Multi-center experience in an optimized right upper lobectomy surgical procedure in China.

BACKGROUND: This multi-center study was aimed at retrospectively evaluating the feasibility, safety, clinical outcomes, and surgical learning curve of an optimized procedure for right upper lobectomy (RUL), which is challenging because of the anatomical structures and features of this lobe. METHODS: This study included 45 RUL cases of robot-assisted thoracoscopy (RATS) in a pilot cohort and 187 RUL cases of video-assisted thoracoscopy (VATS) in three cohorts. A total of 121 and 111 patients underwent traditional and optimized RUL, respectively. The optimized surgical procedure was performed to consecutively transect the superior arterial trunk and bronchus, and finally disconnect the pulmonary vein and posterior ascending artery with interlobar fissures. Clinical and radiological data were reviewed retrospectively. RESULTS: Optimized RUL can be performed successfully by RATS or VATS. The optimized procedure yielded better clinical outcomes than the traditional procedure, including shorter operation times, less blood loss, fewer complications, shorter hospital times, lower costs, and a lower likelihood of postoperative intermedius bronchial kinking. Additionally, for calcified interlobar lymph nodes, the optimized VATS group was less likely to be converted to thoracotomy than the traditional group. The skills required to perform optimized VATS RUL can be gained by surgeons after 12 to 15 cases. The two RUL procedures in the pilot cohort showed similar disease-free survival. CONCLUSIONS: The optimized RUL was safe, economical, and feasible, with a short learning curve and satisfactory disease-free survival.

An updated meta-analysis of the relationship between glutathione S-transferase T1 null/presence gene polymorphism and the risk of lung cancer.

AIM OF STUDY: There were many reports published on the relationship between glutathione S-transferase T1 (GSTT1) null/presence gene polymorphism and the risk of lung cancer in these years. In previous, we conducted a meta-analysis to evaluate the relationship between GSTT1 null/presence gene polymorphism and the risk of lung cancer. This study was conducted to update it. MATERIALS AND METHODS: The association studies were identified from PubMed and Cochrane Library on March 1, 2016. RESULTS: Sixty-three reports were recruited into this meta-analysis for the association of null genotype of GSTT1 with lung cancer susceptibility, consisting of 21,220 patients with lung cancer and 21,496 controls. There was a marked association between GSTT1 null genotype and lung cancer risk in overall populations and in Asians (overall populations: Odds ratio [OR] = 1.17, 95% confidence interval [95% CI]: 1.07-1.28, P = 0.006; Asians: OR = 1.41, 95% CI: 1.23-1.62, P < 0.00001). However, GSTT1 null genotype was not associated with the risk of lung cancer in Caucasians, Brazilian population, and Africans. CONCLUSION: GSTT1 null genotype is associated with the lung cancer risk in overall populations and in Asians.

An updated meta-analysis for association of glutathione S-transferase P1 gene polymorphism with the susceptibility of lung cancer.

AIM OF STUDY: The conclusions on the association between glutathione S-transferase P1 (GSTP1) gene polymorphism and lung cancer risk are still debated. This meta-analysis was performed to update the association between GSTP1 and the risk of lung cancer. MATERIALS AND METHODS: The association investigations were identified from PubMed and Cochrane Library, and eligible studies were included and synthesized using meta-analysis method. RESULTS: Fifty reports were included into this meta-analysis for the association of GSTP1 A/G gene polymorphism and lung cancer susceptibility. The association between GSTPI G allele/GG genotype and lung cancer risk was found in this meta-analysis (G allele: odds ratio [OR] = 1.08, 95% confidence interval [CI]: 1.02-1.14, P = 0.006; GG genotype: OR = 1.09, 95% CI: 1.00-1.18, P = 0.04). However, the AA genotype was not associated with the susceptibility of lung cancer. CONCLUSION: GSTP1 G allele/GG genotype is associated with the lung cancer susceptibility.

Potential signaling pathway of hypoxia-inducible factor in lung cancer and its gene polymorphism with lung cancer risk.

Lung cancer is becoming the leading cause of cancer death worldwide with highest morbidity and mortality, and knowing the pathogenesis and signaling pathway is very important and advances in the diagnosis and treatment of the disease are urgently needed. Gene polymorphism was reported to be associated with the lung cancer risk. We reviewed the potential signaling pathway of hypoxia-inducible factor in lung cancer and conducted a meta-analysis to explore its gene polymorphism with lung cancer risk. In the meta-analysis, hypoxia-inducible factor-1α (HIF-1α) G1790A A allele, AA genotype and GG genotype were associated with lung cancer risk (A allele: OR = 2.31, 95% CI: 1.77-3.02, p < 0.00001; AA genotype: OR = 4.52, 95% CI: 2.31-8.83, p < 0.0001; GG genotype: OR = 0.45, 95% CI: 0.33-0.63, p < 0.00001). Furthermore, HIF-1α C1772 TT genotype and CC genotype were associated with lung cancer risk, but the T allele was not. In conclusion, HIF-1α G1790A A allele, AA genotype and GG genotype, HIF-1α C1772 TT genotype and CC genotype were associated with lung cancer risk. However, more studies should be performed to confirm it.