What Exactly Is a Centrally Located Lung Tumor? Results of an Online Survey

@article{Casal2017WhatEI,
  title={What Exactly Is a Centrally Located Lung Tumor? Results of an Online Survey},
  author={R. Casal and M. Vial and Russell J. Miller and L. Mudambi and H. Grosu and G. Eapen and C. Jimenez and R. Morice and L. Cornwell and D. Ost},
  journal={Annals of the American Thoracic Society},
  year={2017},
  volume={14},
  pages={118–123}
}
Rationale: Accurate mediastinal staging is a cornerstone in the management of patients with lung cancer. For patients with radiographically normal mediastinum, current lung cancer guidelines recommend invasive mediastinal staging when tumors are centrally located. However, definitions of central tumors are nonspecific, and there are discrepancies among guidelines (e.g., some use the inner one‐third of the hemithorax, whereas others use the inner two‐thirds). Objectives: To describe the… Expand
How do we classify a central tumor? Results of a multidisciplinary survey from the SEPAR Thoracic Oncology area
TLDR
The SEPAR Thoracic Oncology area aimed to evaluate the degree of familiarity with various concepts related to tumor site among professionals who see patients with NSCLC in Spain, finding wide variability in the classification of tumor lesions. Expand
Centrally located lung cancer and risk of occult nodal disease: an objective evaluation of multiple definitions of tumour centrality with dedicated imaging software
TLDR
In T1N0M0 nonsmall cell lung cancer, the prevalence of occult mediastinal disease is low regardless of tumour location, however, centrally located tumours are at risk of upstaging to any N. Expand
EVIDENCE FOR EXPANDING INVASIVE MEDIASTINAL STAGING FOR PERIPHERAL T1 LUNG TUMORS.
TLDR
The data indicate that there is a high rate of N2 metastasis among T1 tumors and there is no significant relationship between either tumor diameter or location, which suggests that patients with small, peripheral lung cancers may benefit from invasive mediastinal staging. Expand
Which definition of a central tumour is more predictive of occult mediastinal metastasis in nonsmall cell lung cancer patients with radiological N0 disease?
TLDR
It is suggested that a central tumour should be defined using the inner one-third of the hemithorax adopted by drawing concentric lines from the midline, particularly useful for predicting occult N2 disease in patients with NSCLC. Expand
Geometrical measurement of central tumor location in cT1N0M0 NSCLC predicts N1 but not N2 upstaging.
TLDR
Central tumor location can be assessed by means of IMR and OMR, and predicts N1 upstaging in patients with radiologically and metabolically T1N0M0 tumors, important for the selection of patients for therapies that require N0 tumors. Expand
Up-to date role of interventional pulmonology in the diagnosis and staging of non-small-cell lung cancer
TLDR
The main role of the Interventional Pulmonologist in this setting is to apply these procedures based on a correct interpretation of clinical and radiographic findings, in order to maximize the chances to achieving the diagnostic and staging information needed by the multidisciplinary lung cancer team for the optimal management of each specific case. Expand
Concordance of Clinical and Pathological Nodal Staging in Resectable Lung Cancer.
TLDR
Staging accuracy in lung cancers selected for initial resection declines with >cN0 and central tumors, and center-specific accuracy of IMS is a target for quality improvement. Expand
Is central lung tumour location really predictive for occult mediastinal nodal disease in (suspected) non-small-cell lung cancer staged cN0 on 18F-fluorodeoxyglucose positron emission tomography–computed tomography?
  • H. Decaluwé, J. Moons, +13 authors C. Dooms
  • Medicine
  • European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • 2018
TLDR
The prevalence of occult pN2-3 was only 8% when modern fusion positron emission tomography-computed tomography imaging pointed at clinical N0 non-small-cell lung cancer, prompting question whether indication for preoperative invasive mediastinal staging should be based on centrality alone. Expand
Surgical choice for cIA non-small cell lung cancer: view from regional lymph node metastasis.
TLDR
The pattern of regional LN metastasis in cIA peripheral NSCLC was significantly influenced by tumor size, which may provide evidence on surgical choice (lobectomy, segmentectomy, or wedge resection) for these early-stageNSCLC patients based on tumor size. Expand
A Prediction Model to Help with Oncologic Mediastinal Evaluation for Radiation: HOMER
TLDR
This prediction model can estimate the probability of N0, N1, and N2|3 disease in patients with NSCLC and has the potential to facilitate decision-making in patients when stereotactic ablative radiotherapy is an option. Expand
...
1
2
3
...

