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The prognostic value of pre-treatment thrombocytosis in two cohorts of patients with non-small cell lung cancer treated with curatively intended chemoradiotherapy.

https://arctichealth.org/en/permalink/ahliterature299769
Source
Neoplasma. 2017; 64(6):909-915
Publication Type
Journal Article
Author
G Holgersson
S Bergstrom
A Hallqvist
P Liv
J Nilsson
L Willen
J Nyman
S Ekman
R Henriksson
M Bergqvist
Source
Neoplasma. 2017; 64(6):909-915
Language
English
Publication Type
Journal Article
Keywords
Anemia
Carcinoma, Non-Small-Cell Lung - diagnosis - therapy
Chemoradiotherapy
Clinical Trials, Phase II as Topic
Humans
Leukocytosis
Lung Neoplasms - diagnosis - therapy
Neoplasm Staging
Prognosis
Retrospective Studies
Survival Analysis
Sweden
Thrombocytosis - pathology
Abstract
Chemoradiotherapy is the standard of care for inoperable stage III non-small cell lung cancer (NSCLC). This treatment, however, offers only a small chance of cure and is associated with many side effects. Little research has been made concerning which patients benefit most/least from the treatment. The present study evaluates the prognostic value of anemia, leukocytosis and thrombocytosis at diagnosis in this treatment setting. In the present study, data were collected retrospectively for 222 patients from two different phase II studies conducted between 2002-2007 in Sweden with patients treated with chemoradiotherapy for stage IIIA-IIIB NSCLC. Clinical data and the serum values of hemoglobin (Hgb), White blood cells (WBC) and Platelets (Plt) at enrollment were collected for all patients and studied in relation to overall survival using Kaplan-Meier product-limit estimates and a multivariate Cox proportional hazards regression model. The results showed that patients with thrombocytosis (Plt > 350 x 109/L) had a shorter median overall survival (14.5 months) than patients with normal Plt at baseline (23.7 months). Patients with leukocytosis (WBC > 9 x 109/L) had a shorter median survival (14.9 months) than patients with a normal WBC at baseline (22.5 months). However, in a multivariate model including all lab parameters and clinical factors, only thrombocytosis and performance status displayed a prognostic significance. In Conclusion, thrombocytosis showed to be an independent prognostic marker associated with shorter overall survival in stage III NSCLC treated with curatively intended chemoradiotherapy. This knowledge can potentially be used together with established prognostic factors, such as performance status when choosing the optimal therapy for the individual patient in this clinical setting.
PubMed ID
28895417 View in PubMed
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A systematic review and Canadian consensus recommendations on the use of biomarkers in the treatment of non-small cell lung cancer.

https://arctichealth.org/en/permalink/ahliterature133382
Source
J Thorac Oncol. 2011 Aug;6(8):1379-91
Publication Type
Article
Date
Aug-2011
Author
Peter M Ellis
Normand Blais
Dennis Soulieres
Diana N Ionescu
Meenakshi Kashyap
Geoff Liu
Barb Melosky
Tony Reiman
Phillippe Romeo
Frances A Shepherd
Ming-Sound Tsao
Natasha B Leighl
Author Affiliation
Juravinski Cancer Centre, Hamilton, Ontario, Canada. peter.ellis@jcc.hhsc.ca
Source
J Thorac Oncol. 2011 Aug;6(8):1379-91
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Canada
Carcinoma, Non-Small-Cell Lung - diagnosis - therapy
Clinical Trials as Topic
Consensus
Humans
Lung Neoplasms - diagnosis - therapy
Practice Guidelines as Topic
Tumor Markers, Biological - analysis
Abstract
Greater understanding of molecular pathways important in cell growth and proliferation of thoracic malignancies, particularly non-small cell lung cancer (NSCLC), has resulted in intense clinical and translational research. There is now considerable interest in personalizing treatment based on an understanding of tumor histology and molecular abnormalities. However, there is a multiplicity of data, often with discordant results resulting in confusion and uncertainty among clinicians.
