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1. Strauss GM, Herndon JE 2nd, Maddaus MA, Johnstone DW, Johnson EA, Harpole DH, Gillenwater HH, Watson DM, Sugarbaker DJ, Schilsky RL, Vokes EE, Green MR: Adjuvant paclitaxel plus carboplatin compared with observation in stage IB non-small-cell lung cancer: CALGB 9633 with the Cancer and Leukemia Group B, Radiation Therapy Oncology Group, and North Central Cancer Treatment Group Study Groups. J Clin Oncol; 2008 Nov 1;26(31):5043-51
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  • [Title] Adjuvant paclitaxel plus carboplatin compared with observation in stage IB non-small-cell lung cancer: CALGB 9633 with the Cancer and Leukemia Group B, Radiation Therapy Oncology Group, and North Central Cancer Treatment Group Study Groups.
  • PURPOSE: Adjuvant chemotherapy for resected non-small-cell lung cancer (NSCLC) is now accepted on the basis of several randomized clinical trials (RCTs) that demonstrated improved survival.
  • Although there is strong evidence that adjuvant chemotherapy is effective in stages II and IIIA NSCLC, its utility in stage IB disease is unclear.
  • This report provides a mature analysis of Cancer and Leukemia Group B (CALGB) 9633, the only RCT designed specifically for stage IB NSCLC.
  • PATIENTS AND METHODS: Within 4 to 8 weeks of resection, patients were randomly assigned to adjuvant chemotherapy or observation.
  • Chemotherapy consisted of paclitaxel 200 mg/m(2) intravenously over 3 hours and carboplatin at an area under the curve dose of 6 mg/mL per minute intravenously over 45 to 60 minutes every 3 weeks for four cycles.
  • Grades 3 to 4 neutropenia were the predominant toxicity; there were no treatment-related deaths.
  • However, exploratory analysis demonstrated a significant survival difference in favor of adjuvant chemotherapy for patients who had tumors > or = 4 cm in diameter (HR, 0.69; CI, 0.48 to 0.99; P = .043).
  • CONCLUSION: Because a significant survival advantage was not observed across the entire cohort, adjuvant chemotherapy should not be considered standard care in stage IB NSCLC.
  • A statistically significant survival advantage for patients who had tumors > or = 4 cm supports consideration of adjuvant paclitaxel/carboplatin for stage IB patients who have large tumors.

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  • [CommentIn] J Clin Oncol. 2009 May 1;27(13):2300-1; author reply 2301-2 [19332712.001]
  • [CommentIn] J Clin Oncol. 2008 Nov 1;26(31):5014-7 [18809602.001]
  • [CommentIn] Future Oncol. 2009 Feb;5(1):19-22 [19243293.001]
  • (PMID = 18809614.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA33601; United States / NCI NIH HHS / CA / CA47577; United States / NCI NIH HHS / CA / CA41287; United States / NCI NIH HHS / CA / CA45808; United States / NCI NIH HHS / CA / CA-25224; United States / NCI NIH HHS / CA / U10 CA21661; United States / NCI NIH HHS / CA / CA16450; United States / NCI NIH HHS / CA / CA08025; United States / NCI NIH HHS / CA / CA31946
  • [Publication-type] Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
  • [Other-IDs] NLM/ PMC2652093
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2. Gridelli C, Maione P, Comunale D, Rossi A: Adjuvant chemotherapy in elderly patients with non-small-cell lung cancer. Cancer Control; 2007 Jan;14(1):57-62
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  • [Title] Adjuvant chemotherapy in elderly patients with non-small-cell lung cancer.
  • BACKGROUND: More than two thirds of patients who die of lung cancer in the United States are over 65 years of age.
  • More than 50% of lung cancer patients are diagnosed over the age of 65 and about 30% over the age of 70.
  • METHODS: The authors review recent data from large randomized trials on adjuvant chemotherapy in patients with NSCLC.
  • They discuss age-related changes in organ function, comorbidities and frailty in the elderly, and chemotherapy treatment in elderly patients with NSCLC.
  • RESULTS: Randomized trials suggest that postoperative chemotherapy improves survival after surgery in patients with stage IB to IIIA NSCLC, and awareness of the efficacy of this approach is growing in the scientific community.
  • Elderly patients tolerate chemotherapy poorly because of comorbidity and organ failure, and after lung surgery they are considered at higher risk of chemotherapy-induced toxicity.
  • The survival benefit obtained with platin-based chemotherapy may vanish or decrease in the elderly due to a potential higher toxic death rate or lower compliance to treatment.
  • CONCLUSIONS: Modified schedules or attenuated dose of platin-containing chemotherapy should be investigated in the adjuvant setting by specifically designed trials.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Lung Neoplasms / drug therapy
  • [MeSH-minor] Aged. Chemotherapy, Adjuvant. Humans

