developed a bioinformatic tool (ECLIPSE) for non-invasive tracking of subclonal architecture at low ctDNA levels. ECLIPSE identified patients with polyclonal metastatic dissemination, which was associated with a poor clinical outcome. By measuring subclone cancer cell fractions in preoperative plasma, we found that subclones seeding future metastases were significantly more expanded compared with non-metastatic subclones. Our findings will support (neo)adjuvant trial advances and provide insights into the process of metastatic dissemination using low-ctDNA-level liquid biopsy.
A complete understanding of how exposure to environmental substances promotes cancer formation is lacking. More than 70 years ago, tumorigenesis was proposed to occur in a two-step process: an initiating step that induces mutations in healthy cells, followed by a promoter step that triggers cancer development1. Here we propose that environmental particulate matter measuring ≤2.5 μm (PM2.5), known to be associated with lung cancer risk, promotes lung cancer by acting on cells that harbour pre-existing oncogenic mutations in healthy lung tissue. Focusing on EGFR-driven lung cancer, which is more common in never-smokers or light smokers, we found a significant association between PM2.5 levels and the incidence of lung cancer for 32,957 EGFR-driven lung cancer cases in four within-country cohorts. Functional mouse models revealed that air pollutants cause an influx of macrophages into the lung and release of interleukin-1β. This process results in a progenitor-like cell state within EGFR mutant lung alveolar type II epithelial cells that fuels tumorigenesis. Ultradeep mutational profiling of histologically normal lung tissue from 295 individuals across 3 clinical cohorts revealed oncogenic EGFR and KRAS driver mutations in 18% and 53% of healthy tissue samples, respectively. These findings collectively support a tumour-promoting role for PM2.5 air pollutants and provide impetus for public health policy initiatives to address air pollution to reduce disease burden.
Zhang YZ, Sherlock S, MacMahon S, et al., 2023, Prediction of next generation sequencing test failure in lung adenocarcinoma in a genomic laboratory hub setting, Publisher: ELSEVIER IRELAND LTD, Pages: S1-S2, ISSN: 0169-5002
Osarogiagbon RU, Van Schil P, Giroux DJ, et al., 2023, The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Overview of Challenges and Opportunities in Revising the Nodal Classification of Lung Cancer, JOURNAL OF THORACIC ONCOLOGY, Vol: 18, Pages: 410-418, ISSN: 1556-0864
Lim E, Harris RA, McKeon HE, et al., 2022, Impact of video-assisted thoracoscopic lobectomy versus open lobectomy for lung cancer on recovery assessed using self-reported physical function: VIOLET RCT, HEALTH TECHNOLOGY ASSESSMENT, Vol: 26, ISSN: 1366-5278
Hayes AR, Luong TV, Banks J, et al., 2022, Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH): Prevalence, clinicopathological characteristics and survival outcome in a cohort of 311 patients with well-differentiated lung neuroendocrine tumours., J Neuroendocrinol, Vol: 34
INTRODUCTION: Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is considered to be a rare condition associated with lung neuroendocrine tumours (NET), and its natural history is poorly described. We aimed to assess the prevalence and clinicopathologic characteristics of DIPNECH in the lung NET population, and to investigate predictors of time-to-progression (TTP) and overall survival (OS). METHODS: We retrospectively identified patients diagnosed with DIPNECH between April 2005 and December 2020. Clinical data were collected from medical records. The relationship between baseline characteristics and TTP and OS was analysed using the Kaplan-Meier method. Univariate analysis was performed using the Cox proportional hazards model. RESULTS: Of 311 patients with well-differentiated lung NETs, 61 (20%) had DIPNECH and were included in the study. Baseline demographics described 95% female, 59% never smokers and mean body mass index 34.4 kg m-2 ; 77% were typical carcinoids (TC), 13% atypical carcinoids (AC), and 10% both TC and AC (multicentric). At presentation, 54% of patients were asymptomatic. Multicentric NETs were demonstrated in 16 (26%) on histopathology, and a further 32 (52%) had synchronous NETs suggested on imaging (multiple nodules ≥ 5 mm). Seven (11%) patients developed metastases and the median OS from time of first metastasis was 37 months. AC histopathology and NET TNM stage ≥ IIA were associated with poorer TTP and OS. Of the DIPNECH cohort, the 15-year survival rate was 86%. CONCLUSIONS: DIPNECH may be more prevalent in the lung NET population than previously appreciated, especially in women. Although our results confirm that DIPNECH is predominantly an indolent disease associated with TC, 23% developed AC and these patients may warrant closer observation.
