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Research paper thumbnail of ДОЛЕСПЕЦИФИЧЕСКОЕ МЕТАСТАЗИРОВАНИЕ ПРИ НЕМЕЛКОКЛЕТОЧНОМ РАКЕ ЛЕГКОГО

Siberian journal of oncology, Oct 27, 2021

Аннотация Цель исследования-определить пути лимфогенного метастазирования при различной локализац... more Аннотация Цель исследования-определить пути лимфогенного метастазирования при различной локализации немелкоклеточного рака легкого. материал и методы. Проанализированы частота поражения лимфоузлов средостения и результаты лечения 327 больных с i-iii стадией немелкоклеточного рака легкого с систематической лимфодиссекцией, прооперированных в Югре. результаты. При локализации опухоли в любой доле правого легкого метастазирование происходило в лимфоузлы верхнего и нижнего средостения. При локализации опухоли в левом легком основные пути метастазирования-лимфоузлы верхнего, нижнего средостения и аортальные лимфоузлы. При поражении нижней доли левого легкого чаще всего метастазирование происходило в лимфоузлы нижнего средостения. При любой локализации опухоли были «прыжковые» метастазы. В 19,5 % случаев произошло увеличение стадии при рутинном исследовании всех ипсилатеральных медиастинальных лимфоузлов. Общая 5-летняя выживаемость у больных с немелкоклеточным раком легкого i-iii стадии с принципиальной систематической лимфодиссекцией составила 61,5 %, 10-летняя-49,2 %. Медиана выживаемости составила 103 мес. заключение. Несмотря на определенные закономерности лимфогенного метастазирования в средостении при немелкоклеточном раке легкого, при любой локализации имелось «нетипичное» метастазирование. Это требует выполнения обязательной систематической лимфодиссекции. ключевые слова: рак легкого, хирургическое лечение, систематическая лимфодиссекция, лимфогенное метастазирование. lobe-speciFic metastasis iN NoN-small cell luNg caNceR a.a. aksarin 1 , m.d. ter-ovanesov 2 , a.a. mordovsky 1 , s.m. Kopeyka 1 , p.p. troyan 1

Research paper thumbnail of ESMO Translational Research Fellowship - Zoltan Lohinai

Introduction Malignant pleural mesothelioma (MPM) is a devastating thoracic malignancy with const... more Introduction Malignant pleural mesothelioma (MPM) is a devastating thoracic malignancy with constantly rising incidence over the past decades. Currently, the therapeutic management has shifted from single therapy approaches to multimodality treatment strategies including chemotherapy, radical surgery, and radiation. The combination of cisplatin with pemetrexed is the standard first-line systemic therapy. The recently published phase 3 MAPS study demonstrated that the addition of bevacizumab, a VEGF (vascular endothelial growth factor) neutralizing antibody, to chemotherapy significantly prolongs patients' overall survival (OS). However, the survival benefit achieved with antiangiogenic drugs is modest (can be measured only in a few months). The limited success achieved with these drugs is due in large part to therapy resistance, although the mechanisms of tumor vascularization and resistance against antiangiogenic drugs are poorly understood. The spread of malignant cells to lym...

Research paper thumbnail of P3.04-012 Bronchial Sutures in Anatomic Pulmonary Resections: The Clinical Experience of 865 Cases

Journal of Thoracic Oncology, 2017

Results: All were male and the average age was 76 years (64-86) at the time of surgery. The avera... more Results: All were male and the average age was 76 years (64-86) at the time of surgery. The average duration between SBRT and the surgery was 20 months (10-105). Pathological diagnosis was adenocarcinoma in 7, squamous cell carcinoma in 4, and others in 2. Lobectomy was performed in 10 patients, segmentectomy in 2 and wedge resection in 1. Because the irradiated area was mainly confined to the peripheral lungs, central pulmonary structures were intact after irradiation. There was almost no pleural adhesion related to the irradiation. There was no perioperative mortality and 4 patients had morbidities. One patient had a conversion from VATS to thoracotomy due to bleeding and 3 patients had prolonged air leak postoperatively. The resected tumor diameter ranged from 12 to 50 mm with a median of 33 mm. Viable tumor cells were found in the specimens of all patients. Two patients were positive on mediastinal lymph nodes and were offered adjuvant chemotherapy. At a mean follow-up of 52 months (range, 13 to 103 months), the 3 and 5 year survival rates were 72% and 41%, respectively. Conclusion: Salvage surgery after SBRT was feasible and provided encouraging outcome.

