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Nilssen Y, Brustugun OT, Fjellbirkeland L, Grønberg BH, Haram PM, Helbekkmo N, Helland Å, Wahl SGF, Aanerud M, Solberg S. Small Cell Lung Cancer in Norway: Patterns of Care by Health Region and Survival Trends. Clin Lung Cancer 2024:S1525-7304(24)00046-9. [PMID: 38692990 DOI: 10.1016/j.cllc.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/19/2024] [Accepted: 04/04/2024] [Indexed: 05/03/2024]
Abstract
INTRODUCTION/BACKGROUND There has been a marked survival improvement for patients with non-small-cell lung cancer. We describe the national trends in characteristics and survival, and geographical differences in diagnostic workup, treatment, and survival for patients with small-cell lung cancer (SCLC). MATERIALS AND METHODS Patients registered with SCLC at the Cancer Registry of Norway in 2002 to 2022 were included. Trends in overall survival were estimated for all SCLC patients, patients with limited stage SCLC, patients undergoing surgery, and by health region. Adjusting for case-mix, a multivariable Cox regression was performed examining the association between health region and death. RESULTS The study included 8374 patients. The stage distribution remained unchanged during the study period. The 5-year overall survival increased from 7.7% to 22.8% for patients with limited stage. The use of multidisciplinary team meetings varied from 62.5% to 85.7%, and the use of positron emission tomography-computer tomography varied from 70.4% to 86.2% between the health regions. Treatment patterns differed markedly between the health regions, with the proportion dying without any registered treatment ranging from 1.2% to 10.9%. For limited stage patients in 2018 to 2022, the median overall survival ranged from 16.5 to 25.5 months across health regions, and the 5-year overall survival ranged from 18.7% to 28.7% (P = .019). CONCLUSION The survival for patients with SCLC remains poor. The use of diagnostic procedures, treatment modalities, and survival differed between regions, warranting investigations to further explore the reasons.
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Affiliation(s)
- Yngvar Nilssen
- Department of Registration, Cancer Registry of Norway, Oslo, Norway
| | - Odd Terje Brustugun
- Section of Oncology, Vestre Viken Hospital Trust, Drammen, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars Fjellbirkeland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Respiratory Medicine, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Bjørn Henning Grønberg
- Department of Oncology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Per Magnus Haram
- Department of Cardiothoracic Surgery, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Nina Helbekkmo
- Department of Pulmonology, University Hospital of North Norway, Tromsø, Norway
| | - Åslaug Helland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Sissel Gyrid Freim Wahl
- Department of Pathology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Marianne Aanerud
- Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Steinar Solberg
- Department of Registration, Cancer Registry of Norway, Oslo, Norway; Department of Cardiothoracic Surgery, Rikshospitalet, Oslo University Hospital, Oslo, Norway.
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Lin J, Li Y, Lin X, Che C. Fusion of laser-induced breakdown spectroscopy technology and deep learning: a new method to identify malignant and benign lung tumors with high accuracy. Anal Bioanal Chem 2024; 416:993-1000. [PMID: 38063906 DOI: 10.1007/s00216-023-05089-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/25/2023] [Accepted: 11/28/2023] [Indexed: 01/23/2024]
Abstract
Precisely distinguishing between malignant and benign lung tumors is pivotal for suggesting therapeutic strategies and enhancing prognosis, yet this differentiation remains a daunting task. The growth rates, metastatic potentials, and prognoses of benign and malignant tumors differ significantly. Developing specialized treatment protocols tailored to various tumor types is essential for enhancing patient survival outcomes. Employing laser-induced breakdown spectroscopy (LIBS) in conjunction with a deep learning methodology, we attained a high-precision differential diagnosis of malignant and benign lung tumors. First, LIBS spectra of malignant tumors, benign tumors, and normal tissues were collected. The spectra were preprocessed and Z score normalized. Then, the intensities of the Mg II 279.6, Mg I 285.2, Ca II 393.4, Cu II 518.3, and Na I 589.6 nm lines were analyzed in the spectra of the three tissues. The analytical results show that the elemental lines have different contents in the three tissues and can be used as a basis for distinguishing between the three tissues. Finally, the RF-1D ResNet model was constructed by combining the feature importance assessment method of random forest (RF) and one-dimensional residual network (1D ResNet). The classification accuracy, precision, sensitivity, and specificity of the RF-1D ResNet model were 91.1%, 91.6%, 91.3%, and 91.3%, respectively. And the model demonstrates superior performance with an area under the curve (AUC) value of 0.99. The above results show that combining LIBS with deep learning is an effective way to diagnose malignant and benign tumors.