Pons A, De Sousa P, Proli C, et al., 2022, Impact of Society and National Guidelines on Patient Selection for Lung Cancer Surgery in the UK from 2008 to 2013, Publisher: ELSEVIER SCIENCE INC, Pages: S214-S215, ISSN: 1556-0864
Ashraf MA, AlShammari A, De Sousa P, et al., 2022, Incidence and Resource Burden for the Management of CT Detected Ground Glass Opacities at a Tertiary Lung Cancer Service in the UK, Publisher: ELSEVIER SCIENCE INC, Pages: S196-S197, ISSN: 1556-0864
Zhang YZ, Sherlock S, Brambilla C, et al., 2022, Adenocarcinoma Grade Correlates with PD-L1 and TP53, but not EGFR/KRAS Status and Diagnostic Yield: Analysis of 346 Cases, Publisher: ELSEVIER SCIENCE INC, Pages: S516-S517, ISSN: 1556-0864
Zhang YZ, Nicholson AG, Ly F, et al., 2022, Prediction of Clinically Significant Pathological Upstaging in Resected Lung Cancer: Insight from COVID-19 Pandemic (1st wave), Publisher: ELSEVIER SCIENCE INC, Pages: S112-S114, ISSN: 1556-0864
Pons A, De Sousa P, Proli C, et al., 2022, Impact of society and national guidelines on patient selection for lung cancer surgery in the United Kingdom, EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, Vol: 62, ISSN: 1010-7940
Lim E, Baste J-M, Shackcloth M, 2022, Clinical outcomes of pre-attached reinforced stapler reloads in thoracic surgery: a prospective case series, JOURNAL OF THORACIC DISEASE, ISSN: 2072-1439
Ruffini E, Rami-Porta R, Huang J, et al., 2022, The International Association for the Study of Lung Cancer Thymic Epithelial Tumor Staging Project: Unresolved Issues to be Addressed for the Next Ninth Edition of the TNM Classification of Malignant Tumors, JOURNAL OF THORACIC ONCOLOGY, Vol: 17, Pages: 838-851, ISSN: 1556-0864
Nastase A, Mandal A, Lu SK, et al., 2022, Integrated genomics point to immune vulnerabilities in pleural mesothelioma (vol 11, 19138, 2021), SCIENTIFIC REPORTS, Vol: 12, ISSN: 2045-2322
Sherlock S, Zhang YZ, Ly F, et al., 2022, Reducing fixation time significantly reduces failure rates: an audit of failure rates and turn-around times on next generation sequencing (NGS) of non-small lung carcinomas, Publisher: ELSEVIER IRELAND LTD, Pages: S1-S1, ISSN: 0169-5002
Pons A, Lim E, 2022, Thoracic surgery in the UK, Journal of Thoracic Disease, Vol: 14, Pages: 575-578, ISSN: 2072-1439
Kanesvaran R, Porta C, Wong A, et al., 2021, Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with renal cell carcinoma., ESMO Open, Vol: 6
The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of renal cell carcinoma was published in 2019 with an update planned for 2021. It was therefore decided by both the ESMO and the Singapore Society of Oncology (SSO) to convene a special, virtual guidelines meeting in May 2021 to adapt the ESMO 2019 guidelines to take into account the ethnic differences associated with the treatment of renal cell carcinomas in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with renal cell carcinoma representing the oncological societies of China (CSCO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence and was independent of the current treatment practices and drug access restrictions in the different Asian countries. The latter were discussed when appropriate.
