Abstract:
:Curing cancer requires the treatment of metastatic disease. Whether this is a patient with advanced disease and clinically apparent metastases, or if the patient with localized disease is at risk for development of dissemination, failure to control metastasis will result in a poor outcome. Here, we have presented a molecular guide to our current understanding of the processes underlying metastasis. Experimental clinical trials designed to further the understanding of metastasis are often limited by selection of patients with advanced disease. Therefore, our understanding of the processes involved in the metastatic cascade is limited by the availability of comprehensive experimental model systems. The study of metastasis relies most heavily on xenografts, tumors using human cell lines, or tumor tissue that can grow in mice. These models present a limited recapitulation of the patients. Xenograft models require some degree of immunosuppression on the part of the host, because mice with native immune systems will reject transplanted human tumors, preventing their growth. As a result, mice with immune defects ranging from depleted T cells (nude mice) to absent T, B, and NK cells (SCID-Beige) are used as hosts. As the evasion of the immune system is a key function demonstrated by the metastatic cancer cell, xenograft models, by necessity, subvert this step. Furthermore, recent studies have established that angiogenesis in transplanted tumors is different than in native tumors, further highlighting the limitations of these models. With these limitations, studies of metastasis may require development of models of autochthonous tumors, that is, tumors originating in the study animals. A number of cell lines of autochthonous murine tumors have been established that generate metastatic disease after implantation into mice. Moreover, some transgenic animals spontaneously develop metastatic tumors that, although occurring in genetically engineered animals, may represent the most complete model from early development to late effects. Finally, a very promising field of autochthonous tumor studies lies in work with companion animals (pets). Some dogs will have cancer, often with striking similarities to those of their human counterparts. These pets may represent an important study group, because they have autochthonous tumors, occurring spontaneously, in an outbred population. In all of these cases, the tumor, new vasculature, and the immune system are syngeneic with the host. In addition to the advances in model systems, advances in technology will further our understanding and ability to combat metastatic disease. As demonstrated, genomics is proving to be a powerful tool in identifying those at risk for metastasis. From these genetic signatures, molecular targets may be deduced from the genes altered in patients with poor prognoses. Furthermore, other molecular tools such as proteomic analysis may provide further information. Clearly, therefore, a synthesis of different technologies and complimentary information will be required to target metastases and improve the outcome for patients affected by them.
journal_name
Thorac Surg Clinjournal_title
Thoracic surgery clinicsauthors
Krishnan K,Khanna C,Helman LJdoi
10.1016/j.thorsurg.2005.12.003subject
Has Abstractpub_date
2006-05-01 00:00:00pages
115-24issue
2eissn
1547-4127issn
1558-5069pii
S1547-4127(05)00123-4journal_volume
16pub_type
杂志文章,评审abstract::In spite of numerous clinical trials, the jury is still out on the value of induction therapy for locally advanced lung cancer. We elected to address this topic from the multifaceted views of the clinicians often involved in lung cancer management and according the most recent views on locally advanced NSCLC. The conc...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2011.08.010
更新日期:2012-02-01 00:00:00
abstract::The literature shows that, in the hands of experienced thoracoscopic surgeons, VL is a safe operation that offers patients at least comparable complication and survival rates compared with lobectomy by thoracotomy. VL can be performed safely with proven advantages over conventional thoracotomy for lobectomy: smaller i...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2007.03.019
更新日期:2007-05-01 00:00:00
abstract::The development of chronic pain after thoracic surgery is a particularly undesirable yet common complication. As the study of the pathophysiology of chronic pain with regard to the plasticity of the central nervous system advances, new insights are being gained into not only the potential origins of chronic postthorac...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2004.10.001
更新日期:2005-02-01 00:00:00
abstract::Video-assisted thoracic surgery (VATS) lobectomy has become a standard approach for early stage 1 lung cancer. However, concerns still remain regarding certain clinical situations, such as potential damage to the heart or bypass grafts when VATS is performed after median sternotomy for cardiac surgery. In this article...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2015.04.004
更新日期:2015-08-01 00:00:00
abstract::As we enter the 21st century, thoracic surgeons can look back with pride and gratitude to their predecessors who placed a high premium on clinical practice and certification. Thoracic surgery, however, is dynamic, not static. So, too, should be thoracic surgery recertification. In recent years, considerable effort has...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2007.07.001
