Publications
302 results found
De Sousa P, Mansour F, Barbosa M, et al., 2019, An audit on IASLC compliance of lymph nodes dissection and impact on survival after surgery for non-small cell lung cancer, Publisher: ELSEVIER IRELAND LTD, Pages: S66-S66, ISSN: 0169-5002
Asemota N, Rouhani MJ, Harling L, et al., 2018, Minimally invasive bilateral lung resections and CABG through 5 ports, Case Reports in Surgery, Vol: 2018, Pages: 1-3, ISSN: 2090-6900
Minimal access surgery is increasingly popular to reduce postoperative morbidity and enhance recovery. We present a case of a patient who underwent bilateral minimally invasive thoracic and cardiac surgery. An 81-year-old woman was diagnosed with T1aN0M0 left upper lobe small-cell lung cancer and underwent single-port left video-assisted thoracoscopic surgery (VATS) upper lobectomy in 2016. She developed a contralateral right lower lobe nodule and underwent a single-port right VATS wedge resection of the lower lobe nodule, subsequently confirmed as necrotising granulomatous inflammation with acid-fast bacilli, consistent with previous tuberculosis (TB) infection. On postoperative day 1, she had an episode of self-reverting ventricular tachycardia and bradycardia. Subsequent myocardial perfusion scan and coronary angiogram showed significant LV dysfunction and severe coronary artery disease with a left main stem (LMS) lesion. After agreement at MDT, an Endo-ACAB (endoscopic atraumatic coronary artery bypass grafting) was performed, via 3 ports, with the left internal mammary artery anastomosed to left anterior descending artery. She recovered well postoperatively and was discharged. Multiple sequential minimally invasive procedures are now routine and can be performed safely in patients with a complex combination of pathologies. In this case, bilateral single-port (anatomic and nonanatomic) lung resections were undertaken followed by coronary revascularisation with a total of 5 minimal access ports.
Gilham C, Rake C, Hodgson J, et al., 2018, Past and current asbestos exposure and future mesothelioma risks in Britain: The Inhaled Particles Study (TIPS), International Journal of Epidemiology, Vol: 47, Pages: 1745-1756, ISSN: 0300-5771
BackgroundOccupational and environmental airborne asbestos concentrations are too low and variable for lifetime exposures to be estimated reliably, and building workers and occupants may suffer higher exposure when asbestos in older buildings is disturbed or removed. Mesothelioma risks from current asbestos exposures are therefore not known.MethodsWe interviewed and measured asbestos levels in lung samples from 257 patients treated for pneumothorax and 262 with resected lung cancer, recruited in England and Wales. Average lung burdens in British birth cohorts from 1940 to 1992 were estimated for asbestos-exposed workers and the general population.ResultsRegression analysis of British mesothelioma death rates and average lung burdens in birth cohorts born before 1965 suggests a lifetime mesothelioma risk of approximately 0.01% per fibre/mg of amphiboles in the lung. In those born since 1965, the average lung burden is ∼1 fibre/mg among those with no occupational exposure.ConclusionsThe average lifetime mesothelioma risk caused by recent environmental asbestos exposure in Britain will be about 1 in 10 000. The risk is an order of magnitude higher in a subgroup of exposed workers and probably in occupants in the most contaminated buildings. Further data are needed to discover whether asbestos still present in buildings, particularly schools, is a persistent or decreasing hazard to workers who disturb it and to the general population, and whether environmental exposure occurs predominantly in childhood or after beginning work. Similar studies are needed in other countries to estimate continuing environmental and occupational mesothelioma hazards worldwide, including the contribution from chrysotile.