Research paper thumbnail of P1.07-022 The Role of Surgery in Combination Treatment of Patients with Small Cell Lung Cancer

Journal of Thoracic Oncology, 2017

Research paper thumbnail of Neutrophil–lymphocyte ratio is prognostic in early stage resected small-cell lung cancer

Background: For selected early stage small cell lung cancer (SCLC), curative intent surgery is of... more Background: For selected early stage small cell lung cancer (SCLC), curative intent surgery is often performed. Previous studies, predominantly from East Asia, reported that high neutrophil to lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) correlate with poor prognosis in several types of tumors including SCLC. Our aim was to investigate the prognostic value of NLR and PLR in Caucasian patients with resected SCLC, as potential tool to select patients for multimodal treatment including surgery. Methods: Consecutive patients evaluated at three centers between 2000 and 2013 with histologically confirmed and surgically resected SCLC were retrospectively analyzed. NLR and PLR at diagnosis was used to categorize patients into "high" and "low" groups based on receiver operating curve analysis. Univariate and multivariate analyses were used to evaluate the impact of clinical and pathological characteristics on outcome. Results: There were a total of 189 patients with a median age of 58 years, and the majority had stage I or II disease. We found a significant correlation between NLR and tumor stage (p ¼ 0.007) and age (p ¼ 0.038). Low NLR (LNLR) was associated with significantly longer overall survival, while PLR had no prognostic impact. There were significant associations between NLR and PLR but not with gender, vascular involvement, tumor necrosis, peritumoral inflammation, or tumor grade. Conclusion: Pre-operative LNLR may be a favorable prognostic factor in stage I-II SCLCs. PLR is not prognostic in this population. LNLR is easy to assess and can be integrated into routine clinical practice. Further prospective studies are needed to confirm these observations.

Research paper thumbnail of ДОЛЕСПЕЦИФИЧЕСКОЕ МЕТАСТАЗИРОВАНИЕ ПРИ НЕМЕЛКОКЛЕТОЧНОМ РАКЕ ЛЕГКОГО

Siberian journal of oncology, Oct 27, 2021

Аннотация Цель исследования-определить пути лимфогенного метастазирования при различной локализац... more Аннотация Цель исследования-определить пути лимфогенного метастазирования при различной локализации немелкоклеточного рака легкого. материал и методы. Проанализированы частота поражения лимфоузлов средостения и результаты лечения 327 больных с i-iii стадией немелкоклеточного рака легкого с систематической лимфодиссекцией, прооперированных в Югре. результаты. При локализации опухоли в любой доле правого легкого метастазирование происходило в лимфоузлы верхнего и нижнего средостения. При локализации опухоли в левом легком основные пути метастазирования-лимфоузлы верхнего, нижнего средостения и аортальные лимфоузлы. При поражении нижней доли левого легкого чаще всего метастазирование происходило в лимфоузлы нижнего средостения. При любой локализации опухоли были «прыжковые» метастазы. В 19,5 % случаев произошло увеличение стадии при рутинном исследовании всех ипсилатеральных медиастинальных лимфоузлов. Общая 5-летняя выживаемость у больных с немелкоклеточным раком легкого i-iii стадии с принципиальной систематической лимфодиссекцией составила 61,5 %, 10-летняя-49,2 %. Медиана выживаемости составила 103 мес. заключение. Несмотря на определенные закономерности лимфогенного метастазирования в средостении при немелкоклеточном раке легкого, при любой локализации имелось «нетипичное» метастазирование. Это требует выполнения обязательной систематической лимфодиссекции. ключевые слова: рак легкого, хирургическое лечение, систематическая лимфодиссекция, лимфогенное метастазирование. lobe-speciFic metastasis iN NoN-small cell luNg caNceR a.a. aksarin 1 , m.d. ter-ovanesov 2 , a.a. mordovsky 1 , s.m. Kopeyka 1 , p.p. troyan 1

