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Haiquan Chen - One of the best experts on this subject based on the ideXlab platform.
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Tumor Histology predicts mediastinal nodal status and may be used to guide limited lymphadenectomy in patients with clinical stage i non small cell lung cancer
The Journal of Thoracic and Cardiovascular Surgery, 2018Co-Authors: Xinghua Cheng, Difan Zheng, Yuan Li, Hang Li, Jiaqing Xiang, Haiquan ChenAbstract:Abstract Objective Methods to minimize surgical trauma from mediastinal lymphadenectomy in patients with early-stage lung cancer are still immature. This study aimed to identify predictors of negative pathologic N2, which may be used to select patients for limited mediastinal lymphadenectomy. Methods Clinicopathologic features of 1430 patients with resected clinical stage I non–small cell lung cancer and complete mediastinal lymphadenectomy were retrospectively analyzed for variables associated with negative N2 nodal metastasis (2008-2015). Overall and recurrence-free survival in patients after complete or limited mediastinal lymphadenectomy were assessed via Kaplan–Meier survival analysis and log-rank testing. The accuracy of frozen section diagnosis for predicting final pathology was retrospectively assessed in 126 randomly selected patients after the surgery. Results Multivariable analysis revealed that Tumor size ≤2 cm, negative pN1, lymphovascular invasion, and lepidic adenocarcinoma were associated with negative mediastinal nodal metastasis. Notably, none of the patients with Histology of adenocarcinoma in situ, minimally invasive adenocarcinoma, or lepidic pattern–predominant adenocarcinoma on final pathology had pN2 disease, and the 5-year overall and recurrence free-survival of these patients (99.3% and 99.3%, respectively) was not different from those after limited mediastinal lymphadenectomy (98.7% and 100%, P = .582 and .511, respectively). If these subtypes were classified together as the low-risk group, the concordance rate between frozen section and final pathology diagnosis was 88.9% in the retrospective test cohort. Conclusions Tumor Histology may predict negative mediastinal metastasis in patients with early-stage lung cancer. Future prospective studies are merited to validate the feasibility of using frozen section to select patients for limited mediastinal lymphadenectomy.
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predictive factors of lymph node status in small peripheral non small cell lung cancers Tumor Histology is more reliable
Annals of Surgical Oncology, 2013Co-Authors: Yang Zhang, Yuan Li, Jiaqing Xiang, Lei Shen, Yawei Zhang, Hong Hu, Haiquan ChenAbstract:Background During the past two decades, many studies have sought to find reliable predictors of N0 status in small-sized lung cancers. However, the way of Tumor size measurement was usually not clearly stated, and controversy remains as to whether systematic lymph node dissection should be performed in patients with subcentimeter Tumors.
Robert E. Isaacs - One of the best experts on this subject based on the ideXlab platform.
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Impact of Tumor Histology on Resectability and Neurological Outcome in Primary Intramedullary Spinal Cord Tumors
Neurosurgery, 2015Co-Authors: Isaac O. Karikari, Shahid M. Nimjee, Tiffany R. Hodges, Erin Cutrell, Betsy D. Hughes, Ciaran J. Powers, Ankit I. Mehta, Carolyn Hardin, Carlos A. Bagley, Robert E. IsaacsAbstract:Abstract BACKGROUND: Surgical outcomes for intramedullary spinal cord Tumors are affected by many variables including Tumor Histology and preoperative neurological function. OBJECTIVE: To analyze the impact of Tumor Histology on neurological outcome in primary intramedullary spinal cord Tumors. METHODS: A retrospective review of 102 consecutive patients with intramedullary spinal cord Tumors treated at a single institution between January 1998 and March 2009. RESULTS: Ependymomas were the most common Tumors with 55 (53.9%), followed by 21 astrocytomas (20.6%), 12 hemangioblastomas (11.8%), and 14 miscellaneous Tumors (13.7%). Gross total resection was achieved in 50 ependymomas (90.9%), 3 astrocytomas (14.3%), 11 hemangioblastomas (91.7%), and 12 miscellaneous Tumors (85.7%). At a mean follow-up of 41.8 months (range, 1-132 months), we observed recurrences in 4 ependymoma cases (7.3%), 10 astrocytoma cases (47.6%), 1 miscellaneous Tumor case (7.1%), and no recurrence in hemangioblastoma cases. When analyzed by Tumor location, there was no difference in neurological outcomes (P = .66). At the time of their last follow-up visit, 11 patients (20%) with an ependymoma improved, 38 (69%) remained the same, and 6 (10.9%) worsened. In patients with an astrocytoma, 1 (4.8%) improved, 10 (47.6%) remained the same, and 10 (47.6%) worsened. One patient (8.3%) with a hemangioblastoma improved and 11 (91.7%) remained the same. No patient with a hemangioblastoma worsened. In the miscellaneous Tumor group, 2 (14.3%) improved, 10 (71.4%) remained the same, and 2 (14.3%) worsened. Preoperative neurological status (P = .02), Tumor Histology (P = .005), and extent of resection (P < .0001) were all predictive of functional neurological outcomes. CONCLUSION: Tumor Histology is the most important predictor of neurological outcome after surgical resection because it predicts resectability and recurrence.