Baudin E, Caplin M, Garcia-Carbonero R, et al., 2021, Lung and thymic carcinoids: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up (vol 32, pg 439, 2021), ANNALS OF ONCOLOGY, Vol: 32, Pages: 1453-1455, ISSN: 0923-7534
Fraser S, Baranowski R, Patrini D, et al., 2021, Maintaining safe lung cancer surgery during the COVID-19 pandemic in a global city, EClinicalMedicine, Vol: 39, Pages: 1-8, ISSN: 2589-5370
Background: SARS-CoV-2 has challenged health service provision worldwide. This work evaluates safe surgical pathways and standard operating procedures implemented in the high volume, global city of London during the first wave of SARS-CoV-2 infection. We also assess the safety of minimally invasive surgery(MIS) for anatomical lung resection. Methods: This multicentre cohort study was conducted across all London thoracic surgical units, covering a catchment area of approximately 14.8 Million. A Pan-London Collaborative was created for data sharing and dissemination of protocols. All patients undergoing anatomical lung resection 1st March-1st June 2020 were included. Primary outcomes were SARS-CoV-2 infection, access to minimally invasive surgery, post-operative complication, length of intensive care and hospital stay (LOS), and death during follow up. Findings: 352 patients underwent anatomical lung resection with a median age of 69 (IQR: 35-86) years. Self-isolation and pre-operative screening were implemented following the UK national lockdown. Pre-operative SARS-CoV-2 swabs were performed in 63.1% and CT imaging in 54.8%. 61.7% of cases were performed minimally invasively (MIS), compared to 59.9% pre pandemic. Median LOS was 6 days with a 30-day survival of 98.3% (comparable to a median LOS of 6 days and 30-day survival of 98.4% pre-pandemic). Significant complications developed in 7.3% of patients (Clavien-Dindo Grade 3-4) and 12 there were re-admissions(3.4%). Seven patients(2.0%) were diagnosed with SARS-CoV-2 infection, two of whom died (28.5%). Interpretation: SARS-CoV-2 infection significantly increases morbidity and mortality in patients undergoing elective anatomical pulmonary resection. However, surgery can be safely undertaken via open and MIS approaches at the peak of a viral pandemic if precautionary measures are implemented. High volume surgery should continue during further viral peaks to minimise health service burden and potential harm to cancer pa
Loizidou A, Lim E, 2021, Is Small Cell Lung Cancer a Surgical Disease at the Present Time?, THORACIC SURGERY CLINICS, Vol: 31, Pages: 317-321, ISSN: 1547-4127
Domingo-Sabugo C, Willis-Owen SAG, Mandal A, et al., 2021, Distinct pancreatic and neuronal Lung Carcinoid molecular subtypes revealed by integrative omic analysis
<jats:title>Summary</jats:title><jats:p>Lung Carcinoids (L-CDs) are uncommon low-grade neuroendocrine tumours that are only recently becoming characterised at the molecular level. Notably data on the molecular events that precipitate altered gene expression programmes are very limited. Here we have identified two discrete L-CD subtypes from transcriptomic and whole-genome DNA methylation data, and comprehensively defined their molecular profiles using Whole-Exome Sequencing (WES) and Single Nucleotide Polymorphism (SNP) genotyping. Subtype (Group) 1 features upregulation of neuronal markers (L-CD-NeU) and is characterised by focal spindle cell morphology, peripheral location (71%), high mutational load (<jats:italic>P</jats:italic>=3.4×10<jats:sup>−4</jats:sup>), recurrent copy number alterations and is enriched for Atypical Lung Carcinoids. Group 2 (L-CD-PanC) are centrally located and feature upregulation of pancreatic and metabolic pathway genes concordant with promoter hypomethylation of beta cell and genes related to insulin secretion (<jats:italic>P</jats:italic><1×10<jats:sup>−6</jats:sup>). L-CD-NeU tumours harbour mutations in chromatin remodelling and in SWI/SNF complex members, while L-CD-PanC tumours show aflatoxin mutational signatures and significant DNA methylation loss genome-wide, particularly enriched in repetitive elements (<jats:italic>P</jats:italic><2.2 × 10<jats:sup>−16</jats:sup>). Our findings provide novel insights into the distinct mechanisms of epigenetic dysregulation in these lung malignancies, potentially opening new avenues for biomarker selection and treatment in L-CD patients.</jats:p>
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