1,034 results on '"pulmonary metastases"'
Search Results
2. Study of Outcomes of Radiofrequency Ablation of Lung Tumors
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RITA Medical Systems and James Luketich, Professor
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- 2024
3. Development of a CT-Based comprehensive model combining clinical, radiomics with deep learning for differentiating pulmonary metastases from noncalcified pulmonary hamartomas: a retrospective cohort study.
- Author
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Yunze Liu, Hong Ren, Yanbin Pei, Leilei Shen, Juntang Guo, Jian Zhou, Chengrun Li, and Yang Liu
- Abstract
Background: Clinical differentiation between pulmonary metastases and noncalcified pulmonary hamartomas (NCPH) often presents challenges, leading to potential misdiagnosis. However, the efficacy of a comprehensive model that integrates clinical features, radiomics, and deep learning (CRDL) for differential diagnosis of these two diseases remains uncertain. Objective: This study evaluated the diagnostic efficacy of a CRDL model in differentiating pulmonary metastases from NCPH. Methods: The authors retrospectively analyzed the clinical and imaging data of 256 patients from the First Medical Centre of the General Hospital of the People's Liberation Army (PLA) and 85 patients from Shanghai Changhai Hospital, who were pathologically confirmed pulmonary hamartomas or pulmonary metastases after thoracic surgery. Employing Python 3.7 software suites, the authors extracted radiomic features and deep learning (DL) attributes from patient datasets. The cohort was divided into training set, internal validation set, and external validation set. The diagnostic performance of the constructed models was evaluated using receiver operating characteristic (ROC) curve analysis to determine their effectiveness in differentiating between pulmonary metastases and NCPH. Results: Clinical features such as white blood cell count (WBC), platelet count (PLT), history of cancer, carcinoembryonic antigen (CEA) level, tumor marker status, lesion margin characteristics (smooth or blurred), and maximum diameter were found to have diagnostic value in differentiating between the two diseases. In the domains of radiomics and DL. Of the 1130 radiomics features and 512 DL features, 24 and 7, respectively, were selected for model development. The area under the ROC curve (AUC) values for the four groups were 0.980, 0.979, 0.999, and 0.985 in the training set, 0.947, 0.816, 0.934, and 0.952 in the internal validation set, and 0.890, 0.904, 0.923, and 0.938 in the external validation set. This demonstrated that the CRDL model showed the greatest efficacy. Conclusions: The comprehensive model incorporating clinical features, radiomics, and DL shows promise for aiding in the differentiation between pulmonary metastases and hamartomas. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
4. Pulmonary Resectable Metastases of Osteosarcoma With Anti-angiogenics and CHemotherapy (PROACH)
- Author
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Weibin Zhang, MD, PhD., Professor
- Published
- 2023
5. Predictors of pulmonary metastases on chest computed tomography in children and adolescents with osteosarcoma—tips for qualifying patients for thoracotomy
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Marek Duczkowski, Agnieszka Duczkowska, Anna Olwert, Elżbieta Michalak, Katarzyna Bilska, Teresa Klepacka, Magdalena Rychłowska-Pruszyńska, Anna Raciborska, and Monika Bekiesińska-Figatowska
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Osteosarcoma ,Pulmonary metastases ,Computed tomography ,Thoracotomy ,Metastasectomy ,Children ,Pediatrics ,RJ1-570 - Abstract
Abstract Background Osteosarcoma is the most common primary malignant bone tumour in children and adolescents. Lungs are the most frequent and often the only site of metastatic disease. The presence of pulmonary metastases is a significant unfavourable prognostic factor. Thoracotomy is strongly recommended in these patients, while computed tomography (CT) remains the gold imaging standard. The purpose of our study was to create tools for the CT-based qualification for thoracotomy in osteosarcoma patients in order to reduce the rate of useless thoracotomies. Methods Sixty-four osteosarcoma paediatric patients suspected of lung metastases on CT and their first-time thoracotomies (n = 100) were included in this retrospective analysis. All CT scans were analysed using a compartmental evaluation method based on the number and size of nodules. Calcification and location of lung lesions were also analysed. Inter-observer reliability between two experienced radiologists was assessed. The CT findings were then correlated with the histopathological results of thoracotomies. Various multivariate predictive models (logistic regression, classification tree and random forest) were built and predictors of lung metastases were identified. Results All applied models proved that calcified nodules on the preoperative CT scan best predict the presence of pulmonary metastases. The rating of the operated lung on the preoperative CT scan, dependent on the number and size of nodules, and the total number of nodules on this scan were also found to be important predictors. All three models achieved a relatively high sensitivity (72–92%), positive predictive value (81–90%) and accuracy (74–79%). The positive predictive value of each model was higher than of the qualification for thoracotomy performed at the time of treatment. Inter-observer reliability was at least substantial for qualitative variables and excellent for quantitative variables. Conclusions The multivariate models built and tested in our study may be useful in the qualification of osteosarcoma patients for metastasectomy through thoracotomy and may contribute to reducing the rate of unnecessary invasive procedures in the future.
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- 2024
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6. Predictors of pulmonary metastases on chest computed tomography in children and adolescents with osteosarcoma—tips for qualifying patients for thoracotomy.
- Author
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Duczkowski, Marek, Duczkowska, Agnieszka, Olwert, Anna, Michalak, Elżbieta, Bilska, Katarzyna, Klepacka, Teresa, Rychłowska-Pruszyńska, Magdalena, Raciborska, Anna, and Bekiesińska-Figatowska, Monika
- Subjects
THORACOTOMY ,OSTEOSARCOMA ,METASTASIS ,CHILD patients ,COMPUTED tomography - Abstract
Background: Osteosarcoma is the most common primary malignant bone tumour in children and adolescents. Lungs are the most frequent and often the only site of metastatic disease. The presence of pulmonary metastases is a significant unfavourable prognostic factor. Thoracotomy is strongly recommended in these patients, while computed tomography (CT) remains the gold imaging standard. The purpose of our study was to create tools for the CT-based qualification for thoracotomy in osteosarcoma patients in order to reduce the rate of useless thoracotomies. Methods: Sixty-four osteosarcoma paediatric patients suspected of lung metastases on CT and their first-time thoracotomies (n = 100) were included in this retrospective analysis. All CT scans were analysed using a compartmental evaluation method based on the number and size of nodules. Calcification and location of lung lesions were also analysed. Inter-observer reliability between two experienced radiologists was assessed. The CT findings were then correlated with the histopathological results of thoracotomies. Various multivariate predictive models (logistic regression, classification tree and random forest) were built and predictors of lung metastases were identified. Results: All applied models proved that calcified nodules on the preoperative CT scan best predict the presence of pulmonary metastases. The rating of the operated lung on the preoperative CT scan, dependent on the number and size of nodules, and the total number of nodules on this scan were also found to be important predictors. All three models achieved a relatively high sensitivity (72–92%), positive predictive value (81–90%) and accuracy (74–79%). The positive predictive value of each model was higher than of the qualification for thoracotomy performed at the time of treatment. Inter-observer reliability was at least substantial for qualitative variables and excellent for quantitative variables. Conclusions: The multivariate models built and tested in our study may be useful in the qualification of osteosarcoma patients for metastasectomy through thoracotomy and may contribute to reducing the rate of unnecessary invasive procedures in the future. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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7. Cannonball Pulmonary Metastases as Initial Presentation of Hepatocellular Carcinoma: A Case Report and Literature Review
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Héctor Raúl Ibarra-Sifuentes, Gustavo Abraham Canales-Azcona, Jaqueline Isabel Gómez-Arredondo, and Carlos Javier Rodríguez-Álvarez
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Hepatocellular carcinoma ,Metastases ,Cannonball metastases ,Pulmonary metastases ,Case report ,Surgery ,RD1-811 ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract Background Hepatocellular carcinoma is a major public health problem, as is considered the fastest growing cause of cancer-related death. Cannonball metastases as an initial finding in hepatocellular carcinoma are considered a rare phenomenon. Case Presentation A 59-year-old man presented to the outpatient clinic for subacute cough, asthenia, and involuntary weight loss. Chest X-ray showed multiple, round, bilateral pulmonary solid lesions. Contrast-enhanced computed tomography of the chest and abdomen revealed multiple bilateral, contrast-enhanced pulmonary nodules known as "cannonball" lesions and a heterogeneous lesion located in the right lobe of the liver with retroperitoneal lymphadenopathy. A biopsy was performed, and the histopathological result was compatible with metastatic poorly differentiated hepatocellular carcinoma. Due to the advanced stage of the disease, the patient received palliative care and expired two months later. Conclusion Cannonball metastases in hepatocellular carcinoma are considered a rare finding and represents a poor prognosis. It is important to awaken the interest of clinicians in a timely diagnosis, as well as a possible suspicion of hepatocellular carcinoma in patients with this radiographic pattern.
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- 2024
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8. In Vivo Lung Perfusion for Pulmonary Metastases of Sarcoma
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- 2023
9. A Randomised Trial of Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC)
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Royal Brompton & Harefield NHS Foundation Trust, University of Cambridge, and University of Sussex
- Published
- 2023
10. Cannonball Pulmonary Metastases as Initial Presentation of Hepatocellular Carcinoma: A Case Report and Literature Review.