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  • (PMID = 17242671.001).
  • [ISSN] 1073-2748
  • [Journal-full-title] Cancer control : journal of the Moffitt Cancer Center
  • [ISO-abbreviation] Cancer Control
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 41
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3. Ou SH, Zell JA, Ziogas A, Anton-Culver H: Prognostic factors for survival of stage I nonsmall cell lung cancer patients : a population-based analysis of 19,702 stage I patients in the California Cancer Registry from 1989 to 2003. Cancer; 2007 Oct 1;110(7):1532-41
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  • [Title] Prognostic factors for survival of stage I nonsmall cell lung cancer patients : a population-based analysis of 19,702 stage I patients in the California Cancer Registry from 1989 to 2003.
  • BACKGROUND: Platinum-based adjuvant chemotherapy in randomized trials has failed to provide a survival benefit in patients with resected stage I nonsmall cell lung cancer (NSCLC).
  • Using data from the California Cancer Registry (CCR), we explored factors that had detrimental effects on survival in patients with stage I NSCLC to identify a subset of patients at high risk for disease recurrence and subsequent mortality.
  • METHODS: Between 1989 and 2003, 19,702 incident cases of stage I NSCLC in the CCR were identified and subgrouped into stage IA and IB disease.
  • Patient demographic factors, tumor characteristics, and treatment delivered were examined.
  • RESULTS: Advanced age at diagnosis, male sex, low socioeconomic status (SES), nonsurgical treatment, and poor histologic grade (stage IA NSCLC: hazards ratio [HR], 1.13; 95% confidence interval [95% CI], 1.08-1.19; stage IB NSCLC: HR, 1.11; 95% CI, 1.07-1.16) were associated with increased mortality risk on multivariate analysis.
  • Non-upper lobe tumor location (right middle lobe, right and left lower lobes) and tumor size > or =4 cm (vs <4 cm: HR, 1.23; 95% CI, 1.15-1.30) were additional factors that increased the risk of mortality among patients with stage IB disease.
  • Bronchioloalveolar carcinoma and Asian ethnicity were associated with decreased mortality risk in stage I NSCLC.
  • CONCLUSIONS: Stage I NSCLC with poorly differentiated histology and stage IB NSCLC with non-upper lobar tumor location or tumor size > or =4 cm carried an increased mortality risk.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / mortality. Carcinoma, Non-Small-Cell Lung / pathology. Lung Neoplasms / mortality. Lung Neoplasms / pathology
  • [MeSH-minor] Adenocarcinoma / mortality. Adenocarcinoma / pathology. Adenocarcinoma, Bronchiolo-Alveolar / mortality. Adenocarcinoma, Bronchiolo-Alveolar / pathology. Adult. Aged. Asian Americans / statistics & numerical data. California / epidemiology. Carcinoma, Large Cell / mortality. Carcinoma, Large Cell / pathology. Carcinoma, Squamous Cell / mortality. Carcinoma, Squamous Cell / pathology. Female. Humans. Kaplan-Meier Estimate. Male. Middle Aged. Multivariate Analysis. Neoplasm Staging. Pneumonectomy / methods. Predictive Value of Tests. Prognosis. Proportional Hazards Models. Registries. Risk Assessment. Risk Factors. Survival Rate

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  • (PMID = 17702091.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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4. Broët P, Camilleri-Broët S, Zhang S, Alifano M, Bangarusamy D, Battistella M, Wu Y, Tuefferd M, Régnard JF, Lim E, Tan P, Miller LD: Prediction of clinical outcome in multiple lung cancer cohorts by integrative genomics: implications for chemotherapy selection. Cancer Res; 2009 Feb 1;69(3):1055-62
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prediction of clinical outcome in multiple lung cancer cohorts by integrative genomics: implications for chemotherapy selection.
  • The role of adjuvant chemotherapy in patients with stage IB non-small-cell lung cancer (NSCLC) is controversial.
  • Identifying patient subgroups with the greatest risk of relapse and, consequently, most likely to benefit from adjuvant treatment thus remains an important clinical challenge.
  • Here, we hypothesized that recurrent patterns of genomic amplifications and deletions in lung tumors could be integrated with gene expression information to establish a robust predictor of clinical outcome in stage IB NSCLC.
  • Using high-resolution microarrays, we generated tandem DNA copy number and gene expression profiles for 85 stage IB lung adenocarcinomas/large cell carcinomas.
  • Importantly, the IS also significantly predicted clinical outcome in two other independent stage I NSCLC cohorts (P = 0.003 and P = 0.025), showing its robustness.
  • Our results suggest that recurrent copy number alterations, when combined with gene expression information, can be successfully used to create robust predictors of clinical outcome in early-stage NSCLC.
  • The utility of the IS in identifying early-stage NSCLC patients as candidates for adjuvant treatment should be further evaluated in a clinical trial.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / drug therapy. Carcinoma, Non-Small-Cell Lung / genetics. Lung Neoplasms / drug therapy. Lung Neoplasms / genetics
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / genetics. Adenocarcinoma / pathology. Carcinoma, Large Cell / drug therapy. Carcinoma, Large Cell / genetics. Carcinoma, Large Cell / pathology. Chromosome Aberrations. Cohort Studies. Comparative Genomic Hybridization. Gene Dosage. Gene Expression Profiling. Humans. Neoplasm Staging. Predictive Value of Tests. Reproducibility of Results. Treatment Outcome

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  • (PMID = 19176396.001).
  • [ISSN] 1538-7445
  • [Journal-full-title] Cancer research
  • [ISO-abbreviation] Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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5. Depierre A, Westeel V: Overview of the role of neoadjuvant chemotherapy for early stage non-small cell lung cancer. Semin Oncol; 2001 Aug;28(4 Suppl 14):29-36
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  • [Title] Overview of the role of neoadjuvant chemotherapy for early stage non-small cell lung cancer.
  • Preoperative chemotherapy has been intensively studied in stage IIIA non-small cell lung cancer and, to a lesser extent, in stage IIIB.
  • For a considerable time period, early stage non-small cell lung cancer was dropped from studies.
  • Nevertheless, analysis of relapse patterns shows that preoperative chemotherapy appears to act more on micrometastases than on local control.
  • The first randomized studies of preoperative chemotherapy were conducted only among patients with stage IIIA disease.
  • The French Cooperative Oncology Group presented a large randomized study among 373 stage IB, II, and IIIA patients at the American Society of Clinical Oncology meeting in May 1999.
  • A Cox multivariate analysis showed a protective effect of preoperative chemotherapy, and this effect seemed to preferentially involve patients with early stage disease.
  • Ongoing studies of most US and European oncology groups are including early stage tumors, as in the Southwest Oncology Group trial 9901.
  • The new Intergroupe Francophone de Cancérologie Thoracique also is ready to start a preoperative randomized chemotherapy study in stage I and II non-small cell lung cancer, that will compare two different strategies of preoperative chemotherapy in responding patients.
  • Patients will be randomized to two groups: one group will receive chemotherapy before surgery and the other group will receive it before and after surgery.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Lung Neoplasms / drug therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Clinical Trials as Topic. Humans. Neoadjuvant Therapy