Research paper thumbnail of ESMO Translational Research Fellowship - Zoltan Lohinai

Introduction Malignant pleural mesothelioma (MPM) is a devastating thoracic malignancy with const... more Introduction Malignant pleural mesothelioma (MPM) is a devastating thoracic malignancy with constantly rising incidence over the past decades. Currently, the therapeutic management has shifted from single therapy approaches to multimodality treatment strategies including chemotherapy, radical surgery, and radiation. The combination of cisplatin with pemetrexed is the standard first-line systemic therapy. The recently published phase 3 MAPS study demonstrated that the addition of bevacizumab, a VEGF (vascular endothelial growth factor) neutralizing antibody, to chemotherapy significantly prolongs patients' overall survival (OS). However, the survival benefit achieved with antiangiogenic drugs is modest (can be measured only in a few months). The limited success achieved with these drugs is due in large part to therapy resistance, although the mechanisms of tumor vascularization and resistance against antiangiogenic drugs are poorly understood. The spread of malignant cells to lym...

Research paper thumbnail of P3.04-012 Bronchial Sutures in Anatomic Pulmonary Resections: The Clinical Experience of 865 Cases

Journal of Thoracic Oncology, 2017

Results: All were male and the average age was 76 years (64-86) at the time of surgery. The avera... more Results: All were male and the average age was 76 years (64-86) at the time of surgery. The average duration between SBRT and the surgery was 20 months (10-105). Pathological diagnosis was adenocarcinoma in 7, squamous cell carcinoma in 4, and others in 2. Lobectomy was performed in 10 patients, segmentectomy in 2 and wedge resection in 1. Because the irradiated area was mainly confined to the peripheral lungs, central pulmonary structures were intact after irradiation. There was almost no pleural adhesion related to the irradiation. There was no perioperative mortality and 4 patients had morbidities. One patient had a conversion from VATS to thoracotomy due to bleeding and 3 patients had prolonged air leak postoperatively. The resected tumor diameter ranged from 12 to 50 mm with a median of 33 mm. Viable tumor cells were found in the specimens of all patients. Two patients were positive on mediastinal lymph nodes and were offered adjuvant chemotherapy. At a mean follow-up of 52 months (range, 13 to 103 months), the 3 and 5 year survival rates were 72% and 41%, respectively. Conclusion: Salvage surgery after SBRT was feasible and provided encouraging outcome.

Research paper thumbnail of P1.07-022 The Role of Surgery in Combination Treatment of Patients with Small Cell Lung Cancer

Journal of Thoracic Oncology, 2017

Research paper thumbnail of Neutrophil–lymphocyte ratio is prognostic in early stage resected small-cell lung cancer

Background: For selected early stage small cell lung cancer (SCLC), curative intent surgery is of... more Background: For selected early stage small cell lung cancer (SCLC), curative intent surgery is often performed. Previous studies, predominantly from East Asia, reported that high neutrophil to lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) correlate with poor prognosis in several types of tumors including SCLC. Our aim was to investigate the prognostic value of NLR and PLR in Caucasian patients with resected SCLC, as potential tool to select patients for multimodal treatment including surgery. Methods: Consecutive patients evaluated at three centers between 2000 and 2013 with histologically confirmed and surgically resected SCLC were retrospectively analyzed. NLR and PLR at diagnosis was used to categorize patients into "high" and "low" groups based on receiver operating curve analysis. Univariate and multivariate analyses were used to evaluate the impact of clinical and pathological characteristics on outcome. Results: There were a total of 189 patients with a median age of 58 years, and the majority had stage I or II disease. We found a significant correlation between NLR and tumor stage (p ¼ 0.007) and age (p ¼ 0.038). Low NLR (LNLR) was associated with significantly longer overall survival, while PLR had no prognostic impact. There were significant associations between NLR and PLR but not with gender, vascular involvement, tumor necrosis, peritumoral inflammation, or tumor grade. Conclusion: Pre-operative LNLR may be a favorable prognostic factor in stage I-II SCLCs. PLR is not prognostic in this population. LNLR is easy to assess and can be integrated into routine clinical practice. Further prospective studies are needed to confirm these observations.