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(searched for: doi:10.4103/jcrt.jcrt_140_17)
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Weichun Wu, Yimin Wu, Gang Shen,
Published: 7 January 2021
Journal of Cardiothoracic Surgery, Volume 16, pp 1-4; https://doi.org/10.1186/s13019-020-01387-6

Abstract:
Background As the positions and sizes of nodules in synchronous multiple primary lung cancer (SMPLC) patients differ, the development of surgical strategies to maximize long-term survival and preserved postoperative pulmonary function in SMPLC patients for whom surgical resection is an alternative strategy presents challenges. Case presentation We provide a case managed through video-assisted thoracoscopic surgery (VATS) resection using three-dimensional computed tomography lung reconstruction (3D-CTLR) to reconstruct lobes containing pulmonary nodules to preoperatively simulate and intraoperatively guide the extent and method of resection. Conclusion The successful attempt demonstrates a technically simplified, feasible alternative to preoperative plans utilizing less invasive VATS to manage SMPLC.
Lishu Zhao, Chaoyuan Liu, GuiYuan Xie, ,
Published: 1 October 2020
Cancer Management and Research, pp 10361-10375; https://doi.org/10.2147/cmar.s268081

Abstract:
Abstract: With the widespread implementation of lung cancer screening, more and more patients are being diagnosed with multiple primary lung cancers (MPLCs). In the era of precision medicine, many controversies remain in differentiating MPLCs from intrapulmonary metastasis and the optimum treatment choice, especially in patients exhibiting similar histology. In this review, we summarize common diagnostic criteria and novel discrimination methods with a special emphasis on the emerging value of broad panel next-generation sequencing (NGS) for the diagnosis of MPLCs. We then discuss current advances regarding therapeutic approaches for MPLCs. Radical surgery is the main treatment modality, while stereotactic body radiotherapy (SBRT) is safe and feasible for early-stage MPLC patients with inoperable tumors. In addition, immunotherapy and targeted therapy, particularly epidermal growth factor receptor-tyrosine kinase inhibitors, are emerging therapeutic strategies that are still in their infancy. Characteristics of both genomic profiles and tumor microenvironment are currently being evaluated but warrant further exploration to facilitate the application of targeted systematic therapies in MPLC patients.
Qing Xia, Ling-Yi Zhao, Yi-Dan Yan, Yuan Liao, Ying-San Di, Xiu-Ying Xiao
Published: 31 July 2020
Frontiers in Oncology, Volume 10; https://doi.org/10.3389/fonc.2020.01199

Abstract:
Background: Multiple primary malignancies (MPMs) refer to two or more primary malignant tumors in the same individual, the prevalence of which ranges from 0. 734 to 11.7%. The risk factors for MPMs vary and include both genetic and environmental causes. FANCA gene mutation might be a predisposition to the development of a second primary cancer. Here, we report a case in which a patient with a FANCA mutation developed thyroid papillary carcinoma and gastric adenocarcinoma. Case Presentation: A 48-year-old woman was diagnosed with thyroid cancer underwent resection in 2006. In 2008, the patient developed gastric adenocarcinoma and underwent radical gastrectomy. Gastric cancer was completely remitted after radiochemotherapy, but metastasis developed, and she received immunotherapy. The patient died on October 27, 2019. Peripheral blood gene detection showed germline FANCA mutation. Conclusions: Gene detection is of great importance in cancer patients, especially in those with MPMs. FANCA mutation is a predisposition to tumorigenesis that can increase the risk of developing MPMs. Patients with heterozygous FANCA gene mutations have poorer outcomes.
Zeina Ayoub, Matthew S. Ning, Eric D. Brooks, Jingjing Kang, James W. Welsh, Aileen Chen, Saumil Gandhi, John V. Heymach, Ara A. Vaporciyan,
International Journal of Radiation Oncology - Biology - Physics, Volume 107, pp 261-269; https://doi.org/10.1016/j.ijrobp.2020.02.001

Abstract:
Purpose Management of synchronous early-stage non-small cell lung cancer (NSCLC) remains controversial because resection is not always feasible. This study evaluates efficacy and patterns of failure after SABR for synchronous early-stage NSCLC. Methods and Materials From 2005 to 2015, patients presenting with ≥2 synchronous NSCLC tumors (T1a-T2b) and receiving SABR to ≥1 lesion were reviewed. The most common prescriptions were 50 Gy in 4 or 70 Gy in 10 fractions. Patients underwent multidisciplinary management with workup including chest computed tomography and positron emission tomography/computed tomography, plus brain imaging and endoscopic bronchial ultrasound for most patients to rule out mediastinal and distant disease. Synchronous lesions were defined as multiple ipsilateral or contralateral intrapulmonary lesions diagnosed within 6 months. Results Of 912 patients treated with SABR for early-stage NSCLC at our institution, 82 (9%) presented with synchronous disease, with a total of 169 lesions. SABR was delivered to 142 lesions (84%), with 57 patients (69.5%) receiving SABR for all sites. Median overall survival (OS) and progression-free survival (PFS) were 5.1 and 2.7 years, respectively. At a median follow-up of 58 months, OS was 67% and 52% at 3 and 5 years, and corresponding PFS was 47% and 29%. Thirty-nine patients (48%) had progression, with 21 (26%) experiencing distant failure, and intralobar recurrence was among the first failure for 15 patients (18%). Of the 142 SABR-treated sites, these included 6 in-field (4%) and 4 marginal (3%) recurrences. There were no grade ≥3 adverse events. Among patients receiving SABR for all sites, there were no differences in OS (P = .946), PFS (P = .980), local control (P = .683), regional and distant control (P = .656), or toxicity (P = .791). On multivariable analysis, ipsilateral synchronous disease was associated with greater regional and distant failure (hazard ratio, 2.691; P = .025). Conclusions Synchronous NSCLC can be managed with definitive local therapy. With high control rates and favorable outcomes, SABR is an effective and feasible treatment for synchronous early-stage NSCLC.
Jing Chun An, Han‑Bing Shi, Wen‑Bo Hao, Kun Zhu, Bo Ma
Published: 18 February 2019
Journal: Oncology Letters
Oncology Letters, Volume 17, pp 3790-3798; https://doi.org/10.3892/ol.2019.10045

Abstract:
Lung adenocarcinoma (LAC) is a leading cause of cancer‑associated mortalities, particularly in developed countries. The aberrant expression of microRNAs (miRNAs) has been proven to regulate numerous diseases in the past two decades. miRNAs have been identified in almost all human cancer types. In the present study, the role of miR‑944 in LAC proliferation was examined. It was identified that miR‑944 was downregulated in LAC tissues and cells, and miR‑944 overexpression inhibited A549 and H1299 cell proliferation, as determined by the Cell Counting Kit‑8 and colony formation assay. Signal transducer and activator of transcription 1 (STAT1) was upregulated in LAC tissues and cells. Kaplan‑Meier analysis demonstrated that the 5‑year overall survival in patients with high STAT1 levels was significantly reduced, compared with patients with negative and low STAT1 expression. STAT1 was the direct target of miR‑944. Additionally, a miR‑944 mimic inhibited A549 cell growth in vitro. Collectively, these data demonstrate that miR‑944 serves a pivotal role in LAC tumor growth by targeting STAT1. The data obtained indicated that miR‑944 may be a novel biomarker and could result in potential therapies for LAC.
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