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  • [Copyright] Copyright 2001 by W.B. Saunders Company.
  • (PMID = 11605181.001).
  • [ISSN] 0093-7754
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 43
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6. Wakelee HA, Schiller JH, Gandara DR: Current status of adjuvant chemotherapy for stage IB non-small-cell lung cancer: implications for the New Intergroup Trial. Clin Lung Cancer; 2006 Jul;8(1):18-21
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Current status of adjuvant chemotherapy for stage IB non-small-cell lung cancer: implications for the New Intergroup Trial.
  • Adjuvant chemotherapy after resection of stage II-IIIA non-small-cell lung cancer is now the standard of care based on the results of 3 phase III studies using cisplatin-based regimens, IALT (International Adjuvant Lung Trial), The National Cancer Institute of Canada JBR.10, and ANITA (Adjuvant Navelbine International Trialist Association).
  • The role of adjuvant chemotherapy for stage IB disease remains controversial, even more so now that the updated results from CALGB (Cancer and Leukemia Group B) trial 9633 are statistically negative.
  • CALGB 9633 was the only randomized adjuvant trial to use a carboplatin backbone and focused exclusively on patients with stage IB disease.
  • Initial results, reported in 2004, showed a significant survival advantage with the addition of chemotherapy, but the 2006 updated results are no longer statistically significant.
  • The next large intergroup adjuvant trial in non-small-cell lung cancer will look at bevacizumab in combination with chemotherapy.
  • Because of the recent update, this trial will now limit patients with stage IB disease to those with larger tumors (>or= 4 cm) and will likely include only cisplatin-based regimens.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / drug therapy. Lung Neoplasms / drug therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Clinical Trials as Topic. Humans


7. Okamoto T, Maruyama R, Shoji F, Ikeda J, Miyamoto T, Nakamura T, Asoh H, Ichinose Y: Clinical patterns and treatment outcome of elderly patients in clinical stage IB/II non-small cell lung cancer. J Surg Oncol; 2004 Sep 1;87(3):134-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical patterns and treatment outcome of elderly patients in clinical stage IB/II non-small cell lung cancer.
  • BACKGROUND AND OBJECTIVES: Surgery is a standard treatment in patients with clinical stage IB/II non-small cell lung cancer (NSCLC).
  • The histological types were 50 adenocarcinomas, 51 squamous cell carcinomas, 8 large cell carcinomas, and 3 adenosquamous carcinomas.
  • RESULTS: Seventy-four patients (66%) underwent a surgical resection, including 60 surgery alone, 14 combined modality therapy.
  • Radiotherapy, with or without chemotherapy, was given to 30 patients (27%), and chemotherapy alone to 5 (4.5%).
  • In addition, 3 (2.7%) were given no therapy.
  • The 2-year survival of the radiotherapy group in patients with adenocarcinoma is 58%, while that of patients with squamous cell carcinoma is 22%.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / surgery. Lung Neoplasms / surgery. Pneumonectomy. Practice Patterns, Physicians'
  • [MeSH-minor] Adenocarcinoma / radiotherapy. Aged. Carcinoma, Adenosquamous / surgery. Carcinoma, Squamous Cell / surgery. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Humans. Male. Neoplasm Staging. Prognosis. Radiotherapy, Adjuvant. Survival Analysis. Treatment Outcome

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  • [Copyright] Copyright 2004 Wiley-Liss, Inc.
  • (PMID = 15334641.001).
  • [ISSN] 0022-4790
  • [Journal-full-title] Journal of surgical oncology
  • [ISO-abbreviation] J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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8. Pisters KM, Vallières E, Crowley JJ, Franklin WA, Bunn PA Jr, Ginsberg RJ, Putnam JB Jr, Chansky K, Gandara D: Surgery with or without preoperative paclitaxel and carboplatin in early-stage non-small-cell lung cancer: Southwest Oncology Group Trial S9900, an intergroup, randomized, phase III trial. J Clin Oncol; 2010 Apr 10;28(11):1843-9
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  • [Title] Surgery with or without preoperative paclitaxel and carboplatin in early-stage non-small-cell lung cancer: Southwest Oncology Group Trial S9900, an intergroup, randomized, phase III trial.
  • PURPOSE Patients with early-stage non-small-cell lung cancer (NSCLC) have a poor prognosis even after complete resection.
  • Earlier studies of preoperative (induction) chemotherapy in resectable NSCLC demonstrated feasibility and encouraging survival data.
  • This randomized phase III trial compared overall survival (OS) for preoperative paclitaxel and carboplatin followed by surgery with surgery alone in patients with early-stage NSCLC.
  • PATIENTS AND METHODS Patients with clinical stage IB-IIIA NSCLC (excluding superior sulcus tumors and N2 disease) were eligible.
  • The primary end point was OS; secondary end points were progression-free survival (PFS), chemotherapy response, and toxicity.
  • RESULTS The trial closed early with 354 patients after reports of a survival benefit for postoperative chemotherapy in other studies.
  • The median OS was 41 months in the surgery-only arm and 62 months in the preoperative chemotherapy arm (hazard ratio, 0.79; 95% CI, 0.60 to 1.06; P = .11.
  • ) The median PFS was 20 months for surgery alone and 33 months for preoperative chemotherapy (hazard ratio, 0.80; 95% CI, 0.61 to 1.04; P = .10.
  • ) Major response to chemotherapy was seen in 41% of patients; no unexpected toxicity was observed.
  • CONCLUSION This trial closed prematurely after compelling evidence supporting postoperative chemotherapy emerged.
  • Although OS and PFS were higher with preoperative chemotherapy, the differences did not reach statistical significance.
  • At present, stronger evidence exists for postoperative chemotherapy in early-stage NSCLC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Carcinoma, Non-Small-Cell Lung / surgery. Lung Neoplasms / drug therapy. Lung Neoplasms / surgery
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / secondary. Adenocarcinoma / surgery. Adult. Aged. Aged, 80 and over. Carboplatin / administration & dosage. Carcinoma, Large Cell / drug therapy. Carcinoma, Large Cell / secondary. Carcinoma, Large Cell / surgery. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / secondary. Carcinoma, Squamous Cell / surgery. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Staging. Paclitaxel / administration & dosage. Survival Rate. Thoracic Surgery. Treatment Outcome

