Raja Flores1, Emanuela Taioli2, David F Yankelevitz3, Betsy J Becker4, Artit Jirapatnakul3, Anthony Reeves5, Rebecca Schwartz6, Rowena Yip3, Esther Fevrier3, Kathleen Tam3, Benjamin Steiger3, Claudia I Henschke7. 1. Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York. 2. Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY. 3. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY. 4. Department of Educational Psychology and Learning Systems, College of Education, Florida State University, Tallahassee, Florida. 5. School of Electrical and Computer Engineering, Cornell University, Ithaca, New York. 6. Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Occupational Medicine, Epidemiology and Prevention, Zucker School of Medicine at Hofstra-Northwell, Great Neck, New York. 7. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: Claudia.Henschke@mountsinai.org.
Abstract
INTRODUCTION: To maximize the benefits of computed tomographic screening for lung cancer, optimal treatment for small, early lung cancers is needed. Limiting the extent of surgery spares lung tissue, preserves pulmonary function, and decreases operative time, complications, and morbidities. It also increases the likelihood of resecting future new primary lung cancers. The goal is to assess alternative treatments in a timely manner. METHODS: The focus sessions with patients and physicians separately highlighted the need to consider their perceptions. Literature reviews and analyses of treatment results using large databases were performed to formulate critical questions about long-term treatment outcomes, recurrence, and quality of life of alternative treatments. Based on these analyses, the investigators developed a prospective multi-institutional cohort study, the Initiative for Early Lung Cancer Research for Treatment, to compare treatments for stage I NSCLC. HIPAA compliant institutional review board approval was obtained and we performed a feasibility study of the first 206 surgical patients. RESULTS: Lobectomy was performed in 89 (43.2%) patients, and sublobar resection was performed in 117 (56.7%) patients. Mediastinal lymph node resection was performed in 173 (84.0%) patients, 8 had N1 and 3 N2 lymph node metastases. Patients stated that both the surgeon's opinion (93%) and the patient's own opinion (93%) were extremely important, followed by the patients' view that the chosen procedure would provide the best quality of life (90%). CONCLUSIONS: It was feasible to obtain pre- and postsurgical information from patients and surgeons. We anticipate statistically meaningful results about treatment alternatives in 3 to 5 years.
INTRODUCTION: To maximize the benefits of computed tomographic screening for lung cancer, optimal treatment for small, early lung cancers is needed. Limiting the extent of surgery spares lung tissue, preserves pulmonary function, and decreases operative time, complications, and morbidities. It also increases the likelihood of resecting future new primary lung cancers. The goal is to assess alternative treatments in a timely manner. METHODS: The focus sessions with patients and physicians separately highlighted the need to consider their perceptions. Literature reviews and analyses of treatment results using large databases were performed to formulate critical questions about long-term treatment outcomes, recurrence, and quality of life of alternative treatments. Based on these analyses, the investigators developed a prospective multi-institutional cohort study, the Initiative for Early Lung Cancer Research for Treatment, to compare treatments for stage I NSCLC. HIPAA compliant institutional review board approval was obtained and we performed a feasibility study of the first 206 surgical patients. RESULTS: Lobectomy was performed in 89 (43.2%) patients, and sublobar resection was performed in 117 (56.7%) patients. Mediastinal lymph node resection was performed in 173 (84.0%) patients, 8 had N1 and 3 N2 lymph node metastases. Patients stated that both the surgeon's opinion (93%) and the patient's own opinion (93%) were extremely important, followed by the patients' view that the chosen procedure would provide the best quality of life (90%). CONCLUSIONS: It was feasible to obtain pre- and postsurgical information from patients and surgeons. We anticipate statistically meaningful results about treatment alternatives in 3 to 5 years.
Authors: Rebecca M Schwartz; Rowena Yip; Nan You; Christina Gillezeau; Kimberly Song; David F Yankelevitz; Emanuela Taioli; Claudia I Henschke; Raja M Flores Journal: MDM Policy Pract Date: 2022-03-21
Authors: Kimberly J Song; Rowena Yip; Michael Chung; Qiang Cai; Yeqing Zhu; Ayushi Singh; Erik E Lewis; David Yankelevitz; Emanuela Taioli; Claudia Henschke; Raja Flores Journal: JTCVS Open Date: 2022-02-23
Authors: Claudia I Henschke; Rowena Yip; Dorith Shaham; Javier J Zulueta; Samuel M Aguayo; Anthony P Reeves; Artit Jirapatnakul; Ricardo Avila; Drew Moghanaki; David F Yankelevitz Journal: J Thorac Imaging Date: 2021-01 Impact factor: 5.528