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impact of Tumor Histology on resectability and neurological outcome in primary intramedullary spinal cord Tumors a single center experience with 102 patients
Neurosurgery, 2011Co-Authors: Isaac O. Karikari, Shahid M. Nimjee, Tiffany R. Hodges, Erin Cutrell, Betsy D. Hughes, Ciaran J. Powers, Ankit I. Mehta, Carlos A. Bagley, Carolyn A Hardin, Robert E. IsaacsAbstract:BACKGROUND: Surgical outcomes for intramedullary spinal cord Tumors are affected by many variables including Tumor Histology and preoperative neurological function. OBJECTIVE: To analyze the impact of Tumor Histology on neurological outcome in primary intramedullary spinal cord Tumors. METHODS: A retrospective review of 102 consecutive patients with intramedullary spinal cord Tumors treated at a single institution between January 1998 and March 2009. RESULTS: Ependymomas were the most common Tumors with 55 (53.9%), followed by 21 astrocytomas (20.6%), 12 hemangioblastomas (11.8%), and 14 miscellaneous Tumors (13.7%). Gross total resection was achieved in 50 ependymomas (90.9%), 3 astrocytomas (14.3%), 11 hemangioblastomas (91.7%), and 12 miscellaneous Tumors (85.7%). At a mean follow-up of 41.8 months (range, 1-132 months), we observed recurrences in 4 ependymoma cases (7.3%), 10 astrocytoma cases (47.6%), 1 miscellaneous Tumor case (7.1%), and no recurrence in hemangioblastoma cases. When analyzed by Tumor location, there was no difference in neurological outcomes (P = .66). At the time of their last follow-up visit, 11 patients (20%) with an ependymoma improved, 38 (69%) remained the same, and 6 (10.9%) worsened. In patients with an astrocytoma, 1 (4.8%) improved, 10 (47.6%) remained the same, and 10 (47.6%) worsened. One patient (8.3%) with a hemangioblastoma improved and 11 (91.7%) remained the same. No patient with a hemangioblastoma worsened. In the miscellaneous Tumor group, 2 (14.3%) improved, 10 (71.4%) remained the same, and 2 (14.3%) worsened. Preoperative neurological status (P = .02), Tumor Histology (P = .005), and extent of resection (P < .0001) were all predictive of functional neurological outcomes. CONCLUSION: Tumor Histology is the most important predictor of neurological outcome after surgical resection because it predicts resectability and recurrence.
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impact of Tumor Histology on resectability and neurological outcome in primary intramedullary spinal cord Tumors a single center experience with 102 patients
Neurosurgery, 2011Co-Authors: Isaac O. Karikari, Shahid M. Nimjee, Tiffany R. Hodges, Erin Cutrell, Betsy D. Hughes, Ciaran J. Powers, Ankit I. Mehta, Carolyn Hardin, Carlos A. Bagley, Robert E. IsaacsAbstract:Abstract Surgical outcomes for intramedullary spinal cord Tumors are affected by many variables including Tumor Histology and preoperative neurological function. To analyze the impact of Tumor Histology on neurological outcome in primary intramedullary spinal cord Tumors. A retrospective review of 102 consecutive patients with intramedullary spinal cord Tumors treated at a single institution between January 1998 and March 2009. Ependymomas were the most common Tumors with 55 (53.9%), followed by 21 astrocytomas (20.6%), 12 hemangioblastomas (11.8%), and 14 miscellaneous Tumors (13.7%). Gross total resection was achieved in 50 ependymomas (90.9%), 3 astrocytomas (14.3%), 11 hemangioblastomas (91.7%), and 12 miscellaneous Tumors (85.7%). At a mean follow-up of 41.8 months (range, 1-132 months), we observed recurrences in 4 ependymoma cases (7.3%), 10 astrocytoma cases (47.6%), 1 miscellaneous Tumor case (7.1%), and no recurrence in hemangioblastoma cases. When analyzed by Tumor location, there was no difference in neurological outcomes (P = .66). At the time of their last follow-up visit, 11 patients (20%) with an ependymoma improved, 38 (69%) remained the same, and 6 (10.9%) worsened. In patients with an astrocytoma, 1 (4.8%) improved, 10 (47.6%) remained the same, and 10 (47.6%) worsened. One patient (8.3%) with a hemangioblastoma improved and 11 (91.7%) remained the same. No patient with a hemangioblastoma worsened. In the miscellaneous Tumor group, 2 (14.3%) improved, 10 (71.4%) remained the same, and 2 (14.3%) worsened. Preoperative neurological status (P = .02), Tumor Histology (P = .005), and extent of resection (P
Isaac O. Karikari - One of the best experts on this subject based on the ideXlab platform.