- Author
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Ibarra-Sifuentes, Héctor Raúl, Canales-Azcona, Gustavo Abraham, Gómez-Arredondo, Jaqueline Isabel, and Rodríguez-Álvarez, Carlos Javier
- Abstract
Background: Hepatocellular carcinoma is a major public health problem, as is considered the fastest growing cause of cancer-related death. Cannonball metastases as an initial finding in hepatocellular carcinoma are considered a rare phenomenon. Case Presentation: A 59-year-old man presented to the outpatient clinic for subacute cough, asthenia, and involuntary weight loss. Chest X-ray showed multiple, round, bilateral pulmonary solid lesions. Contrast-enhanced computed tomography of the chest and abdomen revealed multiple bilateral, contrast-enhanced pulmonary nodules known as "cannonball" lesions and a heterogeneous lesion located in the right lobe of the liver with retroperitoneal lymphadenopathy. A biopsy was performed, and the histopathological result was compatible with metastatic poorly differentiated hepatocellular carcinoma. Due to the advanced stage of the disease, the patient received palliative care and expired two months later. Conclusion: Cannonball metastases in hepatocellular carcinoma are considered a rare finding and represents a poor prognosis. It is important to awaken the interest of clinicians in a timely diagnosis, as well as a possible suspicion of hepatocellular carcinoma in patients with this radiographic pattern. [ABSTRACT FROM AUTHOR]
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- 2024
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11. Multiplexed analysis of macrophage polarisation in pulmonary metastases of microsatellite stable colorectal cancer.
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Karjula, Topias, Elomaa, Hanna, Väyrynen, Sara A., Kuopio, Teijo, Ahtiainen, Maarit, Mustonen, Olli, Puro, Iiris, Niskakangas, Anne, Mecklin, Jukka-Pekka, Böhm, Jan, Wirta, Erkki-Ville, Seppälä, Toni T., Sihvo, Eero, Yannopoulos, Fredrik, Helminen, Olli, and Väyrynen, Juha P.
- Abstract
Tumour-associated macrophages (TAMs) express a continuum of phenotypes ranging from an anti-tumoural M1-like phenotype to a pro-tumoural M2-like phenotype. During cancer progression, TAMs may shift to a more M2-like polarisation state, but the role of TAMs in CRC metastases is unclear. We conducted a comprehensive spatial and prognostic analysis of TAMs in CRC pulmonary metastases and corresponding primary tumours using multiplexed immunohistochemistry and machine learning-based image analysis. We obtained data from 106 resected pulmonary metastases and 74 corresponding primary tumours. TAMs in the resected pulmonary metastases were located closer to the cancer cells and presented a more M2-like polarised state in comparison to the primary tumours. Higher stromal M2-like macrophage densities in the invasive margin of pulmonary metastases were associated with worse 5-year overall survival (HR 3.19, 95% CI 1.35–7.55, p = 0.008). The results of this study highlight the value of multiplexed analysis of macrophage polarisation in cancer metastases and might have clinical implications in future cancer therapy. [ABSTRACT FROM AUTHOR]
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- 2024
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12. Mapping the metabolic responses to oxaliplatin-based chemotherapy with in vivo spatiotemporal metabolomics.
- Author
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Olkowicz, Mariola, Ramadan, Khaled, Rosales-Solano, Hernando, Yu, Miao, Wang, Aizhou, Cypel, Marcelo, and Pawliszyn, Janusz
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METABOLOMICS ,ADJUVANT chemotherapy ,CANCER chemotherapy ,PROTON magnetic resonance spectroscopy ,ANTINEOPLASTIC agents ,LUNG diseases - Abstract
Adjuvant chemotherapy improves the survival outlook for patients undergoing operations for lung metastases caused by colorectal cancer (CRC). However, a multidisciplinary approach that evaluates several factors related to patient and tumor characteristics is necessary for managing chemotherapy treatment in metastatic CRC patients with lung disease, as such factors dictate the timing and drug regimen, which may affect treatment response and prognosis. In this study, we explore the potential of spatial metabolomics for evaluating metabolic phenotypes and therapy outcomes during the local delivery of the anticancer drug, oxaliplatin, to the lung. 12 male Yorkshire pigs underwent a 3 h left lung in vivo lung perfusion (IVLP) with various doses of oxaliplatin (7.5, 10, 20, 40, and 80 mg/L), which were administered to the perfusion circuit reservoir as a bolus. Biocompatible solid-phase microextraction (SPME) microprobes were combined with global metabolite profiling to obtain spatiotemporal information about the activity of the drug, determine toxic doses that exceed therapeutic efficacy, and conduct a mechanistic exploration of associated lung injury. Mild and subclinical lung injury was observed at 40 mg/L of oxaliplatin, and significant compromise of the hemodynamic lung function was found at 80 mg/L. This result was associated with massive alterations in metabolic patterns of lung tissue and perfusate, resulting in a total of 139 discriminant compounds. Uncontrolled inflammatory response, abnormalities in energy metabolism, and mitochondrial dysfunction next to accelerated kynurenine and aldosterone production were recognized as distinct features of dysregulated metabolipidome. Spatial pharmacometabolomics may be a promising tool for identifying pathological responses to chemotherapy. [Display omitted] • The potential of in vivo spatiotemporal metabolomics was explored for evaluating the chemotherapy outcome. • SPME microprobes were employed with global metabolite profiling. • Metabolic phenotypes were identified during the local delivery of oxaliplatin to the porcine lung. • Massive alterations in the metabolic patterns were recognized being indicative of acute lung injury (ALI). • Spatiotemporal metabolomics may improve ALI diagnosis and facilitate adjustments to the chemotherapy regimen. [ABSTRACT FROM AUTHOR]
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- 2024
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13. Construction of Microfluidic Exosome Chip for Diagnosis of Lung Metastasis of Osteosarcoma
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- 2022
14. CT-Based Screening for Pulmonary Metastases in Head and Neck Squamous Cell Cancers: Diagnostic Accuracy and Cost Comparison with PET-CECT.
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Mahajan, Abhishek, Shukla, Shreya, Nandi, Debanjan, Sable, Nilesh, Ankathi, Suman Kumar, Vaish, Richa, Patil, Vasundhara, Sahu, Arpita, Bhattacharya, Kajari, Agarwal, Ujjwal, Pai, Prathamesh, Laskar, Sarbani Ghosh, Chaukar, Devendra, Prabhash, Kumar, Cruz, Anil D.', Patil, Asawari, Pantvaidya, Gouri, Noronha, Vanita, Patil, Vijay, and Menon, Nandini
- Abstract
This study's objective was to compare detection rates of radiograph, computed tomography (CT), and positron emission tomography-contrast-enhanced computed tomography (PET-CECT) for pulmonary metastasis/synchronous primary lung tumors in head and neck squamous cell cancer (HNSCC) and its association with clinico-radio-pathological factors. Our retrospective study included 837 HNSCC patients from January 2012 to December 2017. Lung nodules were characterized on CT as benign, indeterminate, and metastatic. The true detection rate and statistical significance of associated risk factors were calculated. Risk factors for metastasis were determined using univariate and multivariate logistic regression models. Seventy-five (8.9%) patients had pulmonary metastasis and 3 (0.3%) had second lung primary. Detection rate of pulmonary metastasis by CT was higher (sensitivity-97.3%, specificity-97.2%) as compared to radiograph (sensitivity 49% and specificity 89%). Correlation was found between pulmonary and extra-pulmonary metastasis and N classification (P = 0.01, P = 0.02) and positive low jugular node (P = 0.001, P = 0.001). Using PET-CECT in place of CT costed an extra outlay of 7,033,805 INR (95,551.85 USD) while detecting distant metastasis in only 4 (0.47%) extra cases. Chest CT is a useful pulmonary metastases screening tool in advanced HNSCC patients with reasonable imaging cost as compared to PET-CT. [ABSTRACT FROM AUTHOR]
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- 2023
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15. Synchronous mucinous metaplasia and neoplasia of the female genital tract with both pulmonary metastases and STK11/KRAS gene mutations: a case report.
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Ru Wang, Hao Yu, Ming Liu, Ting Hao, Xiangyu Wang, and Lianbao Cao
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GENITALIA ,GENETIC mutation ,METAPLASIA ,METASTASIS ,TUMORS ,GENITALIA infections ,PANCREATIC cysts - Abstract
Multiple morphological changes in two or more sites of concurrent multifocal mucinous lesions in the female genital tract are indicative of SMMN-FGT, which is unrelated to high-risk HPV infection. MUC6 and HIK-1083 showed positive characteristic immunohistochemistry. Seldom is the condition described. Here we describe an SMMN-FGT patient who also had lung metastases and STK11/KRAS gene mutations. Based on the current researches, we hypothesize that SMMN-FGT is closely associated with the development of cervical gastric adenocarcinoma. [ABSTRACT FROM AUTHOR]
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- 2023
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16. A New Synthetic Curcuminoid Displays Antitumor Activities in Metastasized Melanoma.