更新日期:2007-08-01 00:00:00
abstract::Cervical mediastinoscopy is a frequently used technique to assess the mediastinum, in particular the mediastinal lymph nodes in patients presenting with non-small cell lung cancer (NSCLC). The senior author of this article is credited for developing in 1989 the concept of what is now called videomediastinoscopy. The i...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2010.01.006
更新日期:2010-05-01 00:00:00
abstract::The current convention is for bilateral one-stage lung volume reduction surgery. Unilateral surgery results in a symptomatic improvement in most patients. A staged approach to the second lung may reduce the risk of surgery and lead to a slower decline in physiologic improvement. The timing of the second operation can ...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2009.02.001
更新日期:2009-05-01 00:00:00
abstract::Despite a prospective randomized trial that reported decreased locoregional recurrence for the intentional use of sublobar resection for stage IA non-small cell lung cancer, it continues to be a point of considerable debate. Improved imaging techniques have introduced a large group of smaller and more indolent tumors ...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2016.04.007
更新日期:2016-08-01 00:00:00
abstract::Early stage non-small cell lung cancer is a potentially curable manifestation of a disease that is typically associated with a grim prognosis. Therapies directed at early stage disease can be challenging to deliver because patients tend to be elderly with multiple comorbidities. Surgery, the standard of care, has been...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2013.05.009
更新日期:2013-08-01 00:00:00
abstract::Stage IVA disease can be de novo disease or more commonly represent recurrent disease. The pleura is the most common site of relapse after thymoma resection. Local pleural disease is usually simply resected. This is usually combined with either induction or adjuvant chemotherapy. The ultimate extended surgery for adva...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2010.08.007
更新日期:2011-02-01 00:00:00
abstract::Patients express risk aversion toward surgery, particularly if surgery can lead to lifelong debility and loss of independence. When faced with a guarantee of progressive lung cancer and no alternatives for cure, however, patients are willing to take extremely high risks of postoperative complications and surgery-relat...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章
doi:10.1016/S1547-4127(04)00016-7
更新日期:2004-08-01 00:00:00
abstract::The search for clinically applicable biologic markers or tumor signatures sufficiently powered as prognosticators of tumor behaviors or responses to therapeutic interventions has significantly advanced in scope and sophistication in the last 10 years. The TNM system, examining of tumor tissues to identify histopatholo...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2006.07.004
更新日期:2006-11-01 00:00:00
abstract::The National Quality Forum (NQF) is a multistakeholder, nonprofit, membership-based organization improving health care through preferential use of valid performance measures. NQF-endorsed measures are considered the gold standard for health care measurement in the United States. The Society of Thoracic Surgeons is the...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2017.03.003
更新日期:2017-08-01 00:00:00
abstract::In recent years, the subxiphoid approach has been used to avoid intercostal nerve damage in the field of thoracic surgery. A subxiphoid single-port thymectomy does not require sternotomy; it is associated with lesser pain because there is no intercostal nerve damage; and it provides excellent cosmetic outcomes. Furthe...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2017.06.006
更新日期:2017-11-01 00:00:00
abstract::Concerns regarding the sequelae of neoadjuvant chemotherapy or chemoradiotherapy on the pleural space and tissue planes had previously deterred the application of video-assisted thoracoscopic (VATS) lobectomy for patients who underwent neoadjuvant therapy. As experience with VATS has increased, however, its applicatio...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2014.07.013
更新日期:2014-11-01 00:00:00
abstract::Gastroesophageal reflux disease (GERD) is a well-defined disease characterized by symptoms or complications caused by an abnormal amount of GER, which is a retrograde movement of gastric contents into the esophagus. Laryngopharyngeal reflux (LPR) is a subset of GERD and given its own identity, because the main symptom...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2011.08.001
更新日期:2011-11-01 00:00:00
abstract::MPM is an uncommon disease with limited treatment options. Early diagnosis, a standardized staging system, early referral to centers experienced in MPM, and efforts to develop collaborative multicenter trials are essential to improving treatment for patients with MPM. Efforts to manage this malignancy, which is projec...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2004.06.009
更新日期:2004-11-01 00:00:00
