Chemotherapy and prognosis in advanced thymic carcinoma patients

OBJECTIVE: The role of chemotherapy in treating advanced thymic carcinoma is unclear. The purpose of the current study was to investigate the efficacy of chemotherapy and the prognostic factors for patients with advanced thymic carcinoma. METHODS: A retrospective review of the medical records of 86 patients treated with chemotherapy for advanced thymic carcinoma was conducted between 2000 and 2012 at our institution. The clinical characteristics, chemotherapy regimens and prognostic factors were analyzed. Survival curves were plotted using the Kaplan-Meier method and the Cox proportional hazard model was used for multivariate analysis. RESULTS: Of the 86 patients, 56 were male and 30 were female. The median survival time was 24.5 months. For the first-line chemotherapy treatment, the objective response rate was 47.7% and the disease control rate was 80.2%. The median progression-free survival for all patients was 6.5 months for first-line chemotherapy. No significant differences in progression-free survival were observed among the different chemotherapy regimens. Multivariate analyses revealed that the prognostic factors for overall survival included performance status (p=0.043), histology grade (p=0.048), and liver metastasis (p=0.047). CONCLUSION: Our results suggest that there is no difference in efficacy between multiagent and doublet regimens. The prognosis of patients with advanced thymic carcinoma can be predicted based on histological grade, liver metastasis and performance status

Progress in Tissue Specimens Alternative for the Driver Genes Testing of Non-small Cell Lung Cancer

Target treatment based on driver genes in advanced non-small cell lung cancer is very important currently. Tumor tissues is the gold standard for driver genes testing. However, most of patients could not get the gene information for lack of enough tissues. To explore the tissue specimens alternatives is a hot spot in clinical work. This report reviews the tissue specimen alternatives of driver gene testing in non-small cell lung cancer

Effects of intrapericardial administration after catheter drainage on malignant pericardial effusion in non‐small cell lung cancer: A real‐world study

Abstract Background Malignant pericardial effusion (MPE) is a serious complication of cancer that can be potentially deadly. It usually occurs in advanced or terminal stages of the disease, and as a result, patients with MPE often have a poor prognosis. There is a limited amount of research available that directly compares the effectiveness and safety of intrapericardial drug administration following pericardial drainage versus catheter drainage alone in non‐small cell lung cancer (NSCLC) patients who have MPE. Methods We retrospectively included 86 patients with NSCLC with MPE at Zhejiang Cancer Hospital. Survival and recurrence estimates were determined with the Kaplan–Meier method. Results We divided the 86 patients with NSCLC into two groups: a pericardial drainage group (34 out of 86, 39.5%) and an intrapericardial administration group (52 out of 86, 60.5%). The response rates were 70.6% and 76.9% (p = 0.510), respectively. The median OS was 132.0 and 234.0 days (p = 0.579), respectively. The median time to recurrent drainage was 43.0 and 104.0 days (p = 0.170), respectively. The incidence of adverse events (AEs) was 44.1% and 61.5% (p = 0.113), respectively. The most frequent AEs were pain (27.9%) and fever (24.4%). Additionally, two patients in the intrapericardial administration group died of cardiac arrest. Conclusions Compared with catheter drainage alone, intrapericardial medication infusion during catheter drainage did not have significantly different effects. AEs require close monitoring and management

Chemotherapy and prognosis in advanced thymic carcinoma patients

OBJECTIVE: The role of chemotherapy in treating advanced thymic carcinoma is unclear. The purpose of the current study was to investigate the efficacy of chemotherapy and the prognostic factors for patients with advanced thymic carcinoma. METHODS: A retrospective review of the medical records of 86 patients treated with chemotherapy for advanced thymic carcinoma was conducted between 2000 and 2012 at our institution. The clinical characteristics, chemotherapy regimens and prognostic factors were analyzed. Survival curves were plotted using the Kaplan-Meier method and the Cox proportional hazard model was used for multivariate analysis. RESULTS: Of the 86 patients, 56 were male and 30 were female. The median survival time was 24.5 months. For the first-line chemotherapy treatment, the objective response rate was 47.7% and the disease control rate was 80.2%. The median progression-free survival for all patients was 6.5 months for first-line chemotherapy. No significant differences in progression-free survival were observed among the different chemotherapy regimens. Multivariate analyses revealed that the prognostic factors for overall survival included performance status (p=0.043), histology grade (p=0.048), and liver metastasis (p=0.047). CONCLUSION: Our results suggest that there is no difference in efficacy between multiagent and doublet regimens. The prognosis of patients with advanced thymic carcinoma can be predicted based on histological grade, liver metastasis and performance status

Therapeutic efficacy of gefitinib and erlotinib in patients with advanced lung adenosquamous carcinoma

