FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2523133693> ?p ?o ?g. }

• W2523133693 endingPage "1614" @default.
• W2523133693 startingPage "1612" @default.
• W2523133693 abstract "Surgical resection is the main curative treatment modality for NSCLC. However, most patients with nodal metastasis die within 5 years.1Asamura H. Chansky K. Crowley J. et al.The International Association for the Study of Lung Cancer Lung Cancer Staging Project: proposals for the revision of the N descriptors in the forthcoming 8th edition of the TNM classification for lung cancer.J Thorac Oncol. 2015; 10: 1675-1684Abstract Full Text Full Text PDF PubMed Scopus (442) Google Scholar Currently available adjuvant therapy is modestly beneficial in such patients, engendering interest in the development of more effective adjuvant therapy for these high-risk patients.2PORT Meta-analysis Trialists GroupPostoperative radiotherapy in non-small-cell lung cancer: systematic review and meta-analysis of individual patient data from nine randomised controlled trials.Lancet. 1998; 352: 257-263Abstract Full Text Full Text PDF PubMed Scopus (848) Google Scholar, 3Pignon J. Tribodet H. Scagliotti G.V. et al.Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE collaborative group.J Clin Oncol. 2008; 26: 3552-3559Crossref PubMed Scopus (1782) Google Scholar The recent reports from the International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee are a clear reminder of the powerful prognostic value of pathologic nodal (pN) stage.1Asamura H. Chansky K. Crowley J. et al.The International Association for the Study of Lung Cancer Lung Cancer Staging Project: proposals for the revision of the N descriptors in the forthcoming 8th edition of the TNM classification for lung cancer.J Thorac Oncol. 2015; 10: 1675-1684Abstract Full Text Full Text PDF PubMed Scopus (442) Google Scholar, 4Goldstraw P. Chansky K. Crowley J. et al.The IASLC Lung Cancer Staging Project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer.J Thorac Oncol. 2016; 11: 39-51Abstract Full Text Full Text PDF PubMed Scopus (2294) Google Scholar These publications, based on retrospectively and prospectively collected data from Asia, Australia, Europe, and North and South America, emanate from the most robust analysis yet of elements associated with outcome differences in patients with lung cancer.5Rami-Porta R. Bolejack V. Giroux D.J. et al.The IASLC Lung Cancer Staging Project: the new database to inform the eighth edition of the TNM classification of lung cancer.J Thorac Oncol. 2014; 9: 1618-1624Abstract Full Text Full Text PDF PubMed Scopus (236) Google Scholar They highlight the prognostic importance of tumor size,6Rami-Porta R. Bolejack V. Crowley J. et al.The IASLC Lung Cancer Staging Project: proposals for the revisions of the T descriptors in the forthcoming eighth edition of the TNM classification for lung cancer.J Thorac Oncol. 2015; 10: 990-1003Abstract Full Text Full Text PDF PubMed Scopus (502) Google Scholar and validate the importance of the anatomic location of lymph node metastasis.1Asamura H. Chansky K. Crowley J. et al.The International Association for the Study of Lung Cancer Lung Cancer Staging Project: proposals for the revision of the N descriptors in the forthcoming 8th edition of the TNM classification for lung cancer.J Thorac Oncol. 2015; 10: 1675-1684Abstract Full Text Full Text PDF PubMed Scopus (442) Google Scholar A less strongly emphasized, but extremely interesting, lesson is the remarkable intercontinental differences in survival between patients with an ostensibly similar pN stage.1Asamura H. Chansky K. Crowley J. et al.The International Association for the Study of Lung Cancer Lung Cancer Staging Project: proposals for the revision of the N descriptors in the forthcoming 8th edition of the TNM classification for lung cancer.J Thorac Oncol. 2015; 10: 1675-1684Abstract Full Text Full Text PDF PubMed Scopus (442) Google Scholar In the analysis leading to the proposals for the eighth edition of the N descriptors, Asian patients with pN0 disease had a 79% 5-year survival rate compared with 67% for Americans, 58% for Australians, and 54% for Europeans. The results with pN1 disease were similarly disparate: 54%, 48%, 41%, and 34%, respectively. There was much less heterogeneity in survival of pN2 disease: 39%, 42%, 33%, and 22%, respectively.1Asamura H. Chansky K. Crowley J. et al.The International Association for the Study of Lung Cancer Lung Cancer Staging Project: proposals for the revision of the N descriptors in the forthcoming 8th edition of the TNM classification for lung cancer.J Thorac Oncol. 