We conducted a systematic review and a consensus meeting of Canadian lung cancer oncologists and pathologists to make recommendations on the use of biomarkers in NSCLC. PubMed covering 2005 to March 2010 was searched using MESH terms for NSCLC and randomized trials, plus text words for the biomarkers of interest. Conference proceedings from 2005 to 2009 ASCO, ESMO, IASLC, and USCAP were also searched. The articles were reviewed by pairs of oncologists and pathologists to determine eligibility for inclusion.
Ten oncologists and pathologists reviewed and summarized the literature at a meeting attended by 37 individuals. Draft recommendations were formulated and agreed upon by consensus process. There is some evidence that histology is prognostic for survival. There is evidence from multiple randomized clinical trials to recommend the following: histologic subtype is predictive of treatment efficacy and for some agents toxicity. Immunohistochemistry testing should be performed on NSCLC specimens that cannot be classified accurately with conventional H&E staining. As EGFR mutations are predictive of benefit from tyrosine kinase inhibitors, diagnostic NSCLC samples should be routinely tested for EGFR-activating mutations. Clinical data on K-RAS mutations are inconsistent, therefore testing is not recommended. There is insufficient evidence to recommend other biomarker testing. No biomarkers to date reliably predict improved efficacy for anti-VEGF therapy. Routine assessment for EML4/ALK mutations is not recommended at present, although emerging data suggest that it may become valuable in the near future.
Assessment of NSCLC biomarkers is becoming increasingly important. Therefore, adequate diagnostic material must be obtained for accurate histologic subtyping and relevant molecular biology assays.
Notes
Comment In: J Thorac Oncol. 2012 Apr;7(4):773-4; author reply 77422425934
PubMed ID
21709590 View in PubMed
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Transfer between hospitals as a predictor of delay in diagnosis and treatment of patients with Non-Small Cell Lung Cancer - a register based cohort-study.

https://arctichealth.org/en/permalink/ahliterature283165
Source
BMC Health Serv Res. 2017 Apr 12;17(1):267
Publication Type
Article
Date
Apr-12-2017
Author
Maria Iachina
Erik Jakobsen
Anne Kudsk Fallesen
Anders Green
Source
BMC Health Serv Res. 2017 Apr 12;17(1):267
Date
Apr-12-2017
Language
English
Publication Type
Article
Keywords
Aged
Carcinoma, Non-Small-Cell Lung - diagnosis - therapy
Denmark
Female
Hospitals
Humans
Lung Neoplasms - diagnosis - therapy
Male
Middle Aged
Patient transfer
Prospective Studies
Referral and Consultation
Registries
Survival Rate
Time-to-Treatment
Abstract
Lung cancer is the second most frequent cancer diagnosis in Denmark. Although improved during the last decade, the prognosis of lung cancer is still poor with an overall 5-year survival rate of approximately 12%. Delay in diagnosis and treatment of lung cancer has been suggested as a potential cause of the poor prognosis and as consequence, fast track cancer care pathways were implemented describing maximum acceptable time thresholds from referral to treatment. In Denmark, patients with lung cancer are often transferred between hospitals with diagnostic facilities to hospitals with treatment facilities during the care pathway. We wanted to investigate whether this organizational set-up influenced the time that patients wait for the diagnosis and treatment. Therefore, the objective of this study was to uncover the impact of transfer between hospitals on the delay in the diagnosis and treatment of Non-Small Cell Lung Cancer (NSCLC).
We performed a historical prospective cohort study using data from the Danish Lung Cancer Registry (DLCR). All patients diagnosed with primary NSCLC from January 1st 2008 to December 31st 2012 were included. Patients with unresolved pathology and incomplete data on the dates of referral, diagnosis and treatment were excluded.