Chang W, Zhang YZ, Lim E, et al., 2018, Developing a Pathological Grading System in Predicting Prognosis for Invasive Mucinous Adenocarcinomas, Publisher: ELSEVIER SCIENCE INC, Pages: S387-S387, ISSN: 1556-0864
Chang W, Zhang YZ, Lim E, et al., 2018, Invasive Size (Not Total Size) Predicts Overall Survival in Invasive Mucinous Adenocarcinomas, Publisher: ELSEVIER SCIENCE INC, Pages: S559-S560, ISSN: 1556-0864
Cao C, Frick AE, Ilonen I, et al., 2018, European questionnaire on the clinical use of video-assisted thoracoscopic surgery., Interact Cardiovasc Thorac Surg, Vol: 27, Pages: 379-383
OBJECTIVES: Video-assisted thoracoscopic surgery (VATS) has emerged as a safe and efficacious alternative approach to conventional thoracotomy for selected patients with non-small-cell lung cancer. The aim of the present study was to assess the current clinical practice of VATS among the European Society of Thoracic Surgeons (ESTS) members. METHODS: A standardized questionnaire was sent to thoracic surgeons on the ESTS mailing list, with collection of data on demographics, use of multiportal or uniportal VATS, institutional experience with VATS procedures and proportion of operations performed by different approaches. Analysis was performed using SPSS statistical software. RESULTS: Complete questionnaire results were collected from 100 unique institutions in 31 countries, representing data on the clinical practice of 461 board-certified thoracic surgeons. Three hundred and twenty-four of the 461 (70%) surgeons claimed to perform anatomical VATS resections, with a total estimated caseload of 9519 resections per year. Two hundred and thirty-one (50%) surgeons reported to have performed lobectomies primarily through the VATS approach. The case volume was significantly correlated to the number (P = 0.019) and proportion (P = 0.001) of surgeons who performed VATS anatomical resections. Overall, 47% of the centres performing anatomical VATS resections reported some use of uniportal approach. There was no association between the number of thoracic surgeons within an institution and the likelihood of performing uniportal VATS lobectomy. CONCLUSIONS: Compared to previous surveys, results of the present European study suggested that there is a strong trend favouring VATS for a range of thoracic procedures in the current clinical setting. However, the use of uniportal VATS is still not yet widespread. The evolving adoption of VATS in Europe should be further assessed with regard to clinical outcomes in the form of large standardized registries.
Giroux DJ, Van Schil P, Asamura H, et al., 2018, The IASLC Lung Cancer Staging Project: A Renewed Call to Participation, JOURNAL OF THORACIC ONCOLOGY, Vol: 13, Pages: 801-809, ISSN: 1556-0864
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- Citations: 36
Proli C, De Sousa P, Jordan S, et al., 2018, A diagnostic cohort study on the accuracy of 18-fluorodeoxyglucose (18FDG) positron emission tomography (PET)-CT for evaluation of malignancy in anterior mediastinal lesions: the DECiMaL study., BMJ Open, Vol: 8, ISSN: 2044-6055
OBJECTIVES: The aim of this study is to collate multi-institutional data to determine the value by defining the diagnostic performance of fluorodeoxyglucose positron emission tomography (FDG PET)/CT for malignancy in patients undergoing surgery with an anterior mediastinal mass in order to ascertain the clinical utility of PET/CT to differentiate malignant from benign aetiologies in patients presenting with an anterior mediastinal mass SETTING: DECiMaL Study is a multicentre, retrospective, collaborative cohort study in seven UK surgical sites. PARTICIPANTS: Between January 2002 and June 2015, a total of 134 patients were submitted with a mean age (SD) of 55 years (16) of which 69 (51%) were men. We included all patients undergoing surgery who presented with an anterior mediastinal mass and underwent PET/CT. PET/CT was considered positive for any reported avidity as stated in the official report and the reference was the resected specimen reported by histopathology using WHO criteria. PRIMARY AND SECONDARY OUTCOME MEASURES: Sensitivity, specificity, positive and negative predicted values of [18F]-FDG PET in determining malignant aetiology for an anterior mediastinal mass. RESULTS: The sensitivity and specificity of PET/CT to correctly classify malignant disease were 83% (95% CI 74 to 89) and 58% (95% CI 37 to 78). The positive and negative predictive values were 90% (95% CI 83% to 95%) and 42% (95% CI 26% to 61%). CONCLUSIONS: The results of our study suggest reasonable sensitivity but no specificity implying that a negative PET/CT is useful to rule out the diagnosis of malignant disease whereas a positive result has no value in the discrimination between malignant and benign diseases of the anterior mediastinum.
