Introduction: Limited consensus exists on the optimal treatment strategy for clinical M1a non-small-cell lung cancer (NSCLC) presenting as a primary tumor with additional intrapulmonary nodules in a contralateral lobe ("M1a-Contra"). This study sought to compare long-term survival of patients with M1a-Contra tumors receiving multimodal therapy with versus without thoracic surgery.
Methods: Overall survival of patients with cT1-4, N0-3, M1a NSCLC with contralateral intrapulmonary nodules who received surgery as part of multimodal therapy ("Thoracic Surgery") versus systemic therapy with or without radiation ("No Thoracic Surgery") in the National Cancer Database from 2010 to 2015 was evaluated using Kaplan-Meier analysis, Cox proportional hazards modeling, and propensity score matching.
Results: Of the 5042 patients who satisfied study inclusion criteria, 357 (7.1%) received multimodal therapy including surgery. In multivariable-adjusted analysis, the Thoracic Surgery cohort had better overall survival than the No Thoracic Surgery cohort (HR: 0.66, 95% CI: 0.56-0.79, P < 0.001). In a propensity score-matched analysis of 386 patients, well-balanced on 12 common prognostic covariates, the Thoracic Surgery group had better 5-year overall survival than the No Thoracic Surgery group (P = 0.020). In propensity score-matched analyses stratified by clinical N status, Thoracic Surgery was associated with better overall survival than No Thoracic Surgery for patients with cN0 disease and cN1-2 disease.
Conclusions: In this national analysis, multimodal treatment including surgery was associated with better overall survival than systemic therapy with or without radiation without surgery for patients with M1a-Contra tumors. These preliminary findings highlight the importance of further evaluation of surgery in a multidisciplinary treatment setting for M1a-Contra tumors.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jss.2023.10.025 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Monitoring Treatment Fidelity in a Pragmatic Pediatric Rehabilitation Trial Comparing Two Physical Therapy Schedules: Analysis and Unexpected Findings.
Phys Ther
January 2025
School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, United States.
Objective: This study aimed to describe the monitoring of treatment fidelity in a pragmatic pediatric rehabilitation trial using the National Institutes of Health Behavior Change Consortium framework, and to identify child and therapist factors that influence treatment fidelity.
Methods: Therapists (n = 28) were trained in the key ingredients (1-on-1, functional, goal-directed, motor learning intervention) and study protocol for a comparative effectiveness trial titled: A Comparison: High Intensity periodic vs. Every week therapy in children with cerebral palsy (ACHIEVE) for children ages 2 to 8 years with cerebral palsy.
Diagnostic Role of Endoscopic Ultrasound in Cardiac Angiosarcoma.
JACC Case Rep
January 2025
Cardiology Department, Schoen Hospital Neustadt, Holstein, Germany.
Primary cardiac tumors are a rare disease, with 20% of the cases being malignant. Among them, angiosarcoma is characterized by a short clinical course and poor prognosis, even after surgery, chemotherapy, and radiation therapy. We present a 67-year-old woman diagnosed with a primary malignant tumor (angiosarcoma) infiltrating the right atrial myocardium.
View Article and Find Full Text PDFRight Atrial and Bicaval Reconstruction for Cardiac Sarcoma.
JACC Case Rep
December 2024
Division of Cardiac Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
Sarcomas represent the most common primary cardiac malignancy. A poor prognosis can be improved with multimodal management including aggressive surgical reconstruction in combination with neoadjuvant or adjuvant therapy. We present the case of a primary cardiac sarcoma to describe our approach to a more radical right atrial and bicaval reconstruction.
View Article and Find Full Text PDFPlasma exchange alone versus combination with intravenous immunoglobulin/methylprednisolone pulse therapy in severe systemic rheumatic diseases: a retrospective study.
Front Immunol
January 2025
Department of Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China.
Background: For severe systemic rheumatic diseases (SRDs), therapeutic plasma exchange (TPE) may be applied as a rescue therapy; it usually combined with intravenous immunoglobulin (IVIG) or intravenous methylprednisolone pulse (IVMP) in severe SRDs. However, the necessity of this combination treatment strategy in SRDs remains uncertain.
Objective: This retrospective study aimed to evaluate the effectiveness of TPE alone versus TPE combined with IVIG/IVMP in treating severe SRDs.
Endoscopic and imaging evaluations of the primary tumor response in patients with proficient mismatch repair colorectal cancer treated with neoadjuvant combination immunotherapy.
Tech Coloproctol
January 2025
Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
Background: Neoadjuvant combination immunotherapy is a potential treatment option for patients with proficient mismatch repair/microsatellite stable colorectal cancer. Preoperative screening via endoscopy and imaging examinations could help identify patients who may potentially achieve a complete response after neoadjuvant combination immunotherapy. This study aims to evaluate the diagnostic accuracy of endoscopic and imaging examinations in predicting pathological complete response after neoadjuvant combination immunotherapy.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!