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BACKGROUND@#Preliminary researches conformed that neoadjuvant immunotherapy combined with chemotherapy had a significant short-term effect in resectable non-small cell lung cancer (NSCLC), but there were few clinical trials about neoadjuvant chemoimmunotherapy in China. We aimed to assess retrospectively the antitumour activity and safety of neoadjuvant chemoimmunotherapy for resectable stage Ib-IIIb NSCLC.@*METHODS@#Twenty patients who had been diagnosed as stage Ib-IIIb NSCLC and received chemoimmunotherapy as neoadjuvant treatment between November 2019 and December 2020, in Beijing Chest Hospital, Capital Medical University were recruited. These patients received neoadjuvant treatment for 21 days as a cycle and antitumour activity and safety were evaluated every two cycles.@*RESULTS@#Of 20 patients received neoadjuvant chemoimmunotherapy, 17 patients underwent surgical resection. 16 patients had R0 resection (no residual tumor resection) and 1 patient had R1 resection (microscopic residual tumor resection). Radiographic objective response rate (ORR) was 85.0% (4 complete response, 13 partial response). 5.0% (1/20) of patients had stable disease, and 10.0% (2/20) of patients had progression disease. The major pathologic response (MPR) was 47.1% (8/17), and complete pathologic response (CPR) was 29.4% (5/17). 1 case developed grade IV immune-related pneumonia (IRP) and 9 (45.0%) cases had grade III hematologic toxicity.@*CONCLUSIONS@#Immunotherapy combined with chemotherapy as neoadjuvant therapy has a better efficiency and tolerable adverse effects for patients with resectable NSCLC in stage Ib-IIIb.
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Objective To discuss the proper operation time of patients with encapsulated empyema secondary to tubercu-lous pleurisy by review the clinical characteristics and duration of these patients.Methods From December 1995 to May 2017, 235 patients with encapsulated empyema and pleural decortication were operated.The course of disease and preopera-tional data were collected.Patients were divided into three groups according to the duration of disease(group A with 113 cases,≤12 months; group B with 53 cases, 12 -24 months; group C with 69 cases, >24 months).Propensity score matching (PSM) was used to decrease the baseline difference among three groups.Preoperational features, such as operation time, bleeding, complications were compared between groups.Results PSM were conducted between group A and group B (45 paired patients), group B and group C(29 paired patients), respectively.The length of operation, amount of bleeding and blood transfusion in group B were significantly higher than those in group A and group C .The days with tube and hospitalization in group B were significantly longer than group A, but they were insignificantly different compared with group C(P>0.05). Postoperative complications were similar between the three groups(P>0.05).Conclusion Encapsulated empyema in early stage(within 1 year of onset) or after the maturation of the fibrous plate(over 2 years) is less difficult for surgical intervention, and try to avoid surgical treatment at high risk(1 to 2 years).
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<p><b>BACKGROUND</b>Personalized medicine becomes essential in lung cancer treatment, however lung-cancer-related gene expression profiles in Chinese patients remain unknown. In this study, the correlation of gene expression profiles and clinical characteristics in non-small-cell lung cancer (NSCLC) was investigated.</p><p><b>METHODS</b>Seventy-six Chinese patients with NSCLC were enrolled in the study to investigate mRNA expression profiles of excision repair cross complement group 1 (ERCC1), thymidylate synthetase (TYMS), ribonucleotide reductase (RRM1), class III β-tubulin (TUBB3), and epidermal growth factor receptor (EGFR) genes and their correlation with patient clinical characteristics. A novel liquidchip technology was used to detect mRNA expression levels in formalin fixed paraffin embedded tumor pathology samples. The relationships between gene expression and clinical characteristics were assessed using the Mann-Whitney test.</p><p><b>RESULTS</b>ERCC1 mRNA levels were higher in tumors from patients with metastatic disease than patients with non-metastatic disease (P = 0.021), and higher in adenocarcinomas than squamous cell carcinomas (P = 0.006). Increased TUBB3 mRNA expression levels were found in patients with performance status (PS) 1 in comparison with PS 0 (P = 0.049), with poorly differentiated tumors in comparison with tumors that were moderately and well differentiated (P ≤ 0.000 1), and with advanced stage in comparison with early stage disease (P ≤ 0.000 1).</p><p><b>CONCLUSIONS</b>ERCC1 mRNA levels were higher in metastatic adenocarcinoma NSCLC; TUBB3 mRNA levels were significantly higher in poorly differentiated tumors and in advanced stage NSCLC, which indicates the poor prognosis.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Carcinoma, Non-Small-Cell Lung , Genetics , DNA-Binding Proteins , Genetics , Endonucleases , Genetics , In Vitro Techniques , Lung Neoplasms , Genetics , ErbB Receptors , Genetics , Tubulin , Genetics , Tumor Suppressor Proteins , GeneticsABSTRACT