abstract::Because the esophagus is a tubular muscular structure only partially filled with air and surrounded by major structures (vessels, lungs, and heart), its radiologic evaluation cannot be performed solely by conventional chest radiograph or barium studies. The emergence of newer techniques has had a dramatic effect on th...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章
doi:10.1016/j.thorsurg.2010.12.007
更新日期:2011-05-01 00:00:00
abstract::Pulmonary metastasis occurs in as many as 88% and 80% of stage IV patients with sarcoma and germ cell tumors, respectively. Pulmonary metastatectomy may be the only means of rendering a patient disease free. Sublobar resection (wedge or segmentectomy), lobectomy, and pneumonectomy achieve complete resection. Bilateral...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2015.09.007
更新日期:2016-02-01 00:00:00
abstract::This article has reviewed radiation treatment of thoracic malignancies in elderly patients. In general the literature suggests that thoracic irradiation is equally efficacious in elderly patients as in younger patients and is associated with increased but acceptable toxicity. Technical advances are allowing a further ...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2009.06.003
更新日期:2009-08-01 00:00:00
abstract::In summary, from the different alternatives to conventional hospitalization developed in the last decades, outpatient surgery has been the one with the greatest growth. However, only few studies have been reported on thoracic surgery and there is still great potential for an increase in outpatient thoracic surgery. Th...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2008.04.003
更新日期:2008-08-01 00:00:00
abstract::With appropriate planning and operative technique, the risk of pulmonary artery injury and bleeding during video-assisted thoracoscopic surgery (VATS) lobectomy can be minimized. However, the risk cannot be completely eliminated; surgeons should always ensure that they are prepared to manage this situation if it occur...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2015.04.007
更新日期:2015-08-01 00:00:00
abstract::Nonintubated video-assisted thoracoscopic surgery for the treatment of primary and secondary pneumothorax was first reported in 1997 by Nezu. However, studies on this technique are few. Research in the past 20 years has focused on the perioperative outcomes, including the surgical duration, length of hospital stay, an...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2019.08.001
更新日期:2020-02-01 00:00:00
abstract::This article focuses on new materials available to thoracic surgeons for the reconstruction of chest wall defects. Each surgeon is called to select the best reconstructive strategy based on the disease for which the resection is needed, the possible extension to adjacent structures, the availability of professional co...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2010.06.005
更新日期:2010-11-01 00:00:00
abstract::Airway complications after lung transplantation present a formidable challenge to the lung transplant team, ranging from mere unusual images to fatal events. The exact incidence of complications is wide-ranging depending on the type of event, and there is still evolution of a universal characterization of the airway f...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2014.09.008
更新日期:2015-01-01 00:00:00
abstract::Professional oaths and codes do not establish a firm basis for the obligation to treat all patients and they provide little or no clear guidance about whether patient nonadherence exempts a physician from a longstanding and still prevalent tradition in surgery supports a strong obligation to one's established patients...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2005.06.012
更新日期:2005-11-01 00:00:00
abstract::Adequate lymphadenectomy represents a fundamental procedure in lung cancer surgery for accurate staging and potential survival benefit. Various techniques are used in current surgical practice for the intraoperative lymph node removal associated with pulmonary resection, without definitive indications concerning the p...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2011.12.001
更新日期:2012-05-01 00:00:00
abstract::Tracheobronchomalacia is an uncommon acquired disorder of the central airways. Common symptoms include dyspnea, constant coughing, inability to raise secretions, and recurrent respiratory infections. Evaluation includes an inspiratory-expiratory chest CT (dynamic CT), an awake functional bronchoscopy, and pulmonary fu...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2018.01.006
更新日期:2018-05-01 00:00:00
abstract::Arterial thoracic outlet syndrome is rare and may be associated with a bony anomaly. Patient presentation can range from mild arm discoloration and claudication to severe limb-threatening ischemia. For patients with subclavian artery dilation without secondary complications, thoracic outlet decompression and arterial ...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2020.09.006
更新日期:2021-02-01 00:00:00
abstract::Surgery for tuberculosis is becoming more relevant today. This article discusses the main indications, contraindications, features of operations, and perioperative period. This information is useful for practicing surgeons and specialists in the treatment of pulmonary tuberculosis. ...
journal_title:Thoracic surgery clinics
pub_type: 杂志文章,评审
doi:10.1016/j.thorsurg.2018.09.003
更新日期:2019-02-01 00:00:00