Background: Adenosquamous carcinoma (ASC) of the lung is a rare subtype of nonsmall-cell lung cancer (NSCLC). To date, the efficacious targeted therapy for advanced ASC remains unclear and the epidermal growth factor receptor (EGFR) mutation rate is not well known. Methods: We retrospectively reviewed clinical information of patients with ASC who were treated with gefitinib or erlotinib at Zhejiang Cancer Hospital between January 2007 and December 2011. Survival analysis was evaluated by the Kaplan-Meier method. EGFR mutations were assessed in part using direct sequencing methods. Results: In total, 49 patients with a median age of 57 years were used in this study. Thirteen patients achieved a partial response and 19 had disease stabilization. The objective response rate was 26.5%, and the disease control rate was 65.3%. The median progression-free survival and overall survival were 4.3 and 17.6 months, respectively. In 21 patients with adequate specimens for molecular analysis, 7 (33.3%) had EGFR mutations (4 with deletions within exon 19 and 3 with L858R messenger mutation in exon 21). EGFR mutations were significantly more frequent in women (4/9, 44.4%) than men (3/12, 25%), never-smokers (6/15, 40%), and smokers (1/6, 16.7%). Conclusion: EGFR-tyrosine kinase inhibitor (TKI) is an effective treatment for ASC. The frequency of EGFR mutation and clinical characteristics of the EGFR mutants in ASC are similar to those of Asian patients with adenocarcinoma

Analysis of the tumor length and other prognosis factors in pT1-2 node-negative esophageal squamous cell carcinoma in a Chinese population

<p>Abstract</p> <p>Background</p> <p>Tumor length is an important prognostic factor for many carcinomas, but its role in esophageal cancer remained undetermined. The aim of this study was to investigate the effect of tumor length on survival for patients with confined tumors (grade pT1-2) without lymph-node metastases in esophageal squamous cell carcinoma.</p> <p>Methods</p> <p>We enrolled 201 patients with esophageal squamous cell carcinoma (SCC) who had undergone surgical resection and been confirmed as pT1-2N0M0. The relationship of tumor length with overall survival was assessed and compared with other factors detailed in the American Joint Committee on Cancer (AJCC) tumor, node, metastasis (TNM) staging system published in 2009.</p> <p>Results</p> <p>The overall survival (OS) rates at 1, 3, and 5 years were 93.0%, 83.7%, and 69.2%, respectively. The tumor length adversely affected OS, with the 5-year rate being 93.5%, 82.0%, 68.6%, 67.9%, 55.3% and 41.1%, respectively for tumor lengths of less than 10 mm, 10 to 20 mm, 20 to 30 mm, 30 to 40 mm, 40 to 50 mm, and greater than 50 mm (<it>P</it>< 0.001). Multivariate analyses showed that the pathologic T classification and grade of tumor was significantly associated with OS. Tumor length of 30 mm or more remained an independent prognostic factor (<it>P</it> = 0.04), as did the other current TNM factors.</p> <p>Conclusion</p> <p>Tumor length appears to affect the OS of patients with early-stage esophageal squamous cell carcinoma. It may provide additional prognostic information for the current TNM staging system.</p

Advances of Molecular Subtype and Targeted Therapy of Lung Cancer

The discovery of multiple molecular mechanisms underlying the development, progression, and prognosis of lung cancer, has created new opportunities for targeted therapy. Each subtype is associated with molecular tests that define the subtype and drugs that may have potential therapeutic effect on lung cancer. In 2004, mutations in the epidermal growth factor receptor (epidermal growth factor receptor, EGFR) gene were discovered in non-small cell lung cancers (NSCLC), especially in adenocarcinomas. And they are strongly associated with sensitivity to EGFR-tyrosine kinase inhibitors (EGFR-TKIs). Moreover, in 2007 the existence of the echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) fusion gene was discovered in NSCLC, and the same as EGFR-TKIs, ALK inhibitors are being found to be highly effective in lung cancers. At present, multiple molecular subtype of lung cancer and relevant targeted drugs are undering study. Here, we review the remarkable progress in molecular subtype of lung cancer and the related targeted therapy

Retrospective Study on Lobe-specific Lymph Node Dissection for Patients with Early-stage Non-small Cell Lung Cancer

Background and objective The aim of this study is to explore the effects of different modes of lymph node dissection in early-stage non-small cell lung cancer (NSCLC) on the survival rate, to study the prognostic factors, and to discuss the clinical application of lobe-specific lymph node dissection. Methods A total of 379 patients with completely resected pathological stage I NSCLC between the years 1998 and 2005 at Shanghai Chest Hospital were retrospectively analyzed. Among the patients, 148 were placed in the systematic lymph node dissection group and 150 in the lobe-specific lymph node dissection group. All of them were in pathological stage I (T1a-2aN0M0). The differences between the two groups were compared. Results No statistical difference was found between the two sets of data in terms of the clinical and pathological features of distribution (P&gt;0.05). The overall survival distribution between the two groups had no statistical difference (P&gt;0.05). The pathological stage, pathological type, and tumor size significantly differed between the two groups. The duration of surgery, blood loss, blood transfusion, drain secretion, duration of drainage, and duration of hospital stay also significantly differed between the two groups (P&lt;0.01). The complications significantly differed between the two groups as well (P&lt;0.05). Conclusion Systematic lymph node dissection does not improve the five-year survival rates in pathological stage I NSCLC. The pathological stage, pathological type, and tumor size critically affect the prognosis. Lobe-specific lymph node dissection can significantly reduce complications and perioperative risks