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Kaps, Leonard, Klefenz, Adrian, Traenckner, Henry, Schneider, Paul, Andronache, Ion, Schobert, Rainer, Biersack, Bernhard, and Schuppan, Detlef
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- *
ANTINEOPLASTIC agents , *MELANOMA , *NATURAL products , *LABORATORY mice , *INTRAPERITONEAL injections - Abstract
Aim: The semisynthetic derivatives MePip-SF5 and isogarcinol, which are aligned with the natural products curcumin and garcinol, were tested for their antitumor effects in a preclinical model of pulmonary melanoma metastasis. Methods and results: MePip-SF5 was almost five times more effective in inhibiting B16F10 melanoma cell proliferation than its original substance of curcumin (IC50 MePip-SF5 2.8 vs. 13.8 µM). Similarly, the melanoma cytotoxicity of isogarcinol was increased by 40% compared to garcinol (IC50 3.1 vs. 2.1 µM). The in vivo toxicity of both drugs was assessed in healthy C57BL/6 mice challenged with escalating doses. Isogarcinol induced toxicity above a dose of 15 mg/kg, while MePip-SF5 showed no in vivo toxicity up to 60 mg/kg. Both drugs were tested in murine pulmonary metastatic melanoma. C57BL/6 mice (n = 10) received 500,000 B16F10 melanoma cells intravenously. After intraperitoneal injection of MePip-SF5 (60 mg/kg) or isorgarcinol (15 mg/kg) at days 8, 11 and 14 and sacrifice at day 16, the MePip-SF5-treated mice showed a significantly (p < 0.05) lower pulmonary macroscopic and microscopic tumor load than the vehicle-treated controls, whereas isogarcinol was ineffective. The pulmonary RNA levels of the mitosis marker Bub1 and the inflammatory markers TNFα and Ccl3 were significantly (p < 0.05) reduced in the MePip-SF5-treated mice. Both drugs were well tolerated, as shown by an organ inspection and normal liver- and kidney-related serum parameters. Conclusions: The novel curcuminoid MePip-SF5 showed a convincing antimetastatic effect and a lack of systemic toxicity in a relevant preclinical model of metastasized melanoma. [ABSTRACT FROM AUTHOR]
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- 2023
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17. Pneumonectomy for Primary Lung Tumors and Pulmonary Metastases: A Comprehensive Study of Postoperative Morbidity, Early Mortality, and Preoperative Clinical Prognostic Factors.
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Grapatsas, Konstantinos, Menghesha, Hruy, Dörr, Fabian, Baldes, Natalie, Schuler, Martin, Stuschke, Martin, Darwiche, Kaid, Taube, Christian, and Bölükbas, Servet
- Subjects
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PNEUMONECTOMY , *PREOPERATIVE risk factors , *LUNG tumors , *METASTASIS , *PATIENT selection - Abstract
Background: Pneumonectomy is a major surgical resection that still remains a high-risk operation. The current study aims to investigate perioperative risk factors for postoperative morbidity and early mortality after pneumonectomy for thoracic malignancies. Methods: We retrospectively analyzed all patients who underwent pneumonectomy for thoracic malignancies at our institution between 2014 and 2022. Complications were assessed up to 30 days after the operation. Mortality for any reason was recorded after 30 days and 90 days. Results: A total of 145 out of 169 patients undergoing pneumonectomy were included in this study. The postoperative 30-day complication rate was 41.4%. The 30-day-mortality was 8.3%, and 90-day-mortality 17.2%. The presence of cardiovascular comorbidities was a risk factor for major cardiopulmonary complications (54.2% vs. 13.2%, p < 0.01). Postoperative bronchus stump insufficiency (OR: 11.883, 95% CI: 1.288–109.591, p = 0.029) and American Society of Anesthesiologists (ASA) score 4 (OR: 3.023, 95% CI: 1.028–8.892, p = 0.044) were independent factors for early mortality. Conclusion: Pneumonectomy for thoracic malignancies remains a high-risk major lung resection with significant postoperative morbidity and mortality. Attention should be paid to the preoperative selection of patients. [ABSTRACT FROM AUTHOR]
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- 2023
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18. Pneumonectomy for Primary Lung Tumors and Pulmonary Metastases: A Comprehensive Study of Postoperative Morbidity, Early Mortality, and Preoperative Clinical Prognostic Factors
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Konstantinos Grapatsas, Hruy Menghesha, Fabian Dörr, Natalie Baldes, Martin Schuler, Martin Stuschke, Kaid Darwiche, Christian Taube, and Servet Bölükbas
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pneumonectomy ,non-small cell lung cancer ,pulmonary metastases ,pulmonary metastasectomy ,complications ,mortality ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Pneumonectomy is a major surgical resection that still remains a high-risk operation. The current study aims to investigate perioperative risk factors for postoperative morbidity and early mortality after pneumonectomy for thoracic malignancies. Methods: We retrospectively analyzed all patients who underwent pneumonectomy for thoracic malignancies at our institution between 2014 and 2022. Complications were assessed up to 30 days after the operation. Mortality for any reason was recorded after 30 days and 90 days. Results: A total of 145 out of 169 patients undergoing pneumonectomy were included in this study. The postoperative 30-day complication rate was 41.4%. The 30-day-mortality was 8.3%, and 90-day-mortality 17.2%. The presence of cardiovascular comorbidities was a risk factor for major cardiopulmonary complications (54.2% vs. 13.2%, p < 0.01). Postoperative bronchus stump insufficiency (OR: 11.883, 95% CI: 1.288–109.591, p = 0.029) and American Society of Anesthesiologists (ASA) score 4 (OR: 3.023, 95% CI: 1.028–8.892, p = 0.044) were independent factors for early mortality. Conclusion: Pneumonectomy for thoracic malignancies remains a high-risk major lung resection with significant postoperative morbidity and mortality. Attention should be paid to the preoperative selection of patients.
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- 2023
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19. Radiomics analysis based on CT for the prediction of pulmonary metastases in ewing sarcoma
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Ying Liu, Ping Yin, Jingjing Cui, Chao Sun, Lei Chen, Nan Hong, and Zhentao Li
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Ewing sarcoma ,Radiomics ,Pulmonary metastases ,Computed tomography ,Medical technology ,R855-855.5 - Abstract
Abstract Objectives This study aimed to develop and validate radiomics models on the basis of computed tomography (CT) and clinical features for the prediction of pulmonary metastases (MT) in patients with Ewing sarcoma (ES) within 2 years after diagnosis. Materials and methods A total of 143 patients with a histopathological diagnosis of ES were enrolled in this study (114 in the training cohort and 29 in the validation cohort). The regions of interest (ROIs) were handcrafted along the boundary of each tumor on the CT and CT-enhanced (CTE) images, and radiomic features were extracted. Six different models were built, including three radiomics models (CT, CTE and ComB models) and three clinical-radiomics models (CT_clinical, CTE_clinical and ComB_clinical models). The area under the receiver operating characteristic curve (AUC), and accuracy were calculated to evaluate the different models, and DeLong test was used to compare the AUCs of the models. Results Among the clinical risk factors, the therapeutic method had significant differences between the MT and non-MT groups (P<0.01). The six models performed well in predicting pulmonary metastases in patients with ES, and the ComB model (AUC: 0.866/0.852 in training/validation cohort) achieved the highest AUC among the six models. However, no statistically significant difference was observed between the AUC of the models. Conclusions In patients with ES, clinical-radiomics model created using radiomics signature and clinical features provided favorable ability and accuracy for pulmonary metastases prediction.
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- 2023
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20. Solitary pulmonary metastases at first recurrence of osteosarcoma: Presentation, treatment, and survival of 219 patients of the Cooperative Osteosarcoma Study Group
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Vanessa L. Mettmann, Daniel Baumhoer, Stefan S. Bielack, Claudia Blattmann, Godehard Friedel, Thekla vonKalle, Leo Kager, Matthias Kevric, Michaela Nathrath, Benjamin Sorg, Matthias Dürken, and Stefanie Hecker‐Nolting
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osteosarcoma ,pulmonary metastases ,recurrence ,survival ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background To evaluate patient and tumour characteristics, treatment and their impact on survival in patients with a solitary pulmonary metastasis at first relapse of high‐grade osteosarcoma. Procedure Two‐hundred and nineteen consecutive patients who had achieved a complete surgical remission and then developed a solitary pulmonary metastasis at first recurrence of high‐grade osteosarcoma were retrospectively reviewed. Results Two hundred and three (94.9%) of 214 patients achieved a second complete remission. After a median time from initial diagnosis of osteosarcoma to first relapse of 2.3 years (range, 0.3–18.8 years), actuarial post‐relapse overall survival after 2 and 5 years was 72.0% and 51.2%. Post‐relapse event‐free survival was 39.1% and 31.1%. Median follow‐up time was 3.2 years (range, 0.1–29.4 years). A longer time until first relapse and diagnosis due to imaging were positive prognostic factors in uni‐ and multivariate analyses, as were a second complete surgical remission and, in regard to death, the absence of a subsequent relapse. The use of salvage chemotherapy and radiotherapy were not associated with patient outcomes, nor was the surgical approach (thoracoscopy vs. thoracotomy) nor the exploration (uni‐ vs. bilateral). Conclusion Approximately half of the patients who experience a solitary pulmonary relapse at first recurrence of osteosarcoma remain alive 5 years after this first relapse. Only one third will remain disease‐free. A complete surgical resection of the lesion is essential for long‐term survival while relapse chemotherapy does not seem to improve survival. Innovative therapies are required to improve outcomes.