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  • (PMID = 20231678.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / N01 CA004919; United States / NCI NIH HHS / CA / CA86780; United States / NCI NIH HHS / CA / CA37981; United States / NCI NIH HHS / CA / CA58348; United States / NCI NIH HHS / CA / CA58416; United States / NCI NIH HHS / CA / CA46136; United States / NCI NIH HHS / CA / CA35261; United States / NCI NIH HHS / CA / U10 CA004919; United States / NCI NIH HHS / CA / N01 CA035431; United States / NCI NIH HHS / CA / CA22433; United States / NCI NIH HHS / CA / CA12644; United States / NCI NIH HHS / CA / CA20319; United States / NCI NIH HHS / CA / N01 CA032102; United States / NCI NIH HHS / CA / U10 CA035192; United States / NCI NIH HHS / CA / CA58658; United States / NCI NIH HHS / CA / U10 CA014028; United States / NCI NIH HHS / CA / N01 CA035119; United States / NCI NIH HHS / CA / N01 CA046441; United States / NCI NIH HHS / CA / CA14028; United States / NCI NIH HHS / CA / CA45377; United States / NCI NIH HHS / CA / U10 CA074647; United States / NCI NIH HHS / CA / CA58861; United States / NCI NIH HHS / CA / CA35090; United States / NCI NIH HHS / CA / N01 CA063844; United States / NCI NIH HHS / CA / CA46282; United States / NCI NIH HHS / CA / U10 CA035261; United States / NCI NIH HHS / CA / U10 CA035178; United States / NCI NIH HHS / CA / CA76447; United States / NCI NIH HHS / CA / U10 CA105409; United States / NCI NIH HHS / CA / U10 CA032102; United States / NCI NIH HHS / CA / U10 CA046282; United States / NCI NIH HHS / CA / CA105409; United States / NCI NIH HHS / CA / CA67663; United States / NCI NIH HHS / CA / N01 CA035178; United States / NCI NIH HHS / CA / N01 CA038926; United States / NCI NIH HHS / CA / U10 CA067575; United States / NCI NIH HHS / CA / U10 CA046441; United States / NCI NIH HHS / CA / U10 CA045377; United States / NCI NIH HHS / CA / CA35192; United States / NCI NIH HHS / CA / CA74647; United States / NCI NIH HHS / CA / U10 CA020319; United States / NCI NIH HHS / CA / CA46113; United States / NCI NIH HHS / CA / U10 CA038926; United States / NCI NIH HHS / CA / U10 CA086780; United States / NCI NIH HHS / CA / U10 CA042777; United States / NCI NIH HHS / CA / U10 CA035431; United States / NCI NIH HHS / CA / U10 CA035119; United States / NCI NIH HHS / CA / CA42777; United States / NCI NIH HHS / CA / N01 CA067575; United States / NCI NIH HHS / CA / U10 CA067663; United States / NCI NIH HHS / CA / CA76429; United States / NCI NIH HHS / CA / U10 CA035090; United States / NCI NIH HHS / CA / U10 CA063844; United States / NCI NIH HHS / CA / U10 CA058861
  • [Publication-type] Clinical Trial, Phase III; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
  • [Other-IDs] NLM/ PMC2860367
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9. Choong NW, Vokes EE: Adjuvant and neoadjuvant therapy for early-stage non-small-cell lung cancer. Clin Lung Cancer; 2005 Dec;7 Suppl 3:S98-104
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adjuvant and neoadjuvant therapy for early-stage non-small-cell lung cancer.
  • Early-stage non-small-cell lung cancer (NSCLC) carries with it an unfavorable prognosis even in patients who have undergone surgical intervention.
  • Efforts to improve the outcome of patients with early-stage NSCLC have focused on adjuvant or neoadjuvant chemotherapy.
  • The role of adjuvant therapy in NSCLC has been clarified by the recent publication of several large randomized trials.
  • The International Adjuvant Lung Trial was the first prospective trial to report that adjuvant chemotherapy following complete surgical resection of NSCLC improved absolute overall survival by approximately 5% at 5 years.
  • As a result, adjuvant chemotherapy following complete resection of stage IB-III NSCLC can now be considered the standard of care.
  • Neoadjuvant chemotherapy, which has long been investigated for stage III NSCLC, was also recently explored in stage I/II NSCLC.
  • Although neoadjuvant chemotherapy seems promising, more work is needed to comprehensively evaluate and optimize this approach.
  • The current evidence for adjuvant and neoadjuvant therapy in early-stage NSCLC is reviewed in this article.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoma, Non-Small-Cell Lung / therapy. Lung Neoplasms / therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Clinical Trials as Topic. Humans. Neoadjuvant Therapy


10. Kato H, Tsuboi M, Kato Y, Ikeda N, Okunaka T, Hamada C: Postoperative adjuvant therapy for completely resected early-stage non-small cell lung cancer. Int J Clin Oncol; 2005 Jun;10(3):157-64
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Postoperative adjuvant therapy for completely resected early-stage non-small cell lung cancer.
  • Consensus on adjuvant therapy for completely resected non-small cell lung cancer until 2002 was as follows. (1) There was no significant impact of postoperative adjuvant chemotherapy based on meta-analysis and previous clinical trials. (2) Confirmatory studies are necessary in large-scale prospective clinical trials.
  • However, recent mega trials have introduced epoch-making changes for postoperative adjuvant chemotherapy in clinical practice since ASCO 2003.
  • Patients with completely resected stage I non-small cell lung cancer, especially T2N0 adenocarcinoma, will benefit from adjuvant chemotherapy with UFT.
  • The results of the International Adjuvant Lung Trial (IALT) have confirmed the meta-analysis in 1995.
  • Also, both the JBR10 and Cancer and Leukemia Group B (CALGB) 9633 studies have also confirmed positive IALT results of the benefit for postoperative platinum-based chemotherapy in completely resected non-small cell lung cancer.
  • Adjuvant chemotherapy for pathological stage IB to II, completely resected non-small cell lung cancer is standard care based on clinical trials.
  • UFT showed the strongest evidence for IB in Japan.
  • Platinum doublet chemotherapy with third-generation anticancer agents is also recommended.
  • Adjuvant chemotherapy should be offered as standard care to patients after completely resected early stage non-small cell lung cancer.
  • However, there is no evidence of the feasibility and efficacy for adjuvant chemotherapy with the platinum-based regimen in Japan.
  • Careful management should be necessary in such treatment.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Lung Neoplasms / drug therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Clinical Trials as Topic. Humans. Japan. Meta-Analysis as Topic. Neoplasm Staging. Survival Analysis. Treatment Outcome