Huang Q, Zhang H, Hai J, et al., 2018, Impact of PD-L1 expression, driver mutations and clinical characteristics on survival after anti-PD-1/PD-L1 immunotherapy versus chemotherapy in non-small-cell lung cancer: A meta-analysis of randomized trials, OncoImmunology, ISSN: 2162-4011
© 2018 Taylor & Francis Group, LLC Purpose: To investigate the impact of programmed death-ligand 1 (PD-L1) expression, oncogenic mutations, and clinical characteristics on survival after treatment with anti-PD-1/PD-L1 antibodies versus chemotherapy in non-small cell lung cancer (NSCLC). Patients and Methods: This meta-analysis included randomized trials comparing anti-PD-1/PD-L1 antibodies with chemotherapy. Hazard ratios (HRs) and 95% confidence interval (CI) for overall survival (OS) for the trial population and prespecified subgroups were extracted. We calculated pooled estimates of treatment efficacy using the fixed-effects or random-effects model when appropriate. All statistical tests were two sided. Results: Seven trials involving 3871 patients were included. The pooled results showed that anti-PD-1/PD-L1 immunotherapy significantly prolonged OS (HR: 0.73; 95% CI, 0.63 to 0.84) and PFS (HR: 0.84; 95% CI, 0.71 to 0.99) compared to chemotherapy. OS benefit from immunotherapy were observed in all PD-L1 expression subgroups (negative: HR, 0.79; 95% CI, 0.67 to 0.93; weak-positive: HR, 0.80; 95% CI, 0.67 to 0.95; strong-positive: HR, 0.61; 95% CI, 0.47 to 0.78). Strong-positive PD-L1 expression showed a trend towards more benefit compared to weak-positive PD-L1 expression (interaction P = 0.08). KRAS mutant (HR: 0.60; 95% CI, 0.39 to 0.93), EGFR wild-type (HR: 0.73; 95% CI, 0.61 to 0.87) and smoker (HR: 0.70; 95% CI, 0.60 to 0.83) subgroups achieved significant OS benefit from immunotherapy compared to corresponding subgroups. Survival benefit to immunotherapy was not significantly associated with histology, CNS metastases, age, gender and performance status. Conclusion: This study confirmed that treatment with anti-PD-1/PD-L1 improves overall survival compared with chemotherapy. Benefit was seen, regardless of PD-L1 expression levels; however, PD-L1 strong-positive patients trended to have greatest benefit. Patients with a KRAS mutant or EGFR wild-type
Lim E, 2018, How much can you "enhance'' recovery after lung resection?, JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, Vol: 155, Pages: 1853-1854, ISSN: 0022-5223
Laggner U, Adefila-Ideozu T, Lim E, et al., 2018, Limiting ROS-1 immunohistochemistry to a population of patients either aged 55 years or younger, or never smokers of any age, as a method for cost-efficient screening ROS-1 gene rearrangements, 107th Annual Meeting of the United-States-and-Canadian-Academy-of-Pathology (USCAP), Publisher: NATURE PUBLISHING GROUP, Pages: 737-737, ISSN: 0893-3952
Laggner U, Adefila-Ideozu T, Lim E, et al., 2018, Limiting ROS-1 immunohistochemistry to a population of patients either aged 55 years or younger, or never smokers of any age, as a method for cost-efficient screening ROS-1 gene rearrangements, 107th Annual Meeting of the United-States-and-Canadian-Academy-of-Pathology (USCAP), Publisher: NATURE PUBLISHING GROUP, Pages: 737-737, ISSN: 0023-6837
Nastase A, Gennatas S, Mandal A, et al., 2018, Targeted next-generation sequencing of malignant pleural mesothelioma identifies recurrent NRAS oncogene mutations, 16th Annual British Thoracic Oncology Group Conference 2018, Publisher: ELSEVIER IRELAND LTD, Pages: S26-S26, ISSN: 0169-5002
Mandal A, Gennatas S, Liu K, et al., 2018, Copy number variations in malignant pleural mesothelioma reveal novel regions of genomic imbalances, Publisher: ELSEVIER IRELAND LTD, Pages: S27-S27, ISSN: 0169-5002
McGranahan N, Rosenthal R, Hiley CT, et al., 2017, Allele-specific HLA loss and immune escape in lung cancer evolution, Cell, Vol: 171, Pages: 1259-1270, ISSN: 0092-8674
Immune evasion is a hallmark of cancer. Losing the ability to present neoantigens through human leukocyte antigen (HLA) loss may facilitate immune evasion. However, the polymorphic nature of the locus has precluded accurate HLA copy-number analysis. Here, we present loss of heterozygosity in human leukocyte antigen (LOHHLA), a computational tool to determine HLA allele-specific copy number from sequencing data. Using LOHHLA, we find that HLA LOH occurs in 40% of non-small-cell lung cancers (NSCLCs) and is associated with a high subclonal neoantigen burden, APOBEC-mediated mutagenesis, upregulation of cytolytic activity, and PD-L1 positivity. The focal nature of HLA LOH alterations, their subclonal frequencies, enrichment in metastatic sites, and occurrence as parallel events suggests that HLA LOH is an immune escape mechanism that is subject to strong microenvironmental selection pressures later in tumor evolution. Characterizing HLA LOH with LOHHLA refines neoantigen prediction and may have implications for our understanding of resistance mechanisms and immunotherapeutic approaches targeting neoantigens.
