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Platelet count predicts prognosis in operable non-small cell lung cancer.

Exp Ther Med. 2013 May;5(5):1351-1354

Authors: Yu D, Liu B, Zhang L, DU K

Abstract
Platelets play a significant role in cancer cell growth, progression and metastasis. However, in non-small cell lung cancer (NSCLC), the association between a patient's platelet count and prognosis has not previously been fully elucidated. The aim of the present study was to investigate the correlation between platelet count, patients' characteristics and prognosis in patients with NSCLC. A total of 510 NSCLC patients were enrolled in the present study. The median platelet count in the NSCLC patients was 203×10(9)/l (95% CI, 115-358×10(9)/l). The median platelet count in T3 and T4 patients was significantly higher than that of T1 and T2 patients (median, 263×10(9)/l and 253.5×10(9)/l vs. 199.5×10(9)/l and 196.5×10(9)/l, respectively; P<0.001). The 3-year cumulative overall survival (OS) probability was 75.3% for patients with normal platelet counts and 59.2% for patients with elevated platelet counts. When compared with the patients with normal platelet counts, the patients with elevated platelet counts had an increased risk of disease progression (HR, 1.568; 95% CI, 1.015-2.453). Pre-operative platelet counts are a novel independent prognostic biomarker in operable NSCLC.

PMID: 23737877 [PubMed - as supplied by publisher]

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Correlation between microtubule-associated gene expression and chemosensitivity of patients with stage II non-small cell lung cancer.

Exp Ther Med. 2013 May;5(5):1506-1510

Authors: Jiang H, Yu XM, Zhou XM, Wang XH, Su D

Abstract
The aim of this study was to explore the correlation between mRNA expression of β-tubulin-III and stathmin in patients with stage II non-small cell lung cancer (NSCLC) and the chemosensitivity to Navelbine plus cisplatin (NP), as well as to provide a basis for personalized treatment. A single-gene quantitative test was performed to detect the mRNA expression of β-tubulin-III and stathmin in the tumor tissue of patients with stage II NSCLC. All the patients underwent NP treatment following surgery and were followed-up to record their disease-free survival (DFS) and overall survival (OS). Statistical analyses were conducted to investigate the correlation between β-tubulin-III and stathmin mRNA expression and DFS and OS in the patients. β-tubulin-III mRNA expression was associated with OS in the 73 patients (P=0.003) and DFS was correlated with β-tubulin-III mRNA expression and lymphatic metastasis (P<0.01). Stathmin mRNA expression was not correlated with OS or DFS (P>0.05). OS and DFS were longer in the patients with low β-tubulin-III mRNA expression than in those with high β-tubulin-III mRNA expression (P<0.01); there was no significant change in OS and DFS between the patients with high and low mRNA expression of stathmin (P>0.05). The mRNA expression levels of β-tubulin-III in the tumor tissue of patients with stage II NSCLC may be considered as an index of prognosis and chemosensitivity, as well as a reference for personalized chemotherapeutic applications in patients.

PMID: 23737908 [PubMed - as supplied by publisher]

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Clinical characteristics and outcomes of patients with small cell lung cancer detected by CT screening.

Med Oncol. 2013 Sep;30(3):623

Authors: Fukushima T, Tateishi K, Yamamoto H, Hanaoka M, Kubo K, Koizumi T

Abstract
The present study was performed to evaluate the clinical characteristics and survival outcomes in patients with small cell lung cancer (SCLC) detected by low-dose computed tomography (CT). We retrospectively reviewed clinical records of patients with SCLC treated at our hospital between 1997 and 2011 and selected patients with SCLC detected by CT screening. We identified 12 patients (male/female 11/1; mean age 67.8 years old. Nine patients had limited disease (LD), and 3 had extensive disease (ED). Five LD patients underwent thoracic surgery, and the pathological staging information included stage IA (n = 1), IB (n = 1), IIA (n = 1), and IIIB (n = 2). Although 2 patients with pathological stages IA and IB had >10-year survival, the median survival times (MST) in LD and ED were 25 months (95 % CI 17.0-32.9) and 16 months (95 % CI; not evaluated), respectively. In addition, MST in 12 patients was not significantly different from that in SCLC patients in general care in our hospital. This analysis suggested that CT screening contributes to the detection of early-stage SCLC in patients that are potentially suitable for surgery, but it remains unclear how to improve clinical outcome in patients with SCLC.

PMID: 23740004 [PubMed - in process]

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A Proposal for Combination of Total Number and Anatomical Location of Involved Lymph Nodes for Nodal Classification in Non-small Cell Lung Cancer.

Chest. 2013 Jun 1;143(6):1618-25

Authors: Saji H, Tsuboi M, Shimada Y, Kato Y, Yoshida K, Nomura M, Matsubayashi J, Nagao T, Kakihana M, Usuda J, Kajiwara N, Ohira T, Ikeda N

Abstract
BACKGROUND: We previously reported the prognostic impact of the number of involved lymph nodes (LNs) on survival in non-small cell lung cancer (NSCLC). However, it remains unknown whether the total number or anatomic location of involved LNs is a superior prognostic factor.
METHODS: A total of 689 patients with NSCLC who underwent complete resection involving dissection of the hilar and mediastinal LNs with curative intent of ≥ 10 LNs were enrolled. The association between the total number of LNs (nN) involved and survival was assessed by comparison with the anatomic location of LN involvement (pathologic lymph node [pN]), the present nodal category.
RESULTS: We classified the patients into five categories according to the combined pN and nN status as follows: pN0-nN0, pN1-nN1-3, pN1-nN4-, pN2-nN1-3, and pN2-nN4. Although there was no statistically significant difference between the pN1-nN4- and pN2-nN1-3 categories, pN2-nN1-3 had better prognoses than pN1-nN4-. On multivariate analysis, the nN category was an independent prognostic factor for overall survival and disease-free survival (vs nN4-; the hazard ratios of nN0 and nN1-3 for overall survival were 0.223 and 0.369, respectively, P &lt; .0001 for all), similar to the pN category. We propose a new classification based on a combination of the pN and nN categories: namely, N0 becomes pN0-nN0, the N1 category becomes pN1-nN1-3, the N2a category becomes pN2-nN1-3 + pN1-nN4-, and the N2b category becomes pN2-nN4. Each survival curve was proportional and was well distributed among the curves.
CONCLUSIONS: A combined anatomically based pN stage classification and numerically based nN stage classification is a more accurate prognostic determinant in patients with NSCLC, especially in the prognostically heterogeneous pN1 and pN2 cases. Further large-scale international cohort validation analyses are warranted.

PMID: 23740149 [PubMed - in process]