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  • [Cites] N Engl J Med. 2000 Oct 26;343(17):1217-22 [11071672.001]
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  • (PMID = 15990962.001).
  • [ISSN] 1341-9625
  • [Journal-full-title] International journal of clinical oncology
  • [ISO-abbreviation] Int. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin
  • [Number-of-references] 19
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11. Santos ES, Castrellon A, Blaya M, Raez LE: Controversies in the management of stage IIIA non-small-cell lung cancer. Expert Rev Anticancer Ther; 2008 Dec;8(12):1913-29
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Controversies in the management of stage IIIA non-small-cell lung cancer.
  • New developments in the management of non-small-cell lung cancer, as well as recent proposals for changing the current lung cancer staging system, are posing a challenge in the therapeutic decision making regarding this disease.
  • For the last two decades, the management of stage IIIA (N2) disease has been controversial and the target for clinical trials has been to determine the best therapeutic approach that may result in better survival outcomes without increasing toxicity.
  • For many years, combined modality treatment (systemic chemotherapy plus radiation therapy) became the standard of care in this setting.
  • In this sense, recent clinical trials in the neoadjuvant setting using chemotherapy alone or combined modality are providing fruitful results and shifting the paradigm on this stage.
  • A recent, large randomized multicenter trial argues against what has slowly become a current practice in some centers - the use of preoperative modality for N2 disease.
  • Another controversy that we will discuss here is the acceptance of adjuvant therapy for resected stage IB-IIIA non-small-cell lung cancer.
  • It was not long ago that adjuvant radiation therapy was still the standard of care for patients who have pathological nodal disease.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / therapy. Lung Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Humans. Male

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  • (PMID = 19046112.001).
  • [ISSN] 1744-8328
  • [Journal-full-title] Expert review of anticancer therapy
  • [ISO-abbreviation] Expert Rev Anticancer Ther
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 92
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12. Filosso PL, Ruffini E, Oliaro A, Rena O, Casadio C, Mancuso M, Turello D, Cristofori RC, Maggi G: Large-cell neuroendocrine carcinoma of the lung: a clinicopathologic study of eighteen cases and the efficacy of adjuvant treatment with octreotide. J Thorac Cardiovasc Surg; 2005 Apr;129(4):819-24
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  • [Title] Large-cell neuroendocrine carcinoma of the lung: a clinicopathologic study of eighteen cases and the efficacy of adjuvant treatment with octreotide.
  • OBJECTIVE: This study was undertaken to evaluate the efficacy of a new adjuvant protocol with octreotide, alone or in combination with radiotherapy, in radically resected large cell neuroendocrine carcinomas of the lung.
  • METHODS: Between 1990 and 2001, a total of 18 consecutive patients affected by large cell neuroendocrine carcinomas of the lung were operated on.
  • Postoperative radiotherapy was performed when stage was higher than Ib.
  • RESULTS: Nine patients (50%) had local recurrences or distant metastases (mean recurrence time 14 months); palliative chemotherapy was given, but all patients died.
  • In 10 cases (55.5%) octreotide alone or in combination with radiotherapy was administered as adjuvant treatment; 9 of these patients (90%) are alive and free of disease ( P = .0007), and the other had liver and brain metastases 21 months after surgery.
  • CONCLUSIONS: Our preliminary results seem to demonstrate the efficacy of octreotide as adjuvant therapy in large cell neuroendocrine carcinomas of the lung when results of preoperative indium In-111 pentetreotide scintigraphy were positive.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Carcinoma, Large Cell / surgery. Carcinoma, Neuroendocrine / surgery. Chemotherapy, Adjuvant. Lung Neoplasms / surgery. Octreotide / therapeutic use
  • [MeSH-minor] Aged. Brain Neoplasms / secondary. Cause of Death. Disease-Free Survival. Female. Follow-Up Studies. Humans. Liver Neoplasms / secondary. Lymph Node Excision. Male. Middle Aged. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Palliative Care. Pneumonectomy. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 15821649.001).
  • [ISSN] 0022-5223
  • [Journal-full-title] The Journal of thoracic and cardiovascular surgery
  • [ISO-abbreviation] J. Thorac. Cardiovasc. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; RWM8CCW8GP / Octreotide
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13. Sato Y, Shimamoto T, Amada S, Asada Y, Hayashi T: Large cell neuroendocrine carcinoma of the uterine cervix: a clinicopathological study of six cases. Int J Gynecol Pathol; 2003 Jul;22(3):226-30
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  • [Title] Large cell neuroendocrine carcinoma of the uterine cervix: a clinicopathological study of six cases.
  • Six cases of cervical large cell neuroendocrine carcinomas (LCNEC) were found among 972 patients (0.6%) with invasive cervical carcinoma.
  • Five tumors were stage Ib and one was IIa.
  • All patients underwent radical hysterectomy and received adjuvant chemotherapy and pelvic radiotherapy.
  • On histologic examination, the tumor cells were arranged in an organoid growth pattern and were larger than those of typical small cell carcinoma.
  • The recognition of LCNECs is necessary to establish the most effective treatment for these aggressive tumors.
  • [MeSH-major] Carcinoma, Neuroendocrine / pathology. Uterine Cervical Neoplasms / pathology
  • [MeSH-minor] Adult. Diagnosis, Differential. Fallopian Tubes / surgery. Fatal Outcome. Female. Humans. Hysterectomy. Lung Neoplasms / secondary. Lung Neoplasms / surgery. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Ovariectomy. Papanicolaou Test. Uterine Hemorrhage. Vaginal Smears