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- 2023
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21. A rare radiological presentation of pulmonary metastases from malignant melanoma
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Nanditha Guruvaiah Sridhara, MD, Namratha Guruvaiah Sridhara, BSc, Wengcheng Li, MD, and Janardhana Ponnatapura, MD
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Malignant melanoma ,Pulmonary metastases ,Atypical presentation ,Crazy paving ,Oncology ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Malignant melanoma is a highly aggressive cancer with metastatic potential to various locations such as the lymph nodes, lungs, liver, brain, and bone. After the lymph nodes, the lungs are the most common site of malignant melanoma metastases. Pulmonary metastases from malignant melanoma commonly presents as solitary or multiple solid nodules, sub-solid nodules or miliary opacities on CT chest. We present a case of pulmonary metastases from malignant melanoma in a 74-year-old man which presented unusually on CT chest as a combination of patterns like “crazy paving,” upper lobe predominance with subpleural sparing, and centrilobular micronodules. Video-assisted thoracoscopic surgery, wedge resection and tissue analysis were performed, which confirmed the diagnosis of malignant melanoma metastases, and the patient further underwent PET-CT for staging and surveillance. Patients with pulmonary metastases from malignant melanoma can have atypical imaging findings, therefore radiologists should be aware of these unconventional presentations to avoid any misdiagnoses.
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- 2023
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22. Survival after radiofrequency ablation and/or chemotherapy for lung cancer and pulmonary metastases: a systematic review and meta-analysis.
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Ziyi Yang, Xia Lyu, Huilin Yang, Bingbing Wang, Dan Xu, Lingyi Huo, Runzi Zhang, Yingjun Huang, and Benshu Diao
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CANCER chemotherapy ,CATHETER ablation ,LUNG cancer ,METASTASIS ,SCIENCE periodicals - Abstract
Background: Radiofrequency ablation (RFA) and chemotherapy are used to treat lung cancer or pulmonary metastases, but no direct comparison of overall survival (OS) has been published. The present study aimed to assess the OS of RFA and/or chemotherapy in patients with lung cancer or pulmonary metastases who were not candidates for surgical resection. Methods: To identify relevant studies, the following databases were electronically searched from their inception to 31 March 2023: PubMed, Embase, Web of Science, Cochrane Library, Scopus, Ovid, ScienceDirect, SinoMed, China National Knowledge Infrastructure Database, Chongqing VIP Chinese Science and Technology Periodical Database, Wanfang Database, LILACS, ClinicalTrials.gov, and Chictr.org. Manual retrieval was also conducted. We used published hazard ratios (HRs) if available or estimates from other survival data. Results: A total of 1,387 participants from 14 trials were included in the final analysis. Patients treated with RFA combined with chemotherapy significantly improved OS compared with those treated with chemotherapy alone [HR 0.50, 95% confidence interval (CI) 0.41-0.61; p < 0.00001], with an absolute difference at 12 months of 29.6% (95% CI 23.7-35.5), at 24 months of 19.2% (95% CI 10.1-28.2), and at 36 months of 22.9% (95% CI 12.0-33.7). No statistically significant difference was observed in the subgroups of case type, cancer type, chemotherapy drugs, and tumor size. The HR for OS with RFA plus chemotherapy vs. RFA alone was 0.53 (95% CI 0.41-0.70; p < 0.00001), corresponding to a 27.1% (95% CI 18.3-35.8), 31.0% (95% CI 19.9-41.9), and 24.9% (95% CI 15.0-34.7) absolute difference in survival at 12 months, 24 months, and 36 months, respectively. Subgroup analysis by geographic region and TNM stage showed that RFA combined with chemotherapy still significantly improved OS compared to RFA. The HR of RFA vs. chemotherapy was 0.98 (95% CI 0.60-1.60; p = 0.94), with an absolute difference at 12 months of 1.4% (95% CI -19.2 to 22.1), at 24 months of 7.8% (95% CI -11.3 to 26.8), and at 36 months of 0.3% (95% CI -13.2 to 13.8). The overall indirect comparison of OS for RFA vs. chemotherapy was 0.95 (95% CI 0.72-1.26; p = 0.74). Data on progression-free survival were not sufficiently reported. Conclusion: RFA combined with chemotherapy might be a better treatment option for patients with lung cancer or pulmonary metastases than chemotherapy alone or RFA alone. The comparison between RFA and/or chemotherapy remains to be specifically tested. [ABSTRACT FROM AUTHOR]
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- 2023
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23. Radiomics analysis based on CT for the prediction of pulmonary metastases in ewing sarcoma.
- Author
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Liu, Ying, Yin, Ping, Cui, Jingjing, Sun, Chao, Chen, Lei, Hong, Nan, and Li, Zhentao
- Subjects
EWING'S sarcoma ,RADIOMICS ,FEATURE extraction ,METASTASIS - Abstract
Objectives: This study aimed to develop and validate radiomics models on the basis of computed tomography (CT) and clinical features for the prediction of pulmonary metastases (MT) in patients with Ewing sarcoma (ES) within 2 years after diagnosis. Materials and methods: A total of 143 patients with a histopathological diagnosis of ES were enrolled in this study (114 in the training cohort and 29 in the validation cohort). The regions of interest (ROIs) were handcrafted along the boundary of each tumor on the CT and CT-enhanced (CTE) images, and radiomic features were extracted. Six different models were built, including three radiomics models (CT, CTE and ComB models) and three clinical-radiomics models (CT_clinical, CTE_clinical and ComB_clinical models). The area under the receiver operating characteristic curve (AUC), and accuracy were calculated to evaluate the different models, and DeLong test was used to compare the AUCs of the models. Results: Among the clinical risk factors, the therapeutic method had significant differences between the MT and non-MT groups (P<0.01). The six models performed well in predicting pulmonary metastases in patients with ES, and the ComB model (AUC: 0.866/0.852 in training/validation cohort) achieved the highest AUC among the six models. However, no statistically significant difference was observed between the AUC of the models. Conclusions: In patients with ES, clinical-radiomics model created using radiomics signature and clinical features provided favorable ability and accuracy for pulmonary metastases prediction. [ABSTRACT FROM AUTHOR]
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- 2023
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24. CT-guided percutaneous microwave ablation for pulmonary metastases from colorectal cancer: Prognosis analyses based on the origin of the primary tumor.
- Author
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Huang, Yuting, Wu, Ketong, Liu, Yang, Li, Dan, Lai, Haiyang, Peng, Tao, Wan, Yuan, and Zhang, Bo
- Subjects
- *
COLORECTAL cancer , *CANCER prognosis , *COLON cancer , *RECTAL cancer , *SURVIVAL analysis (Biometry) , *PROGRESSION-free survival , *PROGNOSIS - Abstract
BACKGROUND: Microwave ablation (MWA) is becoming an effective therapy for inoperable pulmonary metastases from colorectal cancer (CRC). However, it is unclear whether the primary tumor location affects survival after MWA. OBJECTIVE: This study aims to investigate the survival outcomes and prognostic factors of MWA based on different primary origins between colon and rectal cancer. METHODS: Patients who underwent MWA for pulmonary metastases from 2014 to 2021 were reviewed. Differences in survival outcomes between colon and rectal cancer were analyzed with the Kaplan-Meier method and log-rank tests. The prognostic factors between groups were then evaluated by univariable and multivariable Cox regression analyses. RESULTS: A total of 118 patients with 154 pulmonary metastases from CRC were treated in 140 MWA sessions. Rectal cancer had a higher proportion with seventy (59.32%) than colon cancer with forty-eight (40.68%). The average maximum diameter of pulmonary metastases from rectal cancer (1.09 cm) was greater than that of colon cancer (0.89 cm; p = 0.026). The median follow-up was 18.53 months (range 1.10 – 60.63 months). The disease-free survival (DFS) and overall survival (OS) in colon and rectal cancer groups were 25.97 vs 11.90 months (p = 0.405), and 60.63 vs 53.87 months (p = 0.149), respectively. Multivariate analyses showed that only age was an independent prognostic factor in patients with rectal cancer (HR = 3.70, 95% CI: 1.28 – 10.72, p = 0.023), while none in colon cancer. CONCLUSIONS: Primary CRC location has no impact on survival for patients with pulmonary metastases after MWA, while a disparate prognostic factor exists between colon and rectal cancer. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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25. Solitary pulmonary metastases at first recurrence of osteosarcoma: Presentation, treatment, and survival of 219 patients of the Cooperative Osteosarcoma Study Group.