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Affiliation(s)
- Jingjun Lin
- Changchun University of Technology, Changchun, 130012, Jilin, China
| | - Yao Li
- Changchun University of Technology, Changchun, 130012, Jilin, China
| | - Xiaomei Lin
- Changchun University of Technology, Changchun, 130012, Jilin, China.
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Ji H, Hu C, Yang X, Liu Y, Ji G, Ge S, Wang X, Wang M. Lymph node metastasis in cancer progression: molecular mechanisms, clinical significance and therapeutic interventions. Signal Transduct Target Ther 2023; 8:367. [PMID: 37752146 PMCID: PMC10522642 DOI: 10.1038/s41392-023-01576-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 07/04/2023] [Accepted: 07/26/2023] [Indexed: 09/28/2023] Open
Abstract
Lymph nodes (LNs) are important hubs for metastatic cell arrest and growth, immune modulation, and secondary dissemination to distant sites through a series of mechanisms, and it has been proved that lymph node metastasis (LNM) is an essential prognostic indicator in many different types of cancer. Therefore, it is important for oncologists to understand the mechanisms of tumor cells to metastasize to LNs, as well as how LNM affects the prognosis and therapy of patients with cancer in order to provide patients with accurate disease assessment and effective treatment strategies. In recent years, with the updates in both basic and clinical studies on LNM and the application of advanced medical technologies, much progress has been made in the understanding of the mechanisms of LNM and the strategies for diagnosis and treatment of LNM. In this review, current knowledge of the anatomical and physiological characteristics of LNs, as well as the molecular mechanisms of LNM, are described. The clinical significance of LNM in different anatomical sites is summarized, including the roles of LNM playing in staging, prognostic prediction, and treatment selection for patients with various types of cancers. And the novel exploration and academic disputes of strategies for recognition, diagnosis, and therapeutic interventions of metastatic LNs are also discussed.
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Affiliation(s)
- Haoran Ji
- Department of Thoracic Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Chuang Hu
- Department of Thoracic Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Xuhui Yang
- Department of Thoracic Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yuanhao Liu
- Department of Thoracic Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Guangyu Ji
- Department of Thoracic Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Shengfang Ge
- Department of Ophthalmology, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xiansong Wang
- Department of Thoracic Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Mingsong Wang
- Department of Thoracic Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
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Konishi K, Kuwahara H, Morita D, Imai S, Nagata K. Prolonged Survival in a Patient With Extensive-Stage Small Cell Lung Cancer in Spite of Discontinued Immunotherapy With Atezolizumab. Cureus 2023; 15:e37757. [PMID: 37213944 PMCID: PMC10198584 DOI: 10.7759/cureus.37757] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 05/23/2023] Open
Abstract
A 64-year-old man was referred from a local clinic with a chief complaint of cough. Computed tomography (CT) revealed a mass comprising a tumor in the right lower lobe and enlarged mediastinal lymph nodes, and a whole-body workup with positron emission tomography-CT showed bilateral lymph node enlargement and cancerous pericarditis. Biopsy with bronchoscopy of the right lower lobe tumor and mediastinal lymph node confirmed the histological findings of small cell lung carcinoma. The clinical diagnosis of extensive-stage small cell lung cancer (ES-SCLC) was confirmed, and first-line treatment with carboplatin, etoposide, and atezolizumab was initiated, followed by tri-weekly atezolizumab thrice. The patient experienced worsening pleural effusion treated with thoracentesis, pleural drainage, and pleurodesis. He also experienced several recurrences, which were managed with second and third-line chemotherapy with nogitecan and amrubicin. He has been receiving third-line therapy for over 30 months since his initial visit and remains stable as of today. The patient experienced an exceptional treatment outcome considering that the prognosis of ES-SCLC remains poor, with a median survival of approximately 10 months with conventional chemotherapies using cytotoxic agents. The use of immune checkpoint inhibitors (ICI) for ES-SCLC as first-line treatment may demonstrate a persistent antitumor effect, and result in improved survival following discontinuation. In conclusion, therapy including ICI for patients with ES-SCLC is a treatment option that shows possibilities in improving survival even after discontinuation.
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Affiliation(s)
- Kazuhisa Konishi
- Department of Respiratory Medicine, Koseikai Takeda Hospital, Kyoto, JPN
| | - Hiroomi Kuwahara
- Department of Respiratory Medicine, Koseikai Takeda Hospital, Kyoto, JPN
| | - Daiki Morita
- Department of Respiratory Medicine, Koseikai Takeda Hospital, Kyoto, JPN
| | - Shunsuke Imai
- Department of Pathology, Koseikai Takeda Hospital, Kyoto, JPN
| | - Kazuhiro Nagata
- Department of Respiratory Medicine, Koseikai Takeda Hospital, Kyoto, JPN
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