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  • (PMID = 12819387.001).
  • [ISSN] 0277-1691
  • [Journal-full-title] International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists
  • [ISO-abbreviation] Int. J. Gynecol. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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14. Sugio K, Nagashima A, Nakanishi R, Uchiyama A, Inoue M, Osaki T, Yoshimatsu T, Takenoyama M, Hanagiri T, Yasumoto K: Randomized phase II trial of the biweekly schedule of adjuvant chemotherapy with carboplatin plus paclitaxel versus carboplatin plus gemcitabine in patients with non-small cell lung cancer (NSCLC). J Clin Oncol; 2009 May 20;27(15_suppl):7562

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Randomized phase II trial of the biweekly schedule of adjuvant chemotherapy with carboplatin plus paclitaxel versus carboplatin plus gemcitabine in patients with non-small cell lung cancer (NSCLC).
  • : 7562 Background: Carboplatin plus paclitaxel and carboplatin plus gemcitabine chemotherapy have shown a good response and an improved survival against advanced NSCLC.
  • This phase II trial assessed the feasibility, safety and efficacy of a bi-weekly schedule for adjuvant chemotherapy.
  • METHODS: Patients with completely resected stage IB-IIIB NSCLC were randomized to either carboplatin (AUC3) plus paclitaxel (90mg/m2) (arm A) or carboplatin (AUC3) plus gemcitabine (1000 mg/m2) (arm B), q2w for 8 cycles within 8 weeks after surgery.
  • The main inclusion criteria were no prior chemotherapy or radiotherapy, ECOG PS 0-1, an age of less than 80 years, and an adequate organ function.
  • The patients were stratified by gender, histology (adenoca vs. non-adenoca) and disease stage.
  • The histologic types included adenocarcinoma (n=51), squamous cell carcinoma (n=18), large cell carcinoma (n=5), and adenosquamous cell carcinoma (n=1).
  • The pathological stages were IB/IIA/IIB/IIIA/IIIB: 22/10/13/29/1.
  • No treatment related deaths were observed.
  • CONCLUSIONS: This adjuvant bi- weekly scheduled chemotherapy in both arms resulted in a good compliance and feasible with acceptable levels of toxicity in completely resected NSCLC.

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  • (PMID = 27963358.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. Betticher DC: Adjuvant and neoadjuvant chemotherapy in NSCLC: a paradigm shift. Lung Cancer; 2005 Dec;50 Suppl 2:S9-16
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adjuvant and neoadjuvant chemotherapy in NSCLC: a paradigm shift.
  • The role of adjuvant chemotherapy in patients with early-stage non-small cell lung cancer (NSCLC) remained controversial for many years.
  • Although a positive impact on overall survival was long suggested for cisplatin-based chemotherapy, early randomized clinical trials failed to confirm a clear survival benefit.
  • Recently, the results from 4 large randomized trials, IALT, JBR.10, CALGB 9633, and ANITA indicate a significant survival benefit with adjuvant chemotherapy for patients with IB through IIIA NSCLC, and the results of these trials support the adoption of chemotherapy in addition to surgery as a new standard of care.
  • Neoadjuvant chemotherapy is potentially better tolerated compared to post-surgical adjuvant chemotherapy, though definitive survival benefits with this approach have yet to be shown.
  • The current status of adjuvant and neoadjuvant chemotherapy for patients with early-stage NSCLC will be discussed.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Lung Neoplasms / drug therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Cisplatin / therapeutic use. Humans. Neoadjuvant Therapy. Neoplasm Staging. Survival Rate. Taxoids / therapeutic use

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  • (PMID = 16557669.001).
  • [ISSN] 0169-5002
  • [Journal-full-title] Lung cancer (Amsterdam, Netherlands)
  • [ISO-abbreviation] Lung Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Ireland
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Taxoids; 15H5577CQD / docetaxel; Q20Q21Q62J / Cisplatin
  • [Number-of-references] 31
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16. Green MR: Perspectives and opportunities: Docetaxel in the current and future treatment of non-small cell lung cancer. Semin Oncol; 2002 Jun;29(3 Suppl 12):17-21
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  • [Title] Perspectives and opportunities: Docetaxel in the current and future treatment of non-small cell lung cancer.
  • Docetaxel is active as monotherapy in patients with advanced or metastatic non-small cell lung cancer.
  • More recently, the combination of docetaxel with cisplatin in chemotherapy-naive patients has been shown to be significantly superior to the vinorelbine/cisplatin combination in terms of both increased survival and reduced toxicity.
  • Docetaxel can be combined with nonplatinum agents such as gemcitabine to produce regimens that have substantial activity and a favorable therapeutic index.
  • In multimodality therapy, following platinum/etoposide chemoradiation with docetaxel may have played an important role in the encouraging outcome of the recent Southwest Oncology Group 9504 study.
  • Docetaxel can safely be combined with a platinum in patients receiving thoracic radiotherapy; and the combination is a candidate for induction therapy in patients with stage IB-IIIA disease.
  • There is also considerable promise in combining docetaxel with any of the large number of molecularly targeted therapies now becoming available.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / drug therapy. Deoxycytidine / analogs & derivatives. Lung Neoplasms / drug therapy. Paclitaxel / analogs & derivatives. Paclitaxel / therapeutic use. Taxoids
  • [MeSH-minor] Camptothecin / administration & dosage. Camptothecin / analogs & derivatives. Cisplatin / administration & dosage. Clinical Trials, Phase II as Topic. Drug Administration Schedule. Humans. Neoplasm Staging. Randomized Controlled Trials as Topic. Treatment Outcome