2015; 10: 1675-1684Abstract Full Text Full Text PDF PubMed Scopus (442) Google Scholar Do these disparities simply indicate biologic differences between these continental populations or do they reflect something else, such as differences in patient selection for surgery, the quality of surgery, the quality of the pathologic examination, and the appropriate use of adjuvant therapy? Biologic differences, such as the prevalence of prognostic and predictive driver mutations of EGFR, clearly exist between Asian and Western patients with lung cancer. However, this will not explain the differences between the American, Australian, and European populations. The similarity of survival of pN2 disease between the Asian and American populations supports the alternative hypothesis: these differences are (at least partially) caused by differences in the quality of pN staging, a task involving a surgeon and his or her pathologist. Nodal staging is the greatest source of diagnostic and prognostic uncertainty in potentially curable lung cancer. Clinical staging tests significantly underestimate pN stage.7D'Cunha J. Herndon J. Herzan D.L. et al.Poor correspondence between clinical and pathologic staging in stage 1 non-small cell lung cancer: results from CALGB 9761, a prospective trial.Lung Cancer. 2005; 48: 241-246Abstract Full Text Full Text PDF PubMed Scopus (88) Google Scholar Quality of pN staging is heterogeneous. For example, 12% to 18% of lung cancer resections in the United States have no lymph nodes examined (pNX), and the survival curve of pNX resections approximates that for pN1 disease more closely than that for pN0 disease.8Osarogiagbon R.U. Yu X. Nonexamination of lymph nodes and survival after resection of non-small cell lung cancer.Ann Thorac Surg. 2013; 96: 1178-1189Abstract Full Text Full Text PDF PubMed Scopus (69) Google Scholar From 40% to 60% of lung resections in the United States have no mediastinal lymph nodes examined, with significant detriment to survival,9Osarogiagbon R.U. Yu X. Mediastinal lymph node examination and survival in resected early-stage non-small-cell lung cancer in the surveillance, epidemiology, and end results database.J Thorac Oncol. 2012; 7: 1798-1806Abstract Full Text Full Text PDF PubMed Scopus (89) Google Scholar and the number of hilar/intrapulmonary lymph nodes examined in lung resection cases, even in tertiary care institutions in North America, is significantly lower than expected.10Osarogiagbon R.U. Decker P.A. Ballman K. Wigle D. Allen M.S. Darling G.E. Survival implications of variation in the thoroughness of pathologic lymph node examination in American College of Surgeons Oncology Group Z0030 (Alliance).Ann Thorac Surg. 2016; 102: 363-369Abstract Full Text Full Text PDF Scopus (50) Google Scholar Similar problems have been reported in Europe.11Verhagen A.F. Schoenmakers M.C. Barendregt W. et al.Completeness of lung cancer surgery: is mediastinal dissection common practice?.Eur J Cardiothorac Surg. 2012; 41: 834-838Crossref PubMed Scopus (53) Google Scholar Each of these examples of heterogeneous staging quality has a negative impact on the accuracy of staging, the understanding of residual postoperative risk, and the likelihood of selection of currently available adjuvant therapy. Even more importantly, this needless heterogeneity significantly impairs the testing of promising novel adjuvant therapies by increasing the risk of a false-negative result (type II error) and, therefore, the sample size required for clinical trials to be able to show true benefit. Adjuvant therapy trials therefore must either impose nodal staging quality restrictions (which have the practical effect of slowing down patient enrollment, as happened with the RADIANT trial) or use predefined quality parameters as stratification factors (as was done with Eastern Cooperative Oncology Group E1505), which inflates sample size. The intercontinental pN category comparison shines a beam of light on the breadth of the gap in quality of pN staging. This is a universal problem that must be solved with logic, rigor, and candor. A good starting point is to understand the origin of the problem. This can be distilled to three putative sites: events during the surgery, communication between the surgery and pathology teams (including the labeling and secure transportation of specimens), and events in the pathology laboratory.12Osarogiagbon R.U. Allen J.W. Farooq A. Wu J.T. Objective review of mediastinal lymph node examination in a lung cancer resection cohort.J Thorac Oncol. 