<p><b>BACKGROUND</b>With the development of social industrialization and aging of the population, patients with lung cancer have the tendency of becoming youthful and elderly, therefore the way of treatment should be also changed. In resent years, lung cancer in young and elderly patients have been reported respectively, but simultaneous contrast analysis of clinical feature and prognosis in elderly, normal and youthful patients have been rarely reported. Based on the clinic data in the patients, the clinical feature and prognosis of patients with non-small cell lung cancer at different ages were analyzed.</p><p><b>METHODS</b>From January 1996 to January 2003, 1380 patients with NSCLC were treated surgically in thoracic department in our hospital, the patients were divided into three group based on their age, group 1 (G1) (range ≤40), group 2 (G2) (range 41-69), group 3 (G3) (range ≥70). The clinical feature and prognosis were analyzed in each group.</p><p><b>RESULTS</b>The mean age in the whole group was 58.16±0.26, and 35.76±0.57 (range 12-40) in G1, 58.00±0.22 (range 41-69) in G2, 72.30±0.21 (range 70-80) in G3. The ratio of lung cancer in female between G1 and G3 was significant different (P=0.024). The coexisting diseases in G3 were more common than those of other groups (P=0.000). Squamous cell carcinoma was the main type in histology, accounting for 41.79% (28/67), 54.12% (644/1190) and 58.54% (72/123) in each group respectively (P=0.080), but the ratio of adenocarcinoma, higher than that of other groups, were 43.28% (29/67), 29.50% (351/1190) and 26.82% (33/123) (P=0.036). Lobectomy and pneumonectomy were the main surgical procedures, accounting for 58.21%, 65.29%, 78.86% (P=0.004) and 34.33%, 26.22%, 12.20% (P=0.001), respectively. The ratio of stage III were 43.28% (29/67), 38.82% (462/1190), and 26.02% (32/123) in each groups (P=0.015). 55.22% (37/67) in G1 received adjuvant chemotherapy, 47.48% (565/1190) in G2, and 29.27% (36/123) in G3 (P=0.000). 5-year survival rate was 38.96% in the whole group, 29.99% in G1, 39.61% in G2, and 37.99% in G3 (P=0.494).</p><p><b>CONCLUSIONS</b>In young patients with non-small cell lung cancer, female and adenocarcinoma make up the majority of the number, and a lot of patients are in advanced stage and likely to adopt adjuvant chemotherapy. While in elderly, squamous cell carcinoma accounts for the majority of the number, and more coexisting diseases are accompanied, much more complications occur after surgical procedure. Nevertheless, their prognosis has no significant difference.</p>
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<p><b>BACKGROUND</b>The influence of tumor size on prognosis has been determined in different stages of lung cancer, but it is not clear yet within the same stage of lung cancer, especially for those less than 3cm in diameter. The aim of this study is to explore the impact of tumor size on prognosis in stage IA non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>A total of 142 consecutive, surgically treated patients with pathologic stage IA NSCLC were analysed retrospectively. Kaplan-Meier survival curve was performed to estimate the survival of patients with different tumor size. And a COX proportional hazard regression model was used to make multivariate analysis about age, gender, pathologic type, tumor size and chemoradiotherapy or not.</p><p><b>RESULTS</b>There were 60 patients with tumor diameter less than 2.0cm, and 82 between 2.1 to 3.0cm. The overall 3-and 5-year survival rate was 84.41% and 70.89% respectively, in which tumor diameter less than 2.0cm group was 94.91% and 81.40%, tumor diameter between 2.1 to 3.0cm group was 82.18% and 64.91% (P=0.0353), respectively. In both univariate and multivariate analyses, the tumor size was an independent prognostic factor for survival.</p><p><b>CONCLUSIONS</b>Since the tumor size is an independent prognostic factor for NSCLC, it is necessary to improve the level of imageological diagnosis so as to treat the patients much earlier.</p>
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<p><b>BACKGROUND</b>There are many factors that affect the prognosis of non-small cell lung cancer (NSCLC). This study aims to analyze the influential factors and prognosis in patients with NSCLC following operation.</p><p><b>METHODS</b>From January 1996 to January 2003, 1380 patients with NSCLC treated surgically were retrospectively studied. The correlation between clinicopathological characteristics and prognosis was evaluated by univariate and multivariate analyses.</p><p><b>RESULTS</b>In the whole group, 1-, 3- and 5-year survival rate was 78.85%, 49.78% and 38.96% respectively, and median survival time (MST) was 38.77 months. According to univariate analysis, tumor size, pathologic type, clinical type (central or peripheral), TNM stages, lymph node involvement, surgical procedure, postoperative chemotherapy, and cycles of chemotherapy were significantly related to the survival of patients. By multivariate analysis, tumor size, TNM stages, lymph node status and postoperative chemotherapy were independent prognostic factors.</p><p><b>CONCLUSIONS</b>Tumor size, TNM stages, lymph node involvement and postoperative chemotherapy are independent prognostic factors for NSCLC following the surgical procedure.</p>
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Objective Non-small-cell lung cancer with ipsilateral mediastinal lymph node metastasis (N2) belongs to heterogeneous subgroup. We analyzed the prognosis of patients with resected N2 NSCLC to determine the clinical significance. Methods The present study comprised 146 consecutive patients whom underwent surgical resection of N2 NSCLC between January 1997 and January 2000. Histological type, location, T primary tumor status, operation mode, clinical N2 (cN2) factor, N2 level(single or multiple), number of positive nodes(N2-num), and the cycles of adjuvant chemotherapy were estimated from the date of operation using the Kaplan-Meier and Log Rank analysis. The Cox regression model evaluated the influence of factors on the survival. Results The 3-and 5-year survival rate of these N2 NSCLC patients were 19.86% and 14.56%, respectively. The patients with tumor in the right lower lobe showed a significantly longer survival than left lobes. The histological type, tumor location, cN2 factor, N2 level and N2-number were associated with survival. A multivariate analysis using Cox regression identified 4 factors of prognosis: tumor site, T status, N2 level and clinical N2 status. Conclusion This article has identified N2 NSCLC subgroups and found that patients with mN2, N2L1 and single N2 have better prognosis.