Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective study was undertaken in 1990 of 188 patients with the diagnosis of non small cell carcinoma of the lung referred to the Department of Radiation Oncology in 1984. Most patients (178/188) received a course of radiotherapy. This was definitive in 23, palliative in 148 (primary site in 113, metastases in 16, primary plus metastases in 19) and postoperative in 7. This report is a 5 year followup of the 171 patients treated by radiation alone, to assess factors that influence survival. Tumour histology was 50% squamous, 23% adenocarcinoma, 16% large cell and 4% unspecified, non small cell carcinoma. In 8% no histological diagnosis was obtained. The most common symptoms were cough (44%), dyspnoea (43%), chest pain (37%), haemoptysis (33%) and systemic symptoms (36%). Tumour stage (TNM) was assessed retrospectively as I(5%), II(8%), IIIA(18%), IIIB(22%) and IV(28%). A subgroup of 31 cases (18%) of uncertain staging (I-III) was analysed separately and in 2 cases (1%) no staging information was available. Palliative intent of treatment and poorer performance status were related significantly to increasing stage of disease. The effects of palliative treatment were recorded in 79 cases; in 71 there was a reduction in symptoms. The median survival from diagnosis was 8 months (range < 1-72). Using univariate and multivariate analyses, significant and independent prognostic factors for improved survival were good performance status, absence of systemic symptoms, lower tumour stage and curative intent of treatment (higher radiation dose). However the 5-year survival was only 2%. Long-term survival was associated predominantly with early stage disease but not with the type or intent of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Non small cell carcinoma of the lung. A retrospective study. Presented at the 41st annual meeting of the Royal Australasian College of Radiologists, September 1990, Perth. 128 99

A group of 228 patients with cancer of the lungs admitted in the course of 15 months to the Second Clinic for TB and Respiratory Diseases was classified according to the complicating pleural exudate. At the onset or in the course of the disease the exudate developed in 24 patients (11%)--group A, in the remaining 204--group B--there is no information on an exudate. The mean age of the two groups did not differ, smoking habits were similar. Significant differences were recorded as regards the incidence of subjective complaints, in group A the patients complained significantly more frequently of dyspnoea grade III to IV, chest pain, loss of weight and oedema of the neck. As to the number with haemoptysis and exposure to cancerogens the two groups did not differ. As to subsidiary diseases, only CHOPN was more frequent in group B. Differences were recorded also in the ratio of morphological types, in group A the small-cell type was most frequent, in group B the spinocellular type. The two groups differed also as to the incidence of peripheral and central forms, which were significantly more frequent in group A. The TNM stages differed: in group A stage IV predominated, in group B there were 40% of the patients in stage I and II. Significant differences between the groups were found also as to treatment: 17.6% in group B were operated and none in group A. In group A all patients died, in group B to the day of evaluation 25 subjects survive, this difference, is, however, not significant.
 ...
PMID:[Pleural exudates in patients with lung cancer. Comparative study]. 200 91

The prognostic staging of cancer in general, and lung cancer in particular, has customarily depended mainly on morphologic distinctions. The gross anatomic extensiveness of cancers is cited with TNM stages that describe the primary tumor (T), spread to regional lymph nodes (N), and metastatic dissemination (M) to distant sites. Microscopic characteristics are cited according to the cancer's cell type (e.g., adenocarcinoma, epidermoid carcinoma) and/or grade of differentiation (e.g., well differentiated, poorly differentiated, anaplastic). Although the clinical manifestations, functional effects, and associated co-morbidity of a cancer are universally recognized as having major prognostic importance, they have not been classified with a standard system of taxonomy. When considered at all, clinical phenomena have been cited with a surrogate index of "performance status" that ignores the underlying clinical dysfunctions while being greatly affected by non-clinical phenomena, such as the patient's psychic status, economic motivations, and system of social support. The current research was done to develop a standard system of taxonomy (or "staging") for the prognostic impact of clinical distinctions in patients with primary lung cancer. Appropriate data were obtained, computer-coded, and analyzed from medical records for the complete clinical course of an inception cohort of 1266 patients who were first treated at either the Yale-New Haven Hospital or the West Haven Veterans Administration Hospital during the interval January 1, 1953-December 31, 1964. The information under analysis included clinical phenomena as well as anatomic extensiveness (TNM stage), microscopic histology, the chronometric duration of the interval from the first symptom of lung cancer to zero time, the iatrotropic reason why the patient sought medical attention, the presence of anemia, the amount of customary cigarette use, and the conventional demographic data for age and gender. The main clinical phenomena were expressed in variables for symptom pattern severity, and co-morbidity. Symptom pattern referred to the existence of specific pulmonic symptoms (e.g., hemoptysis), systemic symptoms (e.g., complaint of weight loss), and metastatic symptoms that might be mediastinal (e.g., superior vena cava syndrome), regional (e.g., the Horner syndrome), or distantly metastatic (e.g., central nervous system). The symptom severity variable included the amount of weight loss, and the existence of severe dyspnea or particularly severe tumor effects (such as mental obtundation, rather than hemiparesis in patients with CNS metastasis). Prognostic co-morbidity was cited for coexisting diseases, such as recurrent myocardial infarctions, that might be more lethal than the lung cancer itself.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:A clinical-severity staging system for patients with lung cancer. 229 74