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Impact of Tumor Histology on Resectability and Neurological Outcome in Primary Intramedullary Spinal Cord Tumors
Neurosurgery, 2015Co-Authors: Isaac O. Karikari, Shahid M. Nimjee, Tiffany R. Hodges, Erin Cutrell, Betsy D. Hughes, Ciaran J. Powers, Ankit I. Mehta, Carolyn Hardin, Carlos A. Bagley, Robert E. IsaacsAbstract:Abstract BACKGROUND: Surgical outcomes for intramedullary spinal cord Tumors are affected by many variables including Tumor Histology and preoperative neurological function. OBJECTIVE: To analyze the impact of Tumor Histology on neurological outcome in primary intramedullary spinal cord Tumors. METHODS: A retrospective review of 102 consecutive patients with intramedullary spinal cord Tumors treated at a single institution between January 1998 and March 2009. RESULTS: Ependymomas were the most common Tumors with 55 (53.9%), followed by 21 astrocytomas (20.6%), 12 hemangioblastomas (11.8%), and 14 miscellaneous Tumors (13.7%). Gross total resection was achieved in 50 ependymomas (90.9%), 3 astrocytomas (14.3%), 11 hemangioblastomas (91.7%), and 12 miscellaneous Tumors (85.7%). At a mean follow-up of 41.8 months (range, 1-132 months), we observed recurrences in 4 ependymoma cases (7.3%), 10 astrocytoma cases (47.6%), 1 miscellaneous Tumor case (7.1%), and no recurrence in hemangioblastoma cases. When analyzed by Tumor location, there was no difference in neurological outcomes (P = .66). At the time of their last follow-up visit, 11 patients (20%) with an ependymoma improved, 38 (69%) remained the same, and 6 (10.9%) worsened. In patients with an astrocytoma, 1 (4.8%) improved, 10 (47.6%) remained the same, and 10 (47.6%) worsened. One patient (8.3%) with a hemangioblastoma improved and 11 (91.7%) remained the same. No patient with a hemangioblastoma worsened. In the miscellaneous Tumor group, 2 (14.3%) improved, 10 (71.4%) remained the same, and 2 (14.3%) worsened. Preoperative neurological status (P = .02), Tumor Histology (P = .005), and extent of resection (P < .0001) were all predictive of functional neurological outcomes. CONCLUSION: Tumor Histology is the most important predictor of neurological outcome after surgical resection because it predicts resectability and recurrence.