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  • [Copyright] Copyright 2002, Elsevier Science (USA). All rights reserved.
  • (PMID = 12170447.001).
  • [ISSN] 0093-7754
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Taxoids; 0W860991D6 / Deoxycytidine; 15H5577CQD / docetaxel; 7673326042 / irinotecan; B76N6SBZ8R / gemcitabine; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin; XT3Z54Z28A / Camptothecin
  • [Number-of-references] 22
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17. Sangha R, Price J, Butts CA: Adjuvant therapy in non-small cell lung cancer: current and future directions. Oncologist; 2010;15(8):862-72
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  • [Title] Adjuvant therapy in non-small cell lung cancer: current and future directions.
  • The cornerstone of treatment for early-stage non-small cell lung cancer (NSCLC) has long been surgical resection.
  • Over the past few years, there has been a paradigm shift to provide adjuvant platinum-based chemotherapy for patients with completely resected stage II-IIIA NSCLC founded on large randomized clinical trials demonstrating longer overall survival with this treatment.
  • Reassuringly, the National Cancer Institute of Canada Cancer Therapeutics Group JBR.10 trial recently reported a continued survival advantage for patients treated with adjuvant chemotherapy after >9 years of median follow-up.
  • In contrast, the gains from using this approach for stage IB disease are less clear, although data from an unplanned subgroup analysis suggest benefit for patients with tumors > or = 4 cm.
  • Herein, we review the evidence supporting adjuvant therapy in early-stage NSCLC patients before discussing key mitigating factors in providing treatment, such as stage of disease and the impact of the new seventh edition of the tumor-node-metastasis classification system.
  • Criteria such as patient age and performance status, as well as the value of appropriate chemotherapy selection, are highlighted as measures to help guide management.
  • The role of postoperative radiotherapy and the future landscape of early-stage NSCLC research are also explored; namely, therapeutic strategies exploiting pharmacogenomic and gene-expression profiling, in an attempt to personalize care, and the integration of novel targeted therapies into adjuvant clinical trials.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / therapy. Lung Neoplasms / therapy
  • [MeSH-minor] Aged. Combined Modality Therapy. Female. Humans. Male

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  • (PMID = 20682608.001).
  • [ISSN] 1549-490X
  • [Journal-full-title] The oncologist
  • [ISO-abbreviation] Oncologist
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC3228021
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18. Younes RN, Deutsch F, Badra C, Gross J, Haddad F, Deheinzelin D: Nonsmall cell lung cancer: evaluation of 737 consecutive patients in a single institution. Rev Hosp Clin Fac Med Sao Paulo; 2004 Jun;59(3):119-27
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Nonsmall cell lung cancer: evaluation of 737 consecutive patients in a single institution.
  • OBJECTIVE: To analyze surgical and pathological parameters and outcome and prognostic factors of patients with nonsmall cell lung cancer (NSCLC) who were admitted to a single institution, as well as to correlate these findings to the current staging system.
  • Following staging, a multidisciplinary team decision on adequate management was established.
  • Variables included in this analysis were age, gender, histology, Karnofsky index, weight loss, clinical stage, surgical stage, chemotherapy, radiotherapy, and survival rates.
  • The distribution of histologic type was squamous cell carcinoma 51.8%, adenocarcinoma 43.1%, and undifferentiated large cell carcinoma 5.1%.
  • Clinical staging was IA 3.8%, IB 9.2%, IIA 1.4%, IIB 8.1%, IIIA 20.9%, IIIB 22.4%, IV 30.9%.
  • Surgical stage distribution was IA 25.3%, IB 1.4%, IIB 17.1%, IIIA 16.1%, IIIB 20.3%, IV 11.5%.
  • Chemotherapy and radiotherapy were considered therapeutic options in 43% and 72%, respectively.
  • The overall 5-year survival rate of nonsmall cell lung cancer patients in our study was 28%.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / pathology. Lung Neoplasms / pathology

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  • (PMID = 15286831.001).
  • [ISSN] 0041-8781
  • [Journal-full-title] Revista do Hospital das Clínicas
  • [ISO-abbreviation] Rev Hosp Clin Fac Med Sao Paulo
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Brazil
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19. Merk J, Leschber G: Adjuvant therapy for lung cancer. Minerva Chir; 2009 Dec;64(6):599-609
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adjuvant therapy for lung cancer.
  • To improve outcome of patients with lung cancer, the leading cause of cancer mortality worldwide, a multidisciplinary approach is required.
  • Only approximately 30% of all lung cancer patients present with early stage disease (IA-IIIA).
  • For non-small cell lung cancer (NSCLC) complete surgical resection is currently considered to be the optimal treatment, but high rates of recurrence even after complete resection require to investigate regimes of additional therapy.
  • In the last years, evidence for adjuvant chemotherapy in stage II and III of NSCLC was shown, supported by large clinical trials and meta-analyses, while for stage IB disease the role of adjuvant chemotherapy remains controversial.
  • Further there is actually no evidence to support the routine use of adjuvant radiation or radio-chemotherapy in completely resected patients.
  • For small cell lung cancer (SCLC) a multimodality adjuvant approach is feasible in early stages, his definitive value however should be evaluated in further randomized trials.
  • Current efforts are directed toward identification of prognostic and predictive markers to individualize treatment stratification, a realistic goal for the future.
  • The current status and future perspectives of adjuvant therapy in lung cancer are reviewed in this manuscript.
  • [MeSH-major] Lung Neoplasms / therapy
  • [MeSH-minor] Carcinoma, Non-Small-Cell Lung / therapy. Chemotherapy, Adjuvant. Forecasting. Humans. Radiotherapy, Adjuvant

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  • (PMID = 20029357.001).
  • [ISSN] 0026-4733
  • [Journal-full-title] Minerva chirurgica
  • [ISO-abbreviation] Minerva Chir
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Number-of-references] 60
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20. Sulman EP, Komaki R, Klopp AH, Cox JD, Chang JY: Exclusion of elective nodal irradiation is associated with minimal elective nodal failure in non-small cell lung cancer. Radiat Oncol; 2009;4:5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Exclusion of elective nodal irradiation is associated with minimal elective nodal failure in non-small cell lung cancer.
  • BACKGROUND: Controversy still exists regarding the long-term outcome of patients whose uninvolved lymph node stations are not prophylactically irradiated for non-small cell lung cancer (NSCLC) treated with definitive radiotherapy.
  • To determine the frequency of elective nodal failure (ENF) and in-field failure (IFF), we examined a large cohort of patients with NSCLC staged with positron emission tomography (PET)/computed tomography (CT) and treated with 3-dimensional conformal radiotherapy (3D-CRT) that excluded uninvolved lymph node stations.
  • METHODS: We retrospectively reviewed the records of 115 patients with non-small cell lung cancer treated at our institution with definitive radiation therapy with or without concurrent chemotherapy (CHT).
  • RESULTS: The median follow-up time was 18 months (3 to 44 months) among all patients and 27 months (6 to 44 months) among survivors.
  • For 88 patients with stage IIIA/B, the frequencies of IFF, any ENF, isolated ENF, and DM were 23 (26%), 3 (9%), 1 (1.1%) and 36 (40.9%), respectively.
  • The comparable rates for the 22 patients with early stage node-negative disease (stage IA/IB) were 3 (13.6%), 1(4.5%), 0 (0%), and 5 (22.7%), respectively.
  • CONCLUSION: We observed only a 4.3% recurrence of any ENF and a 1.7% recurrence of isolated ENF in patients with NSCLC treated with definitive 3D-CRT without prophylactic irradiation of uninvolved lymph node stations.
  • Thus, distant metastasis and IFF remain the primary causes of treatment failure and cancer death in such patients, suggesting little value of ENI in this cohort.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / pathology. Carcinoma, Non-Small-Cell Lung / radiotherapy. Lung Neoplasms / pathology. Lung Neoplasms / radiotherapy. Lymphatic Irradiation. Patient Selection
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Follow-Up Studies. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Radiotherapy Planning, Computer-Assisted / methods. Retrospective Studies. Treatment Failure