- Author
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Mettmann, Vanessa L., Baumhoer, Daniel, Bielack, Stefan S., Blattmann, Claudia, Friedel, Godehard, von Kalle, Thekla, Kager, Leo, Kevric, Matthias, Nathrath, Michaela, Sorg, Benjamin, Dürken, Matthias, and Hecker‐Nolting, Stefanie
- Subjects
- *
OVERALL survival , *OSTEOSARCOMA , *CANCER relapse , *PROGNOSIS , *SURGICAL excision , *SOLITARY pulmonary nodule - Abstract
Background: To evaluate patient and tumour characteristics, treatment and their impact on survival in patients with a solitary pulmonary metastasis at first relapse of high‐grade osteosarcoma. Procedure: Two‐hundred and nineteen consecutive patients who had achieved a complete surgical remission and then developed a solitary pulmonary metastasis at first recurrence of high‐grade osteosarcoma were retrospectively reviewed. Results: Two hundred and three (94.9%) of 214 patients achieved a second complete remission. After a median time from initial diagnosis of osteosarcoma to first relapse of 2.3 years (range, 0.3–18.8 years), actuarial post‐relapse overall survival after 2 and 5 years was 72.0% and 51.2%. Post‐relapse event‐free survival was 39.1% and 31.1%. Median follow‐up time was 3.2 years (range, 0.1–29.4 years). A longer time until first relapse and diagnosis due to imaging were positive prognostic factors in uni‐ and multivariate analyses, as were a second complete surgical remission and, in regard to death, the absence of a subsequent relapse. The use of salvage chemotherapy and radiotherapy were not associated with patient outcomes, nor was the surgical approach (thoracoscopy vs. thoracotomy) nor the exploration (uni‐ vs. bilateral). Conclusion: Approximately half of the patients who experience a solitary pulmonary relapse at first recurrence of osteosarcoma remain alive 5 years after this first relapse. Only one third will remain disease‐free. A complete surgical resection of the lesion is essential for long‐term survival while relapse chemotherapy does not seem to improve survival. Innovative therapies are required to improve outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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26. Prognostic factors in pulmonary metastases resection from colorectal cancer: impact of right-sided colon cancer and early recurrence
- Author
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Tsukamoto, Yo, Nakada, Takeo, Shigemori, Rintaro, Kato, Daiki, Shibazaki, Takamasa, Mori, Shohei, Odaka, Makoto, and Ohtsuka, Takashi
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- 2024
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27. Aerosolized Azacytidine as Epigenetic Priming for Bintrafusp Alfa-Mediated Immune Checkpoint Blockade in Patients With Unresectable Pulmonary Metastases From Sarcomas, Germ Cell Tumors, or Epithelial Malignancies
- Published
- 2021
28. Benign metastasizing uterine leiomyoma with lymphatic and pulmonary metastases: a case report and literature review
- Author
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Tong Tong, Qiong Fan, Yudong Wang, and Yuhong Li
- Subjects
Benign metastasizing leiomyoma ,Lymph node ,Pulmonary metastases ,Case report ,Gynecology and obstetrics ,RG1-991 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Benign metastasizing leiomyoma (BML) is a rare disease usually observed in women of reproductive or premenopausal age with a history of uterine myomectomy or hysterectomy. The most common sites of metastases are the pulmonary, and other sites include heart, bones, liver, lymph nodes, bladder, skeletal muscles, and central nervous system. Here, we report a case of a 50 year-old woman with a history of hysterectomy who was initially suspected of uterine sarcoma but was finally confirmed to have BML with lung and lymph node metastases, and discuss the treatment and prognosis of BML. Case presentation A 50 year-old woman with a history of total abdominal hysterectomy presented with mild but persistent abdominal pain for more than 3 months. She was suspected of having uterine sarcoma before surgery and laparoscopic extensive debulking surgery including bilateral oophorectomy, pelvic and para-aortic lymph node dissection to the level of the left renal vein, and transcutaneous dissection of the right inguinal lymph nodes. Pathology confirmed a benign leiomyoma, and the patient was diagnosed with BML. No medication was administered after the surgery, and the follow-up was of no significance. Conclusion Benign metastasizing leiomyoma (BML) is a rare disorder in which histologically benign smooth muscle tumors metastasize to extrauterine sites. Metastases are commonly observed in the lung, liver, lymph nodes, skin, bladder, esophagus, and skeletal muscles. BML is usually misdiagnosed as a malignant tumor before surgery until the pathology confirms its benign nature. However, this treatment remains controversial and undetermined. The prognosis is usually favorable owing to its benign nature.
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- 2023
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29. Cardiac angiosarcoma with multiple pulmonary metastases: A case report and literature review
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Enqi Zhao, MB, Mengmeng Peng, MM, Mingjun Xu, MD, Yi Zhang, MD, Kefan Jiao, MB, and Dedong Ma, MD
- Subjects
Angiosarcoma ,Cardiac tumor ,Pulmonary metastases ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
In this report, we describe a 42-year-old man with dyspnea and recurrent hemoptysis who was diagnosed with cardiac angiosarcoma and multiple pulmonary metastases. Before visiting our hospital, he had been misdiagnosed with a lung infection. Bronchoscopy, multiple imaging methods, and extensive laboratory studies failed to identify a clear etiology. Cardiac magnetic resonance imaging and percutaneous lung biopsy revealed cardiac angiosarcoma with multiple pulmonary metastases. Cardiac angiosarcoma is extremely rare and diagnosis is difficult. Diffuse alveolar hemorrhage is not a common manifestation of pulmonary metastases of angiosarcoma and in patients with hemoptysis, clinicians should consider a malignant etiology that is not restricted to the lungs.
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- 2023
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30. Pulmonary metastases of a borderline ovarian tumor with multiple cystic formations: a case report
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Rintaro Hamada, Yo Tsukamoto, Makoto Odaka, Mitsuo Yabe, Rintaro Shigemori, Tadashi Akiba, Naoki Toya, and Takashi Ohtsuka
- Subjects
Pulmonary metastases ,Cyst ,Ovarian tumor ,Borderline ovarian tumor ,Surgery ,RD1-811 - Abstract
Abstract Background Metastatic lung tumors rarely present with cystic formations. This is the first report of multiple cystic formations in pulmonary metastases from mucinous borderline ovarian tumors written in English. Case presentation A 41-year-old woman underwent left adnexectomy + partial omentectomy + para-aortic lymphadenectomy for a left ovarian tumor 4 years ago. The pathological finding was mucinous borderline ovarian tumor with a microinvasion. A chest computed tomography performed 3 years after surgery revealed multiple cystic lesions in both lungs. After 1-year follow-up, the cysts increased in size and wall thickness. Subsequently, she was referred to our department with multiple cystic lesions in both lungs. No laboratory findings indicated infectious diseases or autoimmune disorders that could cause cystic lesions in both lungs. Positron emission tomography showed slight accumulation in the cyst wall. Partial resection of the left lower lobe was performed to confirm the pathological diagnosis. The diagnosis was consistent with pulmonary metastases from a previous mucinous borderline ovarian tumor. Conclusions This is a rare case of lung metastases from a mucinous borderline ovarian tumor presenting with multiple lesions with cystic formation. Pulmonary cystic formations in patients with a borderline ovarian tumor should be considered as possible pulmonary metastases.
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- 2023
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31. The prognostic role of tumor budding and tumor-stroma ratio in pulmonary metastasis of colorectal carcinoma.
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Karjula, Topias, Kemi, Niko, Niskakangas, Anne, Mustonen, Olli, Puro, Iiris, Pohjanen, Vesa-Matti, Kuopio, Teijo, Elomaa, Hanna, Ahtiainen, Maarit, Mecklin, Jukka-Pekka, Seppälä, Toni T., Wirta, Erkki-Ville, Sihvo, Eero, Väyrynen, Juha P., Yannopoulos, Fredrik, and Helminen, Olli
- Subjects
TUMOR budding ,COLORECTAL cancer ,PROGNOSIS ,METASTASECTOMY ,OVERALL survival ,HEREDITARY nonpolyposis colorectal cancer - Abstract
To evaluate the prognostic value of tumor budding and tumor-stroma ratio (TSR) in resected pulmonary metastases of colorectal carcinoma (CRC). In total, 106 pulmonary metastasectomies were performed to 74 patients in two study hospitals during 2000–2020. All relevant clinical data were retrospectively collected. Tumor budding based on the International Tumor Budding Consensus Conference recommendations and TSR in the first resected pulmonary metastases and primary tumors were evaluated from diagnostic hematoxylin-eosin-stained histopathological slides. 60 patients (85.7%) had low tumor budding (≤5 buds/field) and 10 patients (14.3%) had high tumor budding (>5 buds/field) in their first pulmonary metastases of CRC. 5-year overall survival rates of pulmonary metastasectomy in low and high total tumor budding were 28.3% and 37.3% (p = 0.387), respectively. 19 patients (27.1%) had low TSR and 51 patients (72.9%) had high TSR. The 5-year overall survival rates were 32.9% in low and 28.6% in high TSR of first pulmonary metastases (p = 0.746). Tumor budding and TSR did not provide prognostic value in Cox multivariate analysis. Tumor budding and TSR in resected pulmonary metastases were not associated with those of the primary tumor. Tumor budding and TSR in the resected pulmonary metastases of CRC showed no statistically significant prognostic value, however, additional well-powered confirmatory studies are needed. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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32. Aggressive Pursuit of No Evidence of Disease Status in Hepatoblastoma Improves Survival: An Observational Study.