A total of 11 273 patients were included for further analyses. Transfer patients waited longer for treatment after the diagnosis, (Hazard ratio (HR) 0.81 (0.68-0.96)) and in total time from referral to treatment (HR 0.84 (0.77-0.92)), than no-transfer patients. Transfer patients had lower odds of being diagnosed (Odds Ratio (OR) 0.82 (0.74-0.94) and treated (OR 0.66 (0.61-0.72) within the acceptable time thresholds described in the care pathway.
Fast track cancer care pathways were implemented to unify and accelerate the diagnosis and treatment of cancer. We found that the transfer between hospitals during the care pathway might cause delay from diagnosis to treatment as well as in the total time from referral to treatment in patients with Non Small-Cell Lung Cancer. The difference between no-transfer and transfer patients persists after adjusting for known predictors of delay.
Notes
Cites: Eur J Cancer. 2009 Apr;45(6):931-9119171476
Cites: Eur J Cardiothorac Surg. 1997 Dec;12(6):880-49489874
Cites: Br J Cancer. 2014 Oct 28;111(9):1843-5125203519
Cites: Clin Lung Cancer. 2012 Sep;13(5):363-822264658
Cites: Br J Cancer. 2011 Sep 27;105(7):1042-821897390
Cites: Thorax. 2004 Jan;59(1):1-314694232
Cites: J Thorac Dis. 2011 Sep;3(3):183-822263086
Cites: Chest. 2005 Oct;128(4):2282-816236885
Cites: J Thorac Oncol. 2011 Jul;6(7):1254-921610526
Cites: Eur J Cardiothorac Surg. 2008 Sep;34(3):479-8318667329
Cites: J Cardiothorac Surg. 2007 Jan 12;2:517217547
Cites: Thorax. 2004 Jan;59(1):45-914694247
Cites: Thorax. 2009 Sep;64(9):749-5619717709
Cites: Acta Oncol. 2002;41(2):147-5212102158
Cites: J Chronic Dis. 1987;40(5):373-833558716
Cites: J Thorac Oncol. 2008 Sep;3(9):951-718758295
Cites: Ann Agric Environ Med. 2013;20(1):72-623540215
Cites: Can J Surg. 2006 Aug;49(4):251-816948883
Cites: Anticancer Res. 1996 Mar-Apr;16(2):995-98687166
Cites: Intern Med J. 2010 Feb;40(2):126-3219220556
Cites: Am J Respir Crit Care Med. 2009 Apr 1;179(7):595-60018948424
Cites: Radiother Oncol. 2004 Mar;70(3):283-915064014
Cites: Acta Oncol. 2010 Jun;49(5):532-4420491522
Cites: Clin Oncol (R Coll Radiol). 2000;12 (3):141-410942328
Cites: Can J Surg. 2006 Feb;49(1):31-616524140
Cites: Ir Med J. 2005 Sep;98(8):238-916255115
Cites: J Thorac Cardiovasc Surg. 2003 Jan;125(1):108-13; discussion 113-412538992
Cites: Lancet Oncol. 2007 Sep;8(9):773-8317714991
Cites: Lung Cancer. 2001 Nov;34(2):243-5211679183
Cites: Chest. 2008 May;133(5):1167-7318263676
Cites: Curr Oncol. 2012 Oct;19(5):e308-1823144579
Cites: Ann Surg. 2011 Apr;253(4):779-8521475020
Cites: Lancet. 2011 Jan 8;377(9760):127-3821183212
Cites: J Thorac Oncol. 2008 Aug;3(8):865-7018670304
Cites: Eur J Cancer. 2013 Jun;49(9):2187-9823453935
Cites: Lung Cancer. 2002 Apr;36(1):59-6311891034
Cites: BMJ Open. 2014 Feb 12;4(2):e00384624523421
Cites: J Thorac Oncol. 2007 Jul;2(7):590-217607113
Cites: Ann Surg Oncol. 2013 Aug;20(8):2468-7623529782
Cites: Jpn J Clin Oncol. 2012 Oct;42(10):934-922826351
Cites: J Thorac Oncol. 2013 Oct;8(10):1238-4724457234
PubMed ID
28403839 View in PubMed
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