Personalized targeted therapy for esophageal squamous cell carcinoma

Esophageal squamous cell carcinoma continues to heavily burden clinicians worldwide. Researchers have discovered the genomic landscape of esophageal squamous cell carcinoma, which holds promise for an era of personalized oncology care. One of the most pressing problems facing this issue is to improve the understanding of the newly available genomic data, and identify the driver-gene mutations, pathways, and networks. The emergence of a legion of novel targeted agents has generated much hope and hype regarding more potent treatment regimens, but the accuracy of drug selection is still arguable. Other problems, such as cancer heterogeneity, drug resistance, exceptional responders, and side effects, have to be surmounted. Evolving topics in personalized oncology, such as interpretation of genomics data, issues in targeted therapy, research approaches for targeted therapy, and future perspectives, will be discussed in this editorial

Take A Calm View on Heat Wave of Organ Preservation in Esophageal Cancer Treatment

The esophagus plays an extremely important physiological function in human body, and esophageal cancer is a highly lethal disease among all the malignancies. Esophagectomy is still the main treatment for locally advanced esophageal cancer. Ensuring the efficacy of oncology plays a crucial role in exploring organ preservation in the treatment of esophageal cancer. We should always be aware of the inherent difficulties and potential harms of organ preservation for esophageal cancer treatment and seek a personalized and reasonable balance between ensuring cure and preserving organs, provide the best treatment design for esophageal cancer patients, to achieve maximum therapeutic effect without sacrificing the life quality of patients

The Conceptual Oligometastatic Non-small Cell Lung Cancer and Therapeutic Strategies

Non-small cell lung cancer (NSCLC) ranks among the most prevalent malignancies and is the major cause of cancer-related deaths worldwide. Nearly 20%-50% will accompany by metastatic disease and the most common extrapulmonary sites of distant metastases are the brain, bone, liver and adrenal gland. The oligometastatic state is a biologically mild tumor stage and a intermediate state in which spread may be limited to specific organs and metastases might be present in limited numbers. Oligometastases are thought to arise from micrometastases, which have been dormant for a period of time. Local control may be an crucial component of a curative therapeutic strategy in the following four clinical schemes: to prohibit metastases; to cure occult metastatic disease; to remedy oligometastases; and to deracinate any residual lesion after systemic therapy. This review aims to outline the concept of the oligometastatic NSCLC and its strategies of treatment

Thymic Tumors Preface

胸腺肿瘤是一类少见疾病，发病仅为0.17/10万，亚裔人种略高于白种人，约0.3-0.4/10万。胸腺瘤研究与投入均较少，诊断与治疗缺乏统一的指南，尤其在术前定性诊断、组织学分型、术前治疗、手术方式、术后治疗以及对术后复发的治疗等一系列问题上均处于不规范状态。很多医生也对该疾病的治疗经验有限，而且研究进展缓慢，但是对于患者和家属，这是不可接受的理由。2003年美国患者Barbara Neibauer身患胸腺肿瘤，虽经积极的治疗，但仍于两年后去世。Barbara Neibauer去世后，为促进胸腺瘤的研究，其家族出资于2005年成立了全球首个关于胸腺肿瘤的基金会即FTCR（Foundation for Thymic Cancer Research）。2010年5月5日由美国NIH （National Institutes of Health）牵头，在FTCR的基础上于纽约成立了专业胸腺肿瘤学术组织，即ITMIG （International Thymic Malignacy Interest Group）。随后，日本也成立了相应的胸腺肿瘤学术组织即JART（Japanese Association for Research on the hTymus）。2012年6月由方文涛、陈克能等教授发起，在上海成立了中国胸腺肿瘤协作组（ChART），并与JART一同加入到ITMIG。PubMed中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)0273-741

The Evaluation of Pneumonectomy and Bronchoplasty Lobectomy in the Treatment of Non-small Cell Lung Cancer: A Report of 64 Cases

Background and objective Pneumonectomy was the initial successful surgery to treat lung cancer, but there has been being a lot of controversy since its inception. The aim of this study is to evaluate its potential role in the treatment of lung cancer through analyzing the survival for 64 cases underwent pneumonectomy or bronchoplasty lobectomy out of 804 cases underwent lung resection. Methods Eight hundred and four cases of lung cancer underwent pulmonary surgery. We retrospectively reviewed the clinical data, especially foucused on the survival of 64 pneumonectomies or bronchoplasty lobectomies. Results Of the 64 patients, 25 underwent pneumonectomy (6 right, 19 left) due to involvement of ipsilateral pulmonary artery trunk. Owning to involving ipsilateral main bronchus with the distance of tumor from carina <2 cm, 4 pneumonectomies, 19 right upper bronchoplasty lobectomies, 1 left upper sleeve lobectomy and 1 left lower sleeve lobectomy were performed. Due to the ipsilateral main bronchus involvement with the distance of tumor from carina ≥2 cm, 13 cases underwent main bronchus bronchoplasty. One performed right sleeve pneumonectomy because of carina involvement. Overall 1-, 3- and 5-year survival rates of 64 pneumonectomies or bronchoplasty lobectomies were 93.6%, 69.0% and 45.1%, respectively, and that of 489 standard lobectomies done by the same surgery team in the same period were 92.5%, 77.3% and 56.9%, respectively. There was no significant difference in 5-year cumulative survival rates between the two groups (P=0.226). Conclusion Although standard lobectomy remains the main type of surgery, pneumonectomy or bronchoplasty lobectomy is still one of option for the highly selective patients combining the support of induction chemotherapy