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Fleming, Andrew M., Murphy, Andrew J., Sarvode Mothi, Suraj, Interiano, Rodrigo B., Loh, Amos, McCarville, Mary E., Abramson, Zachary, Mansfield, Sara A., Abdelhafeez, Hafeez, Davidoff, Andrew M., Gosain, Ankush, Gartrell, Jessica A., Furman, Wayne L., and Langham, Max R.
- Abstract
The utility of repeated surgical interventions in hepatoblastoma to achieve no evidence of disease (NED) is not well-defined. We examined the effect of aggressive pursuit of NED status on event-free (EFS) and overall survival (OS) in hepatoblastoma with subgroup analysis of high-risk patients. Hospital records were queried for patients with hepatoblastoma from 2005 to 2021. Primary outcomes were OS and EFS stratified by risk and NED status. Group comparisons were performed using univariate analysis and simple logistic regression. Survival differences were compared with log-rank tests. Fifty consecutive patients with hepatoblastoma were treated. Forty-one (82%) were rendered NED. NED was inversely correlated with 5-year mortality (OR 0.006; CI 0.001–0.056; P <.01). Ten-year OS (P <.01) and EFS (P <.01) were improved by achieving NED. Ten-year OS was similar between 24 high-risk and 26 not high-risk patients when NED was attained (P =.83). Fourteen high-risk patients underwent a median of 2.5 pulmonary metastasectomies, 7 for unilateral disease, and 7 for bilateral, with a median of 4.5 nodules resected. Five high-risk patients relapsed, and three were salvaged. NED status is necessary for survival in hepatoblastoma. Repeated pulmonary metastasectomy and/or complex local control strategies to obtain NED can achieve long-term survival in high-risk patients. Level III – Treatment Study - Retrospective Comparative Study. • NED status was defined as normal AFP and absence of detectable radiographic disease on interval surveillance imaging after chemotherapy, resection of the patient's primary tumor, and metastasectomy, if indicated. • NED status is necessary for survival in hepatoblastoma. • Repeated pulmonary metastasectomy and/or complex local control strategies to obtain NED benefit high-risk patients. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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33. Effectiveness of Stereotactic Ablative Radiotherapy for Systemic Therapy Respondents with Inoperable Pulmonary Oligometastases and Oligoprogression.
- Author
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Ho, Chin-Beng, Tsai, Jo-Ting, Chen, Chun-You, Shiah, Her-Shyong, Chen, Hsuan-Yu, Ting, Lai-Lei, Kuo, Chia-Chun, Lai, I-Chun, Lai, Hsin-Yi, Chung, Chi-Li, Lee, Kai-Ling, Tzeng, Huey-En, Lee, Kuen-Haur, Lee, Hsin-Lun, Chen, Shang-Wen, and Chiou, Jeng-Fong
- Subjects
- *
STEREOTACTIC radiotherapy , *PROGNOSIS , *LUNG tumors , *RADIATION pneumonitis , *PROGRESSION-free survival - Abstract
Stereotactic ablative radiotherapy (SABR) may improve survival in patients with inoperable pulmonary oligometastases. However, the impact of pulmonary oligometastatic status after systemic therapy on SABR outcomes remains unclear. Hence, we investigated the outcomes of SABR in 45 patients with 77 lung tumors and the prognostic value of pulmonary oligoprogression. Eligibility criteria were pulmonary oligometastases (defined as ≤5 metastatic lung tumors), controlled extrapulmonary disease (EPD) after front-line systemic therapy, SABR as primary local treatment for inoperable pulmonary metastases, and consecutive imaging follow-up. Oligometastatic lung tumor was classified into controlled or oligoprogressive status. Overall survival (OS), in-field progression-free survival (IFPFS), out-field progression-free survival (OFPFS), and prognostic variables were evaluated. With 21.8 months median follow-up, the median OS, IFPFS, and OFPFS were 28.3, not reached, and 6.5 months, respectively. Two-year OS, IFPFS, and OFPFS rates were 56.0%, 74.2%, and 17.3%, respectively. Oligoprogressive status (p = 0.003), disease-free interval < 24 months (p = 0.041), and biologically effective dose (BED10) < 100 Gy (p = 0.006) were independently associated with inferior OS. BED10 ≥ 100 Gy (p = 0.029) was independently correlated with longer IFPFS. Oligoprogressive status (p = 0.017) and EPD (p = 0.019) were significantly associated with inferior OFPFS. Grade ≥ 2 radiation pneumonitis occurred in four (8.9%) patients. Conclusively, SABR with BED10 ≥ 100 Gy could provide substantial in-field tumor control and longer OS for systemic therapy respondents with inoperable pulmonary oligometastases. Oligoprogressive lung tumors exhibited a higher risk of out-field treatment failure and shorter OS. Hence, systemic therapy should be tailored for patients with oligoprogression to reduce the risk of out-field treatment failure. However, in the absence of effective systemic therapy, SABR is a reasonable alternative to reduce resistant tumor burden. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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34. Issues and prospects of image‐guided thermal ablation in the treatment of primary and metastatic lung tumors
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Meixiang Wang, Zhigang Wei, and Xin Ye
- Subjects
early‐stage ,image‐guided thermal ablation ,issues and prospects ,non‐small cell lung cancer ,pulmonary metastases ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract The precise local minimally invasive or noninvasive treatment represents the important orientation for advancing the treatment of pulmonary malignant tumors. New local treatment methods have emerged as solutions to the shortcomings of minimally invasive or local treatment methods. Image‐guided thermal ablation (IGTA) comes with the characteristics such as more accurate localization, less trauma, more definite efficacy, higher safety, stronger repeatability, fewer complications, and lower cost in treating lung tumors. This paper investigates the existing problems of IGTA in the treatment of lung tumors and puts forward the orientation of studies.
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- 2023
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35. Colorectal Cancer: Management of Distant Metastases
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Hedrick, Traci L., Steele, Scott R., editor, Hull, Tracy L., editor, Hyman, Neil, editor, Maykel, Justin A., editor, Read, Thomas E., editor, and Whitlow, Charles B., editor
- Published
- 2022
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36. Is lung involvement a favorable prognostic factor for pancreatic ductal adenocarcinoma with synchronous liver metastases?—A propensity score analysis.
- Author
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Ouyang, Huaqiang, Ma, Weidong, Jiang, Xiangli, Gerdtsson, Anna Sandström, Liu, Donglin, and Pan, Zhanyu
- Subjects
PANCREATIC duct ,PROGNOSIS ,PANCREATIC intraepithelial neoplasia ,PROPENSITY score matching ,OVERALL survival ,PANCREATIC cancer - Abstract
For advanced pancreatic cancer, pulmonary metastases (PM) have been considered favorable factors compared to metastases of other sites, but it remains unknown whether the prognosis of patients with synchronous liver and lung metastases is better than that of non-PM. Data was derived from a two-decade cohort and included 932 cases of pancreatic adenocarcinoma with synchronous liver metastases (PACLM). Propensity score matching (PSM) was applied to balance 360 selected cases, grouped into PM (n = 90) and non-PM (n = 270). Overall survival (OS) and survival-related factors were analyzed. In PSM-adjusted data, the median OS was 7.3 and 5.8 months, for PM and non-PM, respectively (p = 0.16). Multivariate analysis revealed that male gender, poor performance status, higher hepatic tumor burden, ascites, elevated carbohydrate antigen 19–9, and lactate dehydrogenase were factors of poor survival (p < 0.05). Chemotherapy was the only independent significant factor of favorable prognosis (p < 0.05). Although lung involvement was indicated to be a favorable prognostic factor for patients with PACLM in the whole cohort, PM were not associated with better survivals in the subset of cases subjected to PSM adjustment. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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- View/download PDF
37. Pulmonary metastases of a borderline ovarian tumor with multiple cystic formations: a case report.
- Author
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Hamada, Rintaro, Tsukamoto, Yo, Odaka, Makoto, Yabe, Mitsuo, Shigemori, Rintaro, Akiba, Tadashi, Toya, Naoki, and Ohtsuka, Takashi
- Subjects
OVARIAN tumors ,POSITRON emission tomography ,METASTASIS ,LUNG tumors ,PANCREATIC cysts ,CYSTADENOMA ,AUTOIMMUNE diseases - Abstract
Background: Metastatic lung tumors rarely present with cystic formations. This is the first report of multiple cystic formations in pulmonary metastases from mucinous borderline ovarian tumors written in English. Case presentation: A 41-year-old woman underwent left adnexectomy + partial omentectomy + para-aortic lymphadenectomy for a left ovarian tumor 4 years ago. The pathological finding was mucinous borderline ovarian tumor with a microinvasion. A chest computed tomography performed 3 years after surgery revealed multiple cystic lesions in both lungs. After 1-year follow-up, the cysts increased in size and wall thickness. Subsequently, she was referred to our department with multiple cystic lesions in both lungs. No laboratory findings indicated infectious diseases or autoimmune disorders that could cause cystic lesions in both lungs. Positron emission tomography showed slight accumulation in the cyst wall. Partial resection of the left lower lobe was performed to confirm the pathological diagnosis. The diagnosis was consistent with pulmonary metastases from a previous mucinous borderline ovarian tumor. Conclusions: This is a rare case of lung metastases from a mucinous borderline ovarian tumor presenting with multiple lesions with cystic formation. Pulmonary cystic formations in patients with a borderline ovarian tumor should be considered as possible pulmonary metastases. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