2012; 7: 390-396Abstract Full Text Full Text PDF PubMed Scopus (58) Google Scholar, 13Ramirez R.A. Wang C.G. Miller L.E. et al.Incomplete intrapulmonary lymph node retrieval after routine pathologic examination of resected lung cancer.J Clin Oncol. 2012; 30: 2823-2828Crossref PubMed Scopus (87) Google Scholar The retrieval of hilar and mediastinal nodes depends entirely on the surgery team. Retrieval of intrapulmonary nodes, particularly stations 12 to 14, in most cases depends on the individual tasked with the gross dissection of the resection specimen in the pathology laboratory. Even when surgeons take the pains to dissect stations 11 and 12, retrieval of the more peripheral intrapulmonary lymph nodes remains of prognostic value.14Maeshima A.M. Tsuta K. Asamura H. Tsuda H. Prognostic implication of metastasis limited to segmental (level 13) and/or subsegmental (level 14) lymph nodes in patients with surgically resected nonsmall cell lung carcinoma and pathologic N1 lymph node status.Cancer. 2012; 118: 4512-4518Crossref PubMed Scopus (30) Google Scholar By applying crude logic to these domains of responsibility, one could hypothesize that differences in survival of pN0 disease suggest differences in the quality of the gross dissection of the resection specimen for intrapulmonary lymph nodes (surgical practice being equal), and differences in survival of pN1 disease reflect differences in the quality of the mediastinal nodal dissection (pathologic practice being equal). It is not surprising that differences in survival of pN2 disease are minimal, because such patients have largely overcome the vicissitudes of heterogeneous practice (although, in theory, there are potential differences in the quality of N3 nodal examination). These hypotheses can be tested, and where confirmed, they provide a means of designing effective quality improvement interventions. Such corrective interventions, once proved to be effective, must then be widely disseminated and properly implemented in all the places where patients choose to seek care for their lung cancer. The International Association for the Study of Lung Cancer’s ongoing prospective lung cancer staging project can catalyze the plan-do-study-act cycles required to achieve this broad and deep transformation of the worldwide quality of surgical resection by routinely providing details on the thoroughness of nodal examination, such as the rate of stage pNX; the rate of resections without mediastinal lymph node examination; and the distribution of nodal counts from intrapulmonary, hilar, mediastinal, and all stations. These parameters, if found to be of prognostic value, should then be embedded in the analyses used to determine the various prognostic factors in future iterations of the tumor, node, and metastasis staging system. Currently in the United States, the aggregate 5-year survival of patients with lung cancer is approximately 17.7%. This compares with 65.1% for patients with colorectal cancer and 89.7% for patients with breast cancer. These statistics largely reflect the absence of effective screening programs for lung cancer. However, as lung cancer screening becomes available worldwide, the challenge of improving the quality and outcomes of surgical care will only grow as more patients are identified at an early clinical stage. Improvement of surgical quality requires proper patient selection, the strategic use of preoperative staging tests, a preference for oncologically sound complete resection, minimization of perioperative death (ensuring that more patients survive the surgery), and accurate determination of residual long-term postoperative risk (ensuring that more patients survive the cancer). Transforming the near-universal perception of lung cancer as a death sentence will require success in all these aspects of curative-intent surgical care. Such population-level outcome improvements have been demonstrated in Japan.15Asamura H. Goya T. Koshiishi Y. et al.A Japanese lung cancer registry study. Prognosis of 13,010 resected lung cancers.J Thorac Oncol. 2008; 3: 46-53Abstract Full Text Full Text PDF PubMed Scopus (370) Google Scholar Achieving greater uniformity in pathologic staging and surgical outcomes would open the door to rapid understanding of the real biologic drivers of differences in surgical outcome, leading to the place where the future of lung cancer lies—its banishment as the oncologic scourge of our age. This work was supported by grant R01CA172253." @default.
• W2523133693 created "2016-09-30" @default.