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impact of Tumor Histology on resectability and neurological outcome in primary intramedullary spinal cord Tumors a single center experience with 102 patients
Neurosurgery, 2011Co-Authors: Isaac O. Karikari, Shahid M. Nimjee, Tiffany R. Hodges, Erin Cutrell, Betsy D. Hughes, Ciaran J. Powers, Ankit I. Mehta, Carlos A. Bagley, Carolyn A Hardin, Robert E. IsaacsAbstract:BACKGROUND: Surgical outcomes for intramedullary spinal cord Tumors are affected by many variables including Tumor Histology and preoperative neurological function. OBJECTIVE: To analyze the impact of Tumor Histology on neurological outcome in primary intramedullary spinal cord Tumors. METHODS: A retrospective review of 102 consecutive patients with intramedullary spinal cord Tumors treated at a single institution between January 1998 and March 2009. RESULTS: Ependymomas were the most common Tumors with 55 (53.9%), followed by 21 astrocytomas (20.6%), 12 hemangioblastomas (11.8%), and 14 miscellaneous Tumors (13.7%). Gross total resection was achieved in 50 ependymomas (90.9%), 3 astrocytomas (14.3%), 11 hemangioblastomas (91.7%), and 12 miscellaneous Tumors (85.7%). At a mean follow-up of 41.8 months (range, 1-132 months), we observed recurrences in 4 ependymoma cases (7.3%), 10 astrocytoma cases (47.6%), 1 miscellaneous Tumor case (7.1%), and no recurrence in hemangioblastoma cases. When analyzed by Tumor location, there was no difference in neurological outcomes (P = .66). At the time of their last follow-up visit, 11 patients (20%) with an ependymoma improved, 38 (69%) remained the same, and 6 (10.9%) worsened. In patients with an astrocytoma, 1 (4.8%) improved, 10 (47.6%) remained the same, and 10 (47.6%) worsened. One patient (8.3%) with a hemangioblastoma improved and 11 (91.7%) remained the same. No patient with a hemangioblastoma worsened. In the miscellaneous Tumor group, 2 (14.3%) improved, 10 (71.4%) remained the same, and 2 (14.3%) worsened. Preoperative neurological status (P = .02), Tumor Histology (P = .005), and extent of resection (P < .0001) were all predictive of functional neurological outcomes. CONCLUSION: Tumor Histology is the most important predictor of neurological outcome after surgical resection because it predicts resectability and recurrence.
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impact of Tumor Histology on resectability and neurological outcome in primary intramedullary spinal cord Tumors a single center experience with 102 patients
Neurosurgery, 2011Co-Authors: Isaac O. Karikari, Shahid M. Nimjee, Tiffany R. Hodges, Erin Cutrell, Betsy D. Hughes, Ciaran J. Powers, Ankit I. Mehta, Carolyn Hardin, Carlos A. Bagley, Robert E. IsaacsAbstract:Abstract Surgical outcomes for intramedullary spinal cord Tumors are affected by many variables including Tumor Histology and preoperative neurological function. To analyze the impact of Tumor Histology on neurological outcome in primary intramedullary spinal cord Tumors. A retrospective review of 102 consecutive patients with intramedullary spinal cord Tumors treated at a single institution between January 1998 and March 2009. Ependymomas were the most common Tumors with 55 (53.9%), followed by 21 astrocytomas (20.6%), 12 hemangioblastomas (11.8%), and 14 miscellaneous Tumors (13.7%). Gross total resection was achieved in 50 ependymomas (90.9%), 3 astrocytomas (14.3%), 11 hemangioblastomas (91.7%), and 12 miscellaneous Tumors (85.7%). At a mean follow-up of 41.8 months (range, 1-132 months), we observed recurrences in 4 ependymoma cases (7.3%), 10 astrocytoma cases (47.6%), 1 miscellaneous Tumor case (7.1%), and no recurrence in hemangioblastoma cases. When analyzed by Tumor location, there was no difference in neurological outcomes (P = .66). At the time of their last follow-up visit, 11 patients (20%) with an ependymoma improved, 38 (69%) remained the same, and 6 (10.9%) worsened. In patients with an astrocytoma, 1 (4.8%) improved, 10 (47.6%) remained the same, and 10 (47.6%) worsened. One patient (8.3%) with a hemangioblastoma improved and 11 (91.7%) remained the same. No patient with a hemangioblastoma worsened. In the miscellaneous Tumor group, 2 (14.3%) improved, 10 (71.4%) remained the same, and 2 (14.3%) worsened. Preoperative neurological status (P = .02), Tumor Histology (P = .005), and extent of resection (P
Lisa Diller - One of the best experts on this subject based on the ideXlab platform.