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  • (PMID = 19183471.001).
  • [ISSN] 1748-717X
  • [Journal-full-title] Radiation oncology (London, England)
  • [ISO-abbreviation] Radiat Oncol
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P30 CA016672
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2651897
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21. Parente B, Queiroga H, Teixeira E, Sotto-Mayor R, Barata F, Sousa A, Melo MJ, João F, Neveda R, Cunha J, Fernandes A, Manuel M, Cardoso T, Ferreira L, Nogueira F, Duarte J, Semedo E, Brito U, Pimentel F, Barros S, Costa F, Almodôvar T, Araújo A: [Epidemiological study of lung cancer in Portugal (2000/2002)]. Rev Port Pneumol; 2007 Mar-Apr;13(2):255-65
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Epidemiological study of lung cancer in Portugal (2000/2002)].
  • [Transliterated title] Estudo epidemiológico do cancro do pulmão em Portugal nos anos de 2000/2002.
  • Lung cancer is the most common form of cancer death in the world.
  • It is the 3rd most prevalent type of cancer in Portugal and the primary cause of cancer death.
  • 85% of lung cancer cases are attributable to smoking.
  • One study performed in Portugal for 3 years (2000/2002) by the Lung Oncology Work Committee of the Portuguese Society of Pulmonology in 22 Hospitals showed that of a total of 4396 patients with lung cancer, 81.8% were male and 18.2% were female, with a mean age of 64.49 +/- 11.28 years.
  • Histologically, 37.5% were adenocarcinoma, followed by squamous carcinoma in 30.5% of cases, and small cell lung cancer in 12.5%; neuroendocrine carcinoma presented in 1.4% of cases; non small cell lung cancer in 10.5%; mixed carcinoma in 0.7%; large cell carcinoma in 2.3%; and others/not specified in 4.6% of cases.
  • Staging (known in 4097 patients), showed 113 patients in stage IA (2.8%)and 250 patients in stage IB (6.1%); only 0.8% in stage IIA and 4.5% in stage IIB; 9.1% in stage IIIA and 29.9% in stage IIIB; 46.9% were already in stage IV by the time of diagnosis.
  • The first therapeutic option was known in 3855 patients.
  • Surgery was performed in 8.2% and 21.8% of cases were treated with combined therapies (surgery and chemotherapy or radiotherapy, or combination of chemotherapy and radiotherapy); chemotherapy alone was first choice in 43.7% of patients and in 20.3% only best support therapy was chosen.
  • [MeSH-major] Lung Neoplasms / epidemiology

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  • (PMID = 17571453.001).
  • [ISSN] 0873-2159
  • [Journal-full-title] Revista portuguesa de pneumologia
  • [ISO-abbreviation] Rev Port Pneumol
  • [Language] por
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Portugal
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22. Tropé C, Kristensen GB, Abeler VM: Clear-cell and papillary serous cancer: treatment options. Best Pract Res Clin Obstet Gynaecol; 2001 Jun;15(3):433-46

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clear-cell and papillary serous cancer: treatment options.
  • Clear-cell carcinoma (CCC) and serous papillary carcinoma of the endometrium (UPSC) are rare subtypes of endometrial carcinoma (10%).
  • The histological diagnosis can be made on the dilation and curettage specimens in both types in a very high percentage of the cases.
  • This is important in the planning of treatment.
  • CCC and UPSC are associated with about 50% of all relapses occurring in endometrial carcinoma, and the 5-year survival rate is, on average, 42% and 27% respectively.
  • Surgico-pathological stage, age, and vessel invasion are independent prognostic factors for both groups.
  • Stage Ia patients treated with complete surgical staging alone have a low risk of relapse and need not be offered adjuvant systemic therapy or pelvic radiation.
  • The treatment of patients with CCC and UPSC stage Ib, Ic, II and III should include radical debulking surgery and some form of adjuvant therapy, but it is not clear which type is most effective.
  • Adjuvant pelvic radiotherapy plus intracavitary radiotherapy is usually given in early-stage disease and pelvic radio therapy/or whole abdomen irradiation plus adjuvant systemic chemotherapy (PAC) in advanced disease.
  • However, we are urgently waiting for a large prospective randomized study to compare both modalities.
  • [MeSH-major] Adenocarcinoma, Clear Cell / therapy. Cystadenocarcinoma, Papillary / therapy. Endometrial Neoplasms / therapy
  • [MeSH-minor] Age Factors. Aneuploidy. Combined Modality Therapy. Dilatation and Curettage. Female. Genes, p53. Humans. Liver Neoplasms / secondary. Lung Neoplasms / secondary. Neoplasm Invasiveness / genetics. Neoplasm Staging. Prognosis. Transcriptional Activation. Treatment Outcome

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  • [Copyright] Copyright 2001 Harcourt Publishers Ltd.
  • (PMID = 11476564.001).
  • [ISSN] 1521-6934
  • [Journal-full-title] Best practice & research. Clinical obstetrics & gynaecology
  • [ISO-abbreviation] Best Pract Res Clin Obstet Gynaecol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 61
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