• W2523133693 creator A5006021643 @default.
• W2523133693 creator A5017685562 @default.
• W2523133693 creator A5021752702 @default.
• W2523133693 creator A5036843800 @default.
• W2523133693 creator A5045624001 @default.
• W2523133693 creator A5062012032 @default.
• W2523133693 date "2016-10-01" @default.
• W2523133693 modified "2023-10-13" @default.
• W2523133693 title "Comment on the Proposals for the Revision of the N Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Lung Cancer" @default.
• W2523133693 cites W1521983415 @default.
• W2523133693 cites W1907932102 @default.
• W2523133693 cites W1981302939 @default.
• W2523133693 cites W2001734426 @default.
• W2523133693 cites W2011526788 @default.
• W2523133693 cites W2026676774 @default.
• W2523133693 cites W2041555601 @default.
• W2523133693 cites W2052992819 @default.
• W2523133693 cites W2104504726 @default.
• W2523133693 cites W2154951566 @default.
• W2523133693 cites W2165831947 @default.
• W2523133693 cites W2228221433 @default.
• W2523133693 cites W2235547202 @default.
• W2523133693 cites W2416631205 @default.
• W2523133693 cites W4256661845 @default.
• W2523133693 doi "https://doi.org/10.1016/j.jtho.2016.06.008" @default.
• W2523133693 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/27663398" @default.
• W2523133693 hasPublicationYear "2016" @default.
• W2523133693 type Work @default.
• W2523133693 sameAs 2523133693 @default.
• W2523133693 citedByCount "19" @default.
• W2523133693 countsByYear W25231336932017 @default.
• W2523133693 countsByYear W25231336932018 @default.
• W2523133693 countsByYear W25231336932019 @default.
• W2523133693 countsByYear W25231336932020 @default.
• W2523133693 countsByYear W25231336932021 @default.
• W2523133693 countsByYear W25231336932022 @default.
• W2523133693 countsByYear W25231336932023 @default.
• W2523133693 crossrefType "journal-article" @default.
• W2523133693 hasAuthorship W2523133693A5006021643 @default.
• W2523133693 hasAuthorship W2523133693A5017685562 @default.
• W2523133693 hasAuthorship W2523133693A5021752702 @default.
• W2523133693 hasAuthorship W2523133693A5036843800 @default.
• W2523133693 hasAuthorship W2523133693A5045624001 @default.
• W2523133693 hasAuthorship W2523133693A5062012032 @default.
• W2523133693 hasBestOaLocation W25231336931 @default.
• W2523133693 hasConcept C143998085 @default.
• W2523133693 hasConcept C2776256026 @default.
• W2523133693 hasConcept C61434518 @default.
• W2523133693 hasConcept C71924100 @default.
• W2523133693 hasConceptScore W2523133693C143998085 @default.
• W2523133693 hasConceptScore W2523133693C2776256026 @default.
• W2523133693 hasConceptScore W2523133693C61434518 @default.
• W2523133693 hasConceptScore W2523133693C71924100 @default.
• W2523133693 hasIssue "10" @default.
• W2523133693 hasLocation W25231336931 @default.
• W2523133693 hasLocation W25231336932 @default.
• W2523133693 hasOpenAccess W2523133693 @default.
• W2523133693 hasPrimaryLocation W25231336931 @default.
• W2523133693 hasRelatedWork W1967103478 @default.
• W2523133693 hasRelatedWork W2019250753 @default.
• W2523133693 hasRelatedWork W2032912323 @default.
• W2523133693 hasRelatedWork W2102644969 @default.
• W2523133693 hasRelatedWork W2372561159 @default.
• W2523133693 hasRelatedWork W2375344515 @default.
• W2523133693 hasRelatedWork W2390152934 @default.
• W2523133693 hasRelatedWork W3208701539 @default.
• W2523133693 hasRelatedWork W4313346385 @default.
• W2523133693 hasRelatedWork W4317816533 @default.
• W2523133693 hasVolume "11" @default.
• W2523133693 isParatext "false" @default.
• W2523133693 isRetracted "false" @default.
• W2523133693 magId "2523133693" @default.
• W2523133693 workType "article" @default.