The various forms of bronchoplastic and angioplastic procedures are the best means of avoiding pneumonectomy. Essential indications are limited respiratory reserve and central site of a malignancy. In a retrospective study 248 broncho- and angioplastic operations carried out in the years 1973 to 1983 were analyzed. Reference date for the analysis of survival was January 1986. In consequence the minimum period of follow-up was two years. For all patients (n = 248) the 5-year-survival was 22% with a 30-day-lethality of 13%. The 5-year-survival of all bronchial sleeve resections operated radically (stage I and II of the TNM-classification) (n = 44) was 42% with a 30-day-lethality of 7%. The 5-year-survival of all bronchoplastic operations of stage I and II (n = 88) was 38% with a 30-day-lethality of 14%. Improved suture material and surgical techniques caused a reduction of operative lethality from 23% to 8% during the described period. In the first thirty postoperative days the following complications caused death: Hemoptysis (n = 5), insufficiency of the anastomosis (n = 3), right heart failure (n = 5), pulmonary embolism (n = 4) and sepsis (n = 1).
 ...
PMID:[Bronchoplastic and angioplastic operations in bronchial carcinoma]. 282 31

We evaluated the relationship of clinical characteristics and survival in 1,635 patients with non-small cell lung cancer (NSCLC) treated in Brazil. The following variables were included: sex, age, smoking, Karnofsky's performance status (PS), weight loss, symptoms at diagnosis (cough, dyspnea, hemoptysis, chest pain, wheezing, and hoarseness), presence of superior vena cava syndrome (SVCS), histologic type, TNM stage, and therapeutic modality (surgery, chemotherapy [CT] and radiotherapy [RT]). Multivariate prognostic models were obtained by Cox regression. Patients unsuitable for surgery or who had recidivant disease were elected to further RT and/or CT, and long-term results in this group were equivalent to those in the group treated only by surgery. A diagnosis of bronchioloalveolar carcinoma, small tumors, absence of hoarseness, treatment by surgery, and RT were independent factors related to good overall survival in stage I and II. Weight loss and clinical signs of SVCS were related to poor prognosis in stage III. PS, diagnosis of adenocarcinoma or undifferentiated carcinoma, absence of weight loss and dyspnea, NO or N1 disease, ability to receive RT, CT, and to perform some palliative surgical procedure were good prognostic factors in stage IV. Clinical features of patients with NSCLC at diagnosis offer additional information to estimate their prognosis.
 ...
PMID:Clinical factors and prognosis in non-small cell lung cancer. 1052 Oct 57