38. SPACES: Our team’s experience in lung tumor microwave ablation.
- Author
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Zhigang Wei, Xia Yang, Jing Wu, Peng Zhang, Guanghui Huang, Yang Ni, Guoliang Xue, and Xin Ye
- Subjects
- *
NON-small-cell lung carcinoma , *LUNG tumors , *ATRIAL flutter , *HEAT stroke , *MICROWAVES , *ABLATION techniques , *CATHETER ablation - Abstract
The standard treatment of stage I nonsmall cell lung cancer is lobectomy with systematic mediastinal lymph node evaluation. Unfortunately, up to 25% of patients with stage I nonsmall cell lung cancer are not candidates for surgery due to severe medical comorbidities (poor cardiopulmonary function). Image‑guided thermal ablation is an alternative for those patients, includes radiofrequency ablation, microwave ablation (MWA), cryoablation, and laser ablation. Compared to them, MWA is a relatively new technique with some potential advantages, such as faster heating times, higher intralesional temperatures, larger ablation zones, less procedural pain, relative insensitivity to “heat sinks,” and less sensitivity to tissue types. However, some advantages of MWA mentioned above (such as higher intralesional temperatures, larger ablation zones) also have potential risks and problems, and an innovative and standardized guidance system is needed to avoid and solve these risks and problems. This article combs our team’s clinical experience over the past decade, summarizes a systematic and standardized guidance system, and names it SPACES (Selection, Procedure, Assessment, Complication, Evaluation, Systemic therapy). Both primary and metastatic pulmonary tumors can be efficiently treated with image‑guided thermal ablation in selected candidates. The selection and use of ablation techniques should consider the size and location of the target tumor, the risk of complications, and the expertise and skills of the professionals, among which the size of the target tumor (<3 mm) is a major factor determining the success of ablation. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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39. Radioactive Iodine-Refractory Pulmonary Metastases of Papillary Thyroid Cancer in Children, Adolescents, and Young Adults.
- Author
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Tian Tian, Shuhui Huang, Hongyuan Dai, Mengfang Qi, Bin Liu, and Rui Huang
- Subjects
IODINE isotopes ,THYROID cancer ,YOUNG adults - Abstract
Context: Few studies have explored radioactive iodine–refractory (RAIR) disease in children, adolescents, and young adults with papillary thyroid cancer (CAYA-PTC). Objective: This study systematically investigated the clinicopathologic characteristics and prognosis of CAYA-PTC with RAIR disease. Methods: Sixty-five patients with PTC aged ≤20 years were enrolled in this study, and all patients were confirmed to have pulmonary metastases. Clinicopathologic profiles were compared between the radioactive iodine–avid (RAIA) and RAIR groups. Univariate and multivariate regression analyses were performed to identify risk factors for RAIR status and progressive disease (PD). Gene alterations were detected in 17 patients. Results: Overall, 20 patients were included in the RAIR group, accounting for 30.8% (20/65) of all patients. No significant difference in pathologic characteristics was observed between patients aged <15 years and patients aged 15-20 years, but younger patients were more likely to develop RAIR disease (hazard ratio [HR] 3.500, 95% CI 1.134-10.803, P=.023). RET fusions were the most common genetic alterations in CAYA-PTC, but an association with RAIR disease was not detected (P=.210). RAIR disease (HR 10.008, 95% CI 2.427-41.268, P=.001) was identified as an independent predictor of PD. The Kaplan–Meier curve revealed a lower progression-free survival (PFS) and disease-specific survival (DSS) rate in the RAIR group than in the RAIA group (P<.001 and P=.039). Likewise, RAIR disease was a risk factor for unfavorable PFS in patients aged <15 years (P<.001). Conclusion: RAIR disease occurs in one-third of CAYA-PTC with pulmonary metastases. Younger patients (aged<15 years) are more susceptible to RAIR status, which leads to unfavorable PFS and DSS. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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40. Preoperative PDW levels predict pulmonary metastasis in patients with hepatocellular carcinoma
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Wen-juan Huang, Guang-yu Wang, Zeng-yao Liu, Meng-lin Zhang, Wen Wang, Xin Zhang, and Rui-tao Wang
- Subjects
Hepatocellular carcinoma ,Pulmonary metastases ,Platelet distribution width ,Prognosis ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background In hepatocellular carcinoma (HCC), pulmonary metastasis (PM) after hepatectomy is associated with poor clinical outcomes. The crucial phases of tumour cell proliferation, angiogenesis, and metastasis all entail platelet activation. In HCC, platelet distribution width (PDW) suggests platelet size changes and predicts a worse prognosis. The aim of this study was to assess the association between PDW and PMs in HCC patients receiving hepatectomy. Material/methods From January 2013 to December 2015, a cohort of patients who underwent hepatectomy for HCC at the Harbin Medical University Cancer Hospital in China were retrospectively evaluated. The relationship between PDW levels and clinical and demographic parameters was examined. To investigate the relationships between predicted factors and PM, a competing risk model was used. From January 2016 to December 2018, a validation cohort of 109 patients from the First Affiliated Hospital of Harbin Medical University was studied independently. Results In the primary cohort, 19 out of 214 patients had postoperative PMs. In HCC patients with PM, PDW levels were lower than in those without PM. There was a significant difference in the cumulative incidence of 2-year PM between the high-PDW and low-PDW groups after controlling for competing risk events (death prior to the development of PM) (p
- Published
- 2022
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41. Long term survival after multiple microwave ablations for colorectal cancer lung metastases: A case report
- Author
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Victoria T. Y Lee, Yueh-Hsin Lin, Derek Glenn, MD, Suhrid Lodh, MD, and David L. Morris, MD
- Subjects
Pulmonary microwave ablation ,Colorectal cancer ,Pulmonary metastases ,Long term prognosis ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Colorectal cancer is one of the leading causes of cancer-associated morbidity and mortality in the world, with lower survival rates when metastases are present. We present a case of a 69-year-old man, diagnosed with metastatic rectal cancer to the lungs in 2015. Over the course of 5 years, he was treated with 4 microwave ablation procedures to both his lungs. Despite this, he does not have any local recurrence or any symptoms since he was first diagnosed 7 years ago. This case highlights the potential for microwave ablation to be used for curative intent in pulmonary metastases in colorectal cancer as an alternative to more invasive and complex procedures such as metastasectomies or lung resection, as well as the benefit of using microwave ablation for disease control to improve patients’ quality of life.
- Published
- 2022
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42. Use of Thoracoscopic Intraoperative Lung Ultrasound to Identify Pulmonary Metastases in Patients Submitted to Pulmonary Metastasectomy With Radical Intent. (VATS-US1)
- Author
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Maastricht University and Francesco Londero, Principal Investigator
- Published
- 2020
43. Diffuse Pulmonary Metastases at Presentation of Giant Cell Tumor of Bone: A Case Report and Synthesis of Literature.
- Author
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Leland, Christopher R., Pratilas, Christine A., Gross, John M., and Levin, Adam S.
- Subjects
- *
GIANT cell tumors , *BONE cells , *METASTASIS , *SHOULDER pain , *YOUNG adults , *PULMONARY nodules - Abstract
Case: We present a 23-year-old man with acute-on-chronic shoulder pain with an aggressive-appearing, destructive lesion of the left proximal humerus and diffuse lung metastases. Biopsy revealed conventional giant cell tumor of bone (GCTB) without sarcomatous differentiation, treated with resection and proximal humerus reconstruction. Without systemic treatment, his pulmonary metastases demonstrated modest spontaneous regression, with no impairment of pulmonary function. Conclusions: Although GCTB is known to metastasize to lungs, these deposits most commonly follow local recurrence. We describe a young adult with diffuse pulmonary nodules at initial presentation, although still following an indolent clinical course without the need for additional systemic therapy. [ABSTRACT FROM AUTHOR]
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- 2023
- Full Text
- View/download PDF
44. CD3 + and CD8 + T-Cell-Based Immune Cell Score and PD-(L)1 Expression in Pulmonary Metastases of Microsatellite Stable Colorectal Cancer.