Trialists M, Lim E, 2017, Surgical Selection in Pleurectomy Decortication for Mesothelioma - an Overview from Screening and Selection from MARS 2 Pilot, Publisher: ELSEVIER SCIENCE INC, Pages: S1748-S1748, ISSN: 1556-0864
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- Citations: 2
Cufari ME, Proli C, De Sousa P, et al., 2017, Increasing frequency of non-smoking lung cancer: Presentation of patients with early disease to a tertiary institution in the UK, EUROPEAN JOURNAL OF CANCER, Vol: 84, Pages: 55-59, ISSN: 0959-8049
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- Citations: 44
Gao S, Zhang Z, Aragon J, et al., 2017, The Society for Translational Medicine: clinical practice guidelines for the postoperative management of chest tube for patients undergoing lobectomy, JOURNAL OF THORACIC DISEASE, Vol: 9, Pages: 3255-3264, ISSN: 2072-1439
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- Citations: 29
Filosso PL, Guerrera F, Evangelista A, et al., 2017, Adjuvant chemotherapy for large-cell neuroendocrine lung carcinoma: results from the European Society for Thoracic Surgeons Lung Neuroendocrine Tumours Retrospective Database, EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, Vol: 52, Pages: 339-345, ISSN: 1010-7940
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- Citations: 34
Mallorie A, Goldring J, Patel A, et al., 2017, Assessment of nodal involvement in non-small-cell lung cancer with <SUP>18</SUP>F-FDG-PET/CT: mediastinal blood pool cut-off has the highest sensitivity and tumour SUV<sub>max</sub>/2 has the highest specificity, NUCLEAR MEDICINE COMMUNICATIONS, Vol: 38, Pages: 715-719, ISSN: 0143-3636
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- Citations: 7
Soo RA, Stone ECA, Cummings KM, et al., 2017, Scientific Advances in Thoracic Oncology 2016, JOURNAL OF THORACIC ONCOLOGY, Vol: 12, Pages: 1183-1209, ISSN: 1556-0864
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- Citations: 31
Jamal-Hanjani M, Wilson GA, McGranahan N, et al., 2017, Tracking the Evolution of Non-Small-Cell Lung Cancer, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 376, Pages: 2109-2121, ISSN: 0028-4793
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- Citations: 1352
Abbosh C, Birkbak NJ, Wilson GA, et al., 2017, Phylogenetic ctDNA analysis depicts early-stage lung cancer evolution, NATURE, Vol: 545, Pages: 446-451, ISSN: 0028-0836
The early detection of relapse following primary surgery for non-small-cell lung cancer and the characterization of emerging subclones, which seed metastatic sites, might offer new therapeutic approaches for limiting tumour recurrence. The ability to track the evolutionary dynamics of early-stage lung cancer non-invasively in circulating tumour DNA (ctDNA) has not yet been demonstrated. Here we use a tumour-specific phylogenetic approach to profile the ctDNA of the first 100 TRACERx (Tracking Non-Small-Cell Lung Cancer Evolution Through Therapy (Rx)) study participants, including one patient who was also recruited to the PEACE (Posthumous Evaluation of Advanced Cancer Environment) post-mortem study. We identify independent predictors of ctDNA release and analyse the tumour-volume detection limit. Through blinded profiling of postoperative plasma, we observe evidence of adjuvant chemotherapy resistance and identify patients who are very likely to experience recurrence of their lung cancer. Finally, we show that phylogenetic ctDNA profiling tracks the subclonal nature of lung cancer relapse and metastasis, providing a new approach for ctDNA-driven therapeutic studies.
McElnay PJ, Lim E, 2017, Modern Techniques to Insert Chest Drains, THORACIC SURGERY CLINICS, Vol: 27, Pages: 29-+, ISSN: 1547-4127
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- Citations: 11
Leung M, Ryan D, Hulme R, et al., 2017, Defining molecular residual disease after lung cancer resection, LUNG CANCER, Vol: 103, Pages: S72-S73, ISSN: 0169-5002
Gennatas S, Lu SK, Anbunathan H, et al., 2017, Somatic BAP1 and NF2 mutations in pleural malignant mesothelioma and their correlation with clinical phenotype
Chudasama DY, Freydina DV, Freidin MB, et al., 2016, Inertia based microfluidic capture and characterisation of circulating tumour cells for the diagnosis of lung cancer, ANNALS OF TRANSLATIONAL MEDICINE, Vol: 4, ISSN: 2305-5839
Landau D, Lim E, 2016, Prophylactic radiotherapy to prevent procedure-tract metastases, LANCET ONCOLOGY, Vol: 17, Pages: E418-E418, ISSN: 1470-2045
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- Citations: 2
Filosso PL, Guerrera F, Thomas P, et al., 2016, Management of bronchial carcinoids: international practice survey among the European Society of Thoracic Surgeons, FUTURE ONCOLOGY, Vol: 12, Pages: 1985-1999, ISSN: 1479-6694
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- Citations: 11
Lim E, 2016, Quality of life after video-assisted surgery for lung cancer, LANCET ONCOLOGY, Vol: 17, Pages: E317-E317, ISSN: 1470-2045
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