Diagnostic Utility of Virtual Bronchoscopic Navigation Assisted Endobronchial Ultrasonography with Guide Sheath for Peripheral Pulmonary Lesions

Background and objective Virtual bronchoscopic navigation (VBN) assisted endobronchial ultrasonography with guide sheath (EBUS-GS) has reduced the difficulty and even avoiding radiation exposure during performing transbronchus lung biopsy (TBLB). To evaluate the feasibility and safety of virtual bronchoscopic navigation assisted endobronchial ultrasonography with guide sheath for peripheral pulmonary lesions. Methods We performed a retrospective analysis of the patients with PPLs who received VBN assisted EBUS-GS-TBLB in Peking University Cancer Hospital from January 2016 to December 2017. Their clinicopathologic data and complications were assessed. Results A total of 121 patients were enrolled in the study. The patients included 65 men and 56 women, with a mean age of (58.8±10.3) years. A total of 121 PPLs were examined, and 108 lesions of which could be detected by EBUS. The overall diagnostic yield of EBUS-GS was 73.5%. The diagnostic yield of malignancy was 82.5%. The combination of transbronchial lung biopsy, brush smear and bronchoalveolar lavage fluid provided the greatest diagnostic yield (χ2=6.084, P=0.014). Factors that significantly affected and predicted diagnostic success were EBUS probe within the lesions (χ2=20.372, P=0.000) and PPLs located in the central two-thirds of the lung (χ2=10.810, P=0.001). 1 patient (0.8%) suffered from intraoperative bleeding which could be managed under endoscopy. Conclusion VBN assisted EBUS-GS-TBLB for PPLs was an effective and safe procedure

Application of 18F-FDG PET/CT in Pulmonary Disease: A Report of 419 Cases

Background and objective The application and the value of PET/CT in lung cancer are on the way to development. The aim of this study is to summarize the data from 419 patients with pulmonary tumor or tumor-like disease and to explore the appliance of PET/CT. Methods From Dec 2007 to Aug 2011, 594 patients with pulmonary tumor or tumor-like disease underwent PET/CT examination during the different course of treatment, which were treated by single surgery team from Peking University Cancer Hospital. Of these patients, 419 cases diagnosed pathologically were included into study. The clinicapathological and follow-up data were collected to analyze the value of PET/CT in diagnosis, TNM staging, therapy response evaluation and posttherapy monitoring. Results Four hundred and nineteen cases comprised of 63 benign and 356 malignant, of which, 338 were primary lung cancer, and 18 were metastases. The SUVmax cutoff was defined as 2.5 to differentiate the benign and malignant disease. PET/CT obtained the role of diagnosis with sensitivity as 85.0%, specificity as 52.4%, accuracy rate as 79.2%, positive predictive value as 89.2% and negative predictive value as 42.9%, respectively. Of 338 primary cases, 275 underwent PET/CT at initial diagnosis, in which, 46 (16.7%) distant metastasis were found, including 8 additional metastasis not found by conventional utilities. Six of 43 recurrences were found by PET/CT following conventional examination. In T staging, SUVmax is positively correlated with diameter of tumors (P<0.05). In N staging, 610 stations of lymph nodes were resected from 168 cases, with 37 stations predicted as positive by PET/CT and 102 stations pathologically proven positive, therefore, calculating the sensitivity as 36.3%, specificity as 93.9%, accuracy rate as 84.3%, positive predictive value as 54.4% and negative predictive value as 88.0%, respectively. Ten patients underwent PET/CT scan for chemotherapy response evaluation, with SUVmax changing following T downstaging. Conclusion PET/CT is one optional method for diagnosis of pulmonary tumors. In TNM staging, PET/CT showed the superiority than conventional utilities in M staging, but possesses the high specificity but inferior sensitivity in N staging. Therefore, PET/CT should be used as routine examination for postoperation follow-up. Furthermore, PET/CT performed the outstanding role in chemotherapy response evaluation