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Karjula, Topias, Elomaa, Hanna, Niskakangas, Anne, Mustonen, Olli, Puro, Iiris, Kuopio, Teijo, Ahtiainen, Maarit, Mecklin, Jukka-Pekka, Seppälä, Toni T., Wirta, Erkki-Ville, Sihvo, Eero, Väyrynen, Juha P., Yannopoulos, Fredrik, and Helminen, Olli
- Subjects
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TISSUE arrays , *PROGRAMMED death-ligand 1 , *IMMUNOHISTOCHEMISTRY , *ONE-way analysis of variance , *METASTASIS , *LUNG tumors , *COLORECTAL cancer , *GENE expression , *COMPARATIVE studies , *CHI-squared test , *RESEARCH funding , *RECEIVER operating characteristic curves , *ANTIGENS , *OVERALL survival - Abstract
Simple Summary: The lung is the second most common site of metastases in colorectal cancer (CRC). The aim of our study was to evaluate the prognostic value of CD3+ and CD8+ T-cell density based immune cell score (ICS) and PD-1/PD-L1 expression in resected pulmonary metastases of microsatellite stable CRC. The T-cell infiltration was higher in the first pulmonary metastases compared to primary tumour. Pulmonary metastases with high ICS had improved survival compared to low ICS after adjusting for confounders. High tumour cell PD-L1 expression was associated with favourable prognosis. Our results might have clinical feasibility in planning future therapies. The objective of this study was to evaluate the prognostic value of CD3+ and CD8+ based immune cell score (ICS), programmed death -1 (PD-1) and programmed death ligand -1 (PD-L1) in pulmonary metastases of proficient mismatch repair colorectal cancer (CRC) patients. A total of 101 pulmonary metastases and 62 primary CRC tumours were stained for CD3+, CD8+, PD-1 and PD-L1 expression. The prognostic value of ICS, PD-1/PD-L1 expression in 67 first pulmonary metastases and 61 primary CRC tumour was analysed. Comparative analysis was also performed between primary tumours and pulmonary metastases, as well as between T-cell densities and PD-1/PD-L1 expression. The 5-year overall survival rates of low, intermediate, and high ICS in pulmonary metastases were 10.0%, 25.5% and 47.0% (p = 0.046), respectively. Patients with high vs. low ICS in pulmonary metastases had a significantly better 5-year survival (adjusted HR 0.25, 95% CI 0.09–0.75, p = 0.013). High tumour cell PD-L1 expression in the pulmonary metastases was associated with improved survival (p = 0.024). Primary tumour CD8+ expression was significantly correlated with all T-cell densities in pulmonary metastases. Conclusion: The ICS evaluated from the resected pulmonary metastases of CRC showed significant prognostic value. High PD-L1 expression in pulmonary metastases is associated with favourable prognosis. [ABSTRACT FROM AUTHOR]
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- 2023
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45. Issues and prospects of image‐guided thermal ablation in the treatment of primary and metastatic lung tumors.
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Wang, Meixiang, Wei, Zhigang, and Ye, Xin
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LUNG cancer treatment , *COMPUTER-assisted surgery , *LUNG tumors , *METASTASIS , *CATHETER ablation , *TUMOR classification , *TREATMENT effectiveness , *RESEARCH funding , *ABLATION techniques , *PATIENT safety - Abstract
The precise local minimally invasive or noninvasive treatment represents the important orientation for advancing the treatment of pulmonary malignant tumors. New local treatment methods have emerged as solutions to the shortcomings of minimally invasive or local treatment methods. Image‐guided thermal ablation (IGTA) comes with the characteristics such as more accurate localization, less trauma, more definite efficacy, higher safety, stronger repeatability, fewer complications, and lower cost in treating lung tumors. This paper investigates the existing problems of IGTA in the treatment of lung tumors and puts forward the orientation of studies. [ABSTRACT FROM AUTHOR]
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- 2023
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46. Survival prognostic factors for differentiated thyroid cancer patients with pulmonary metastases: A systematic review and meta-analysis .
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Hao Zhao, Chun-Hao Liu, Yue Cao, Li-Yang Zhang, Ya Zhao, Yue-Wu Liu, Hong-Feng Liu, Yan-Song Lin, and Xiao-Yi Li
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THYROID cancer ,PROGNOSIS ,CANCER patients ,PROGRESSION-free survival ,METASTASIS ,OVERALL survival - Abstract
Background: The prognostic factors for differentiated thyroid cancer (DTC) patients with pulmonary metastases (PM) remain scantly identified and analyzed. Therefore, this systematic review and meta-analysis were performed to identify and summarize the prognostic factors in adult DTC patients with PM to help distinguish patients with different prognoses and inform the rational treatment regimens. Method: We performed a comprehensive search of the relevant studies published in the Cochrane Library, PubMed, Scopus, Embase, Wanfang database, VIP database, China National Knowledge Infrastructure, and Google Scholar from their inception until February 2021. The pooled hazard ratios (HR) for overall survival and/or progression-free survival (PFS) with 95% confidence intervals were applied to evaluate and identify the potential prognostic factors. Pooled OS at different time points were also calculated for the available data. A random-effects model was used in the meta-analysis. Results: The review and meta-analysis included 21 studies comprising 2722 DTC patients with PM. The prognostic factors for poor OS were: age over 40 years (HR=7.21, 95% confidence interval [CI] 1.52-34.10, P=0.01, N=788), age over 45 years (HR=2.18, 95% CI 1.26-3.77, P<0.01, N=601), male gender (HR=1.01, 95% CI 1.01-1.19, P=0.03, N=1396), follicular subtype of thyroid cancer (HR=1.63, 95% CI 1.36-1.96, P<0.01, N=2110), iodine non-avidity (HR=3.10, 95% CI 1.79-5.37, P<0.01, N=646), and metastases to other organs (HR=3.18, 95% CI 2.43-4.16, P<0.01, N=1713). Factors associated with poor PFS included age over 45 years (HR=3.85, 95% CI 1.29-11.47, P<0.01, N=306), male gender (HR=1.36, 95% CI 1.06-1.75, P=0.02, N=546), iodine non-avidity (HR=2.93, 95% CI 2.18-3.95, P<0.01, N=395), pulmonary metastatic nodule size over 10mm (HR=2.56, 95% CI 2.02-3.24, P<0.01, N=513), and extra-thyroidal invasion (HR=2.05, 95% CI 1.15-3.67, P=0.02, N=271). The pooled 1, 3, 5, 10, 15, and 20-years OS were 95.24%, 88.46%, 78.36%, 64.86%, 56.57%, and 51.03%, respectively. Conclusions: This review and meta-analysis identified the prognostic factors of DTC patients with PM. Notably, FTC, metastases to other organs, and iodine nonavidity were particularly associated with poor prognosis. The identified prognostic factors will help guide the clinical management of DTC patients with PM. [ABSTRACT FROM AUTHOR]
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- 2022
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47. Exceptional widespread, life threatening lung metastasis in stage IA ovarian endometrioid carcinoma: A case report
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Shuo-Mei Hung and Jen-Ruei Chen
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Endometrioid adenocarcinoma ,Low risk ,Ovarian cancer ,Pulmonary metastases ,Gynecology and obstetrics ,RG1-991 - Abstract
Objective: Low-risk, early stage, ovarian endometrioid carcinoma seems to have little chance to recur in clinical practice. Such a patient developed widespread, life-threatening pulmonary metastases is also extreme rare and is worthy to be reported. Case report: A 53-year-old female, who was diagnosed to have stage IA, grade 2, ovarian endometrioid carcinoma, developed a life threatening widespread lung metastasis in 2 years after primary surgery. She received salvage systemic chemotherapy with paclitaxel plus carboplatin. Bevacizumab was added after occurrence of paroxysmal supraventricular tachycardia during chemotherapy. The patient had clinical improvement and radiological stable after systemic therapy. Conclusion: Our case report enhances the aggressive post-operative surveillance including chest field would still be recommended even in the low-risk patients. To detect distant metastases earlier probably has higher chance of cure by systemic therapy.
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- 2022
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48. Rectal Resections
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Sarpel, Umut and Sarpel, Umut
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- 2021
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49. A Child with Papillary Thyroid Cancer and Metastatic Pulmonary Disease: Role of Radioactive Iodine Therapy
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Arango, Monica L., Waguespack, Steven G., Grani, Giorgio, editor, Cooper, David S., editor, and Durante, Cosimo, editor
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- 2021
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50. Survival prognostic and recurrence risk factors after single pulmonary metastasectomy
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Céline Forster, Amaya Ojanguren, Jean Yannis Perentes, Matthieu Zellweger, Thorsten Krueger, Etienne Abdelnour-Berchtold, and Michel Gonzalez
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Pulmonary metastases ,Pulmonary metastasectomy ,VATS ,Surgery ,RD1-811 ,Anesthesiology ,RD78.3-87.3 - Abstract
Abstract Background Identification of the prognostic factors of recurrence and survival after single pulmonary metastasectomy (PM). Methods Retrospective analysis of all consecutive patients who underwent PM for a single lung metastasis between 2003 and 2018. Results A total of 162 patients with a median age of 64 years underwent single PM. Video-Assisted Thoracic Surgery (VATS) was performed in 83.9% of cases. Surgical resection was achieved by wedge in 73.5%, segmentectomy in 7.4%, lobectomy in 17.9% and pneumonectomy in 1.2% of cases. The median durations of hospital stay and of drainage were 4 days (IQR 3–7) and 1 day (IQR 1–2), respectively. During the follow-up (median 31 months; IQR 15–58), 93 patients (57.4%) presented recurrences and repeated PM could be realized in 35 patients (21.6%) achieved by VATS in 77.1%. Non-colorectal tumour (HR 1.84), age
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- 2021
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