References

SHOWING 1-10 OF 17 REFERENCES
Location as an important predictor of lymph node involvement for pulmonary adenocarcinoma.
TLDR
Tumor location for pulmonary adenocarcinoma should be considered when planning therapy because central tumors have a high incidence of lymph node metastases (regardless of size) and a poorer prognosis. Expand
Revised ESTS guidelines for preoperative mediastinal lymph node staging for non-small-cell lung cancer.
  • P. D. De Leyn, C. Dooms, +9 authors M. Zieliński
  • Medicine
  • European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • 2014
TLDR
A revision of the ESTS guidelines was needed because more evidence of the different mediastinal staging technique has become available and both endoscopic techniques and surgical procedures are available, but their negative predictive value is lower compared with the results obtained in baseline staging. Expand
Methods for staging non-small cell lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines.
TLDR
It is demonstrated that PET scanning is more accurate than CT scanning, but tissue biopsy is still required to confirm PET scan findings, and evidence suggests that more complete staging improves patient outcomes. Expand
Risk factors for occult mediastinal metastases in clinical stage I non-small cell lung cancer.
TLDR
For patients deemed at clinical stage I NSCLC by CT and PET, the prevalence of missed N2 metastases increased significantly with larger tumor size and central location and a high PET SUV(max) of the primary tumor were other risk factors. Expand
Incidence of occult mediastinal node involvement in cN0 non-small-cell lung cancer patients after negative uptake of positron emission tomography/computer tomography scan.
  • A. Gómez-Caro, S. García, +5 authors F. Lomeña
  • Medicine
  • European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • 2010
TLDR
Mediastinal staging of NSCLC by FDG-PET/CT showed a considerable incidence of FNs, which is lower than previously reported and the preoperative mediastinal staged by 18FDG- PET/CT may jeopardise the accurate treatment for early stageNSCLC patients. Expand
A prediction model for N2 disease in T1 non-small cell lung cancer.
TLDR
A 4-predictor model that can estimate the probability of N2 disease in computed tomography-defined T1N0 non-small cell lung cancer can help to determine the cost-effective use of mediastinal staging procedures. Expand
Central versus Peripheral Tumor Location: Influence on Survival, Local Control, and Toxicity Following Stereotactic Body Radiotherapy for Primary Non–Small-Cell Lung Cancer
TLDR
Central tumor location did not predict for inferior OS, LC, or toxicity following SBRT when a lower mean BED was utilized, suggesting central tumors were less likely to have acute grade greater than or equal to three toxicity than those with peripheral tumors. Expand
A Prediction Model for Pathologic N2 Disease in Lung Cancer Patients with a Negative Mediastinum by Positron Emission Tomography
TLDR
A prediction model for pathologic N2 disease (pN2), using six previously described risk factors: tumor location and size by computed tomography (CT), nodal disease by CT, maximum standardized uptake value of the primary tumor, N1 by PET, and histology, has reasonable performance characteristics. Expand
Development and validation of a clinical prediction model for N2 lymph node metastasis in non-small cell lung cancer.
TLDR
The prediction model estimated the pretest probability of N2 disease in computed tomography-defined N0 NSCLC and was more accurate than the existing models and can be of assistance when making clinical decisions about invasive or expensive mediastinal staging procedures. Expand
Stereotactic body radiation therapy for inoperable early stage lung cancer.
TLDR
Patients with inoperable non-small cell lung cancer who received stereotactic body radiation therapy had a survival rate of 55.8% at 3 years, high rates of local tumor control, and moderate treatment-related morbidity. Expand
...
1
2
...