Brachytherapy allows the delivery of higher radiation doses, possibly leading to improved locoregional tumor control and subsequent prolonged survival. The purpose of our study was to evaluate the long-term clinical survival in patients with malignant airway compromise treated with endobronchial brachytherapy and to estimate possible influence of other factors on survival and to review complications of the therapy. In a retrospective study 55 patients with malignant inoperable tracheobronchial lesions underwent 71 brachytherapy treatments with 137Cesium. Either MicroSelectron (N=56) or Selectron (N=15) were used. All except 4 patients received external radiation, 20 patients received chemotherapy, 37 patients received laser excision. Major symptomatic improvement was noted in 75% of patients. Substantial or complete relief of hemoptysis was achieved in 85%, of dyspnea in 65% and of cough in 68%. Response evaluation showed no complete response, partial response was achieved in 70.9% and the endoscopic finding was not changed, or recurrence of the tumor was found in 29.1%. A relatively small number of complications of the endobronchial brachytherapy occured. Significant bleeding was observed in 1 procedure and an inability to tolerate in 3 cases. In 2 cases, it was not possible to place an applicator due to extreme hypoxia. Bronchomediastinal fistula developed in 1 patient and tracheal stenosis in 1 patient. The overall incidence of complications was 15%. The median survival from establishing the diagnosis was 510 days. The median survival after the first brachytherapy treatment was 200 days. We compared the survival in the subgroups of patients in relation to TNM status, chemotherapy, laser debulking brachytherapy device used. The stage IIIA patients survived longer from diagnosis than IIIB patients but the difference was on the border of significance (p = 0.090). In the evaluation of chemotherapy, more patients survived 12 months from the diagnosis (p = 0.045) when treated by chemotherapy comparing to the patients treated without chemotherapy. However, this difference disappeared during the further development of the disease. In the Nd-YAG laser treatment, the patients treated by brachytherapy with the previous laser debulking survived significantly longer from the time of the first brachytherapy session (p = 0.005). No statistical difference was found in the survival of patients treated by either the Selectron or MicroSelectron device. The LDR endobronchial brachytherapy is a well tolerated, safe and effective technique for palliation of malignant airway occlusions. In our group of patients, the long-term survival was longer in IIIA stage comparing to the IIIB, in the group treated by the previous chemotherapy compared to the patients without chemotherapy and in the group with the Nd-YAG laser therapy, comparing to the group treated by the brachytherapy only. No difference of the brachytherapy device used was found.
 ...
PMID:Long-term clinical benefits of the low dose rate endobronchial irradiation of malignant airway obstructions. 1158 95

Lung cancer is the commonest cause of cancer death, with a very poor survival rate. By the time of diagnosis, most cases are at an advanced stage and about 30% present with symptoms caused by central endobronchial obstruction. Endobronchial cryosurgery is an effective technique, which can be used to relieve tracheobronchial obstruction caused by lung cancer. This report describes the technique, using a nitrous oxide cooled cryoprobe, inserted through a bronchoscope, to remove the obstruction and reopen the airway. In this study, 476 consecutive patients (mean age 68.3 years, M:F ratio 1.9:1) with obstructive tracheobronchial tumours underwent a mean of 2.4 cryosurgical treatments. Their TNM staging was, stage II 6.7%, IIIa 21.0%, IIIb 23.9%, IV 48.4%. Improvement in symptom quantification was found with 76.4, 69.0, 59.2, and 42.6% of symptomatic patients for haemoptysis, cough, dyspnoea, and chest pain, respectively. Mean values for respiratory function improved from 1.38 to 1.41 litres for FEV1 and 1.91 to 2.04 litres for FVC (p </= 0.0001). Mean performance status improved from 59.6 to 75.2 for Karnofsky scale and 3.04 to 2.20 for the WHO scale and the complication rate was 3.5% of treatments. The Kaplan-Meier median survival was 8.2 months and 1- and 2-year survival 38.4 and 15.9%, respectively. Survival analysis suggested a possible survival advantage over alternative palliative techniques. Endobronchial cryosurgery provides a safe and effective method for the palliation of otherwise inoperable lung cancer. It has advantages over other methods in terms of safety, cost, and a low complication rate. Cryosurgery can be repeated as often as required.
 ...
PMID:The application of cryosurgery in the treatment of lung cancer. 1496 82

Chest wall (CW) involvement occurs in approximately 5% of all primary lung neoplasms. According to the most recent TNM classification, lung tumors invading CW are classified as T3, and they represent approximately 45% of all T3 lung cancers. The most common clinical symptom at presentation is chest pain (>60%), which is highly specific of CW infiltration (>90%). Dyspnoea and hemoptysis are also described, especially in case of large lesions. A realistic chance to cure locally advanced tumors invading CW is a surgical resection, consisting in the excision of the primary lung cancer along with the involved CW (sometimes an "en-bloc" resection) and an appropriate lymph-nodal dissection. However, such patients are at high-risk of facing postoperative complications; prognosis mainly depends on: (I) the completeness of resection; and (II) the lymph-nodal involvement. Hence, due to these reasons (incidence, symptoms, prognosis, post-operative complications), such category of patients are to be carefully assessed preoperatively and if deemed practicable, surgery should be taken into consideration. In this view, the aim of this paper is to critically review the most recent series of lung tumors invading the CW, with a particular focus on patients' preoperative evaluation, surgical techniques, postoperative complications and overall outcome.
 ...
PMID:Primary lung tumors invading the chest wall. 2794 7