A new study, however, led by UT Southwestern Medical Center researchers has shown that even in advanced stages total tumor size can have a major impact on survival.
Using data from a National Cancer Institute-sponsored Phase 3 trial involving 850 patients with advanced lung cancer, Dr. David Gerber, assistant professor of internal medicine at UT Southwestern, and colleagues from other academic medical centers reviewed the recorded total tumor dimensions – which may include not only the primary tumor, but also those in lymph nodes and other sites of metastatic disease. Dr. Gerber’s team found that total tumor measurements greater than 3 inches predicted shorter survival times.
“The traditional view is that once a cancer has spread to the lymph nodes or to other organs, tumor dimensions are unlikely to affect patient outcomes,” explained Dr. Gerber, a member of the Harold C. Simmons Comprehensive Cancer Center and lead author of the study. “However, the survival differences we found are not only statistically significant, but also clinically meaningful.”
In the study, published online in the British Journal of Cancer, the average total tumor dimension was 7.5 centimeters, or roughly 3 inches. Patients with total tumor dimensions above this size lived an average of 9.5 months. Patients with total dimensions below 7.5 centimeters lived an average of 12.6 months, representing a 30 percent increase in survival.
When total tumor dimension was further divided into quartiles, the survival differences were even greater, ranging from 8.5 months to 13.3 months. These differences persisted even when multiple prognostic factors, such as age, gender, and type of treatment, were included in the analysis.
Dr. Gerber explained that, if confirmed in other populations, these findings could affect future clinical trials and patient care.
“Ultimately, clinical researchers might consider this information as they review outcome data, making sure survival differences are attributed to treatment effects and not to baseline differences in total tumor dimensions,” he said. “Practicing physicians may also use the information to estimate prognosis.”
Precise measurements of lung cancer tumors can be used in tailoring therapy and helping doctors steer patients to the best clinical trials, he added.
While the study did not seek to explain the biological reasons why this size association may hold true, a number of preclinical observations link tumor size with therapeutic resistance. It is generally thought that as tumors grow, the proportion of cells resistant to chemotherapy increases. Larger cancers may also have relatively poor blood supply and more pronounced gradients in interstitial pressure, hypoxia, and acidity, which may influence tumor cell sensitivity to chemotherapeutics and radiation treatments.
Other UT Southwestern investigators involved in this study were Dr. David Johnson, chairman of internal medicine and senior author; Dr. Joan Schiller, chief of hematology/oncology and deputy director of the Simmons Cancer Center; and Daniel H. Ahn, a former internal medicine resident and palliative care fellow. Researchers from the Dana Farber Cancer Institute, Johns Hopkins University, and the Oregon Health Sciences University also contributed.
This analysis was completed with support from the National Institutes of Health and the Department of Health and Human Services. This work was also supported in part by a National Cancer Institute Cancer Clinical Investigator Team Leadership Award and the North and Central Texas Clinical and Translational Science Initiative.
Visit the Harold C. Simmons Cancer Center to learn more about cancer research, screening, and therapy at UT Southwestern, including highly individualized treatments for cancer at the region’s only National Cancer Institute-designated center.
About UT Southwestern Medical Center
UT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has many distinguished members, including five who have been awarded Nobel Prizes since 1985. Numbering more than 2,700, the faculty is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide medical care in 40 specialties to nearly 90,000 hospitalized patients and oversee more than 1.9 million outpatient visits a year.Media Contact: Alex Lyda
Alex Lyda | EurekAlert!
Researchers identify cause of hereditary skeletal muscle disorder
22.02.2017 | Klinikum der Universität München
Second cause of hidden hearing loss identified
20.02.2017 | Michigan Medicine - University of Michigan
In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport
Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...
The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.
The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...
Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...
Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".
Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...
13.02.2017 | Event News
10.02.2017 | Event News
09.02.2017 | Event News
22.02.2017 | Power and Electrical Engineering
22.02.2017 | Life Sciences
22.02.2017 | Physics and Astronomy