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Tumor Histology during induction therapy in patients with high risk neuroblastoma
Pediatric Blood & Cancer, 2012Co-Authors: Rani E George, Antonio R Perezatayde, Wendy B London, Robert C Shamberger, Donna Neuberg, Lisa DillerAbstract:Background In high-risk neuroblastoma patients, response to induction chemotherapy is emerging as an important determinant of overall survival. We sought to determine whether histological changes in the primary Tumor following induction therapy could be used as a marker of response. Procedure Second-look primary Tumor specimens from 43 patients were reviewed according to specific morphological features. Results In the majority, induction therapy resulted in a shift from an intermediate/high to low mitosis-karyorrhexis index (MKI) (P = 0.0009) and from undifferentiated/poorly differentiated to differentiating Tumors (P < 0.0001). Following induction therapy, persistence of intermediate/high Tumor MKI and ≥90% persistent neuroblastic cells were predictive of a poor outcome (P = 0.001 and 0.03, respectively). Less than 10% Tumor necrosis was associated with a trend towards lower survival. Conclusions High proliferative activity in the primary Tumor following induction therapy portends a poor outcome in patients with high-risk neuroblastoma. If confirmed in a larger cohort, Tumor Histology at second-look surgery could be used to define a subset of very high risk patients who would benefit from alternative therapies prior to myeloablative dose-intensive transplant. Pediatr Blood Cancer 2012;59:506–510. © 2011 Wiley Periodicals, Inc.
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Tumor Histology during induction therapy in patients with high-risk neuroblastoma.
Pediatric Blood & Cancer, 2011Co-Authors: Rani E George, Wendy B London, Robert C Shamberger, Donna Neuberg, Antonio R. Perez-atayde, Lisa DillerAbstract:Background In high-risk neuroblastoma patients, response to induction chemotherapy is emerging as an important determinant of overall survival. We sought to determine whether histological changes in the primary Tumor following induction therapy could be used as a marker of response. Procedure Second-look primary Tumor specimens from 43 patients were reviewed according to specific morphological features. Results In the majority, induction therapy resulted in a shift from an intermediate/high to low mitosis-karyorrhexis index (MKI) (P = 0.0009) and from undifferentiated/poorly differentiated to differentiating Tumors (P
Jiaqing Xiang - One of the best experts on this subject based on the ideXlab platform.
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Tumor Histology predicts mediastinal nodal status and may be used to guide limited lymphadenectomy in patients with clinical stage i non small cell lung cancer
The Journal of Thoracic and Cardiovascular Surgery, 2018Co-Authors: Xinghua Cheng, Difan Zheng, Yuan Li, Hang Li, Jiaqing Xiang, Haiquan ChenAbstract:Abstract Objective Methods to minimize surgical trauma from mediastinal lymphadenectomy in patients with early-stage lung cancer are still immature. This study aimed to identify predictors of negative pathologic N2, which may be used to select patients for limited mediastinal lymphadenectomy. Methods Clinicopathologic features of 1430 patients with resected clinical stage I non–small cell lung cancer and complete mediastinal lymphadenectomy were retrospectively analyzed for variables associated with negative N2 nodal metastasis (2008-2015). Overall and recurrence-free survival in patients after complete or limited mediastinal lymphadenectomy were assessed via Kaplan–Meier survival analysis and log-rank testing. The accuracy of frozen section diagnosis for predicting final pathology was retrospectively assessed in 126 randomly selected patients after the surgery. Results Multivariable analysis revealed that Tumor size ≤2 cm, negative pN1, lymphovascular invasion, and lepidic adenocarcinoma were associated with negative mediastinal nodal metastasis. Notably, none of the patients with Histology of adenocarcinoma in situ, minimally invasive adenocarcinoma, or lepidic pattern–predominant adenocarcinoma on final pathology had pN2 disease, and the 5-year overall and recurrence free-survival of these patients (99.3% and 99.3%, respectively) was not different from those after limited mediastinal lymphadenectomy (98.7% and 100%, P = .582 and .511, respectively). If these subtypes were classified together as the low-risk group, the concordance rate between frozen section and final pathology diagnosis was 88.9% in the retrospective test cohort. Conclusions Tumor Histology may predict negative mediastinal metastasis in patients with early-stage lung cancer. Future prospective studies are merited to validate the feasibility of using frozen section to select patients for limited mediastinal lymphadenectomy.
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predictive factors of lymph node status in small peripheral non small cell lung cancers Tumor Histology is more reliable
Annals of Surgical Oncology, 2013Co-Authors: Yang Zhang, Yuan Li, Jiaqing Xiang, Lei Shen, Yawei Zhang, Hong Hu, Haiquan ChenAbstract:Background During the past two decades, many studies have sought to find reliable predictors of N0 status in small-sized lung cancers. However, the way of Tumor size measurement was usually not clearly stated, and controversy remains as to whether systematic lymph node dissection should be performed in patients with subcentimeter Tumors.
