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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To evaluate the utility of nuclear morphometry as a prognostic indicator in lung cancer, 5-year follow-up information was obtained in 46 cases of surgically resected Stage I non-small cell lung cancer (NSCLC). Nuclear area, perimeter, major diameter, minor diameter, and nuclear shape factor were determined from representative histologic sections of the tumors with a computer-assisted digitizing system. The morphometric parameters were compared between patients with favorable outcome (Group I: alive with no evidence of disease, n = 17) and those with poor outcome (Group II: dead of disease or with recurrence of disease, n = 29). No significant differences in any of the morphometric parameters were found between tumors in Groups I and II for individual tumor cell types or the combined cases. Failure to demonstrate a correlation between morphometric parameters and prognosis in Stage I NSCLC indicates that future efforts to determine objective prognostic factors should concentrate on other variables, such as specific genetic abnormalities.
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PMID:Absence of correlation between nuclear morphometry and survival in stage I non-small cell lung carcinoma. 131 90

The NK activity and ADCC of peripheral blood mononuclear cell were examined to evaluate the contribution of ADCC and NK activity to host immune response against lung cancer. The NK activity and ADCC were examined in 58 patients with primary lung cancer and 40 healthy volunteers as normal controls. The NK activity of patients with lung cancer was significantly subnormal, but ADCC was at a normal level. The NK activity was decreased in non-small cell lung cancer (NSCLC), but not in small cell lung cancer (SCLC) compared to normal controls. According to stage, the NK activity in stage II, III-M0 and III-M1 NSCLC showed low levels compared to that of stage I NSCLC, but there was no difference of NK activity in patients with SCLC. The NK activity was not affected by performance status. There was no significant difference of ADCC in patients with lung cancer according to cell type, stage and performance compared with that of normal controls. The NK activity and ADCC were not changed after chemotherapy and operation respectively.
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PMID:Natural killer activity and antibody-dependent cellular cytotoxicity in patients with primary lung cancer. 150 29

Surgical management of patients with concomitant critical cardiac disease and resectable lung lesions is controversial. During a 7-year period (1982 to 1988), 21 patients underwent combined cardiac and pulmonary operations. Patients had cardiac symptoms only; the lung lesions were found on preoperative chest roentgenograms. The pathological diagnosis was established in only 2 of the patients before operation. All underwent concurrent pulmonary resection during cardiac operations requiring extracorporeal circulation. The pulmonary operations included 17 wedge resections and four lobectomies. The final diagnoses in 8 patients with stage I non-small cell lung cancer included epidermoid carcinoma (4), adenocarcinoma (3), and bronchoalveolar carcinoma (1). Postoperatively, 1 patient required a permanent pacemaker and 1 patient died. The actuarial survival at 5 years for all patients who underwent combined procedures was 95%. The 5-year survival for the 8 patients with lung cancer was 88% compared with 100% for those with benign pulmonary pathology (p = 0.172). This experience suggests that combining pulmonary resection with cardiac operations is safe and offers a favorable prognosis to a select group of patients.
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PMID:Pulmonary resection combined with cardiac operations. 224 46

The overall 5-year survival of surgically resected non-small cell lung cancer (NSCLC) remains less than 50% and is unlikely to improve until there are effective systemic adjuvant therapies. Two studies of the Lung Cancer Study Group (LCSG) have shown a modest impact of adjuvant CAP chemotherapy on disease-free and overall survival. In addition, a Finnish study, which randomized patients with T1-T3, N0 disease to CAP chemotherapy or follow-up, has also demonstrated an improvement in recurrence-free survival, as well as overall survival, at 5 and 10 years. On the other hand, an LCSG trial of adjuvant CAP in Stage I NSCLC (T2, N0, T1 N1) showed no benefit, although compliance with treatment was poor. Similarly, adjuvant trials using vindesine and cisplatin have not demonstrated benefit in studies done in Montreal and New York. Clearly, more effective systemic therapy is needed and must be evaluated in randomized trials in which patients have been carefully staged intra-operatively. Biological markers, such as vascular invasiveness, oncogene mutations and other factors may allow identification of specific subsets of patients at high risk of recurrence who can be targeted for aggressive adjuvant approaches in the future.
Lung Cancer 1995 Apr
PMID:Adjuvant chemotherapy: results and perspectives. 755 33

Results of surgical treatment of 152 cases of stage I non-small cell lung cancer from 1985 to 1989 are reported. The 1, 3, 5-year survival rates were 92.1%, 74.5%, 64.6%, respectively. Among 152 cases, there were 100 squamous carcinoma, 44 adenomatous carcinoma and 8 squamous and adenomatous mixtures. There were 50 cases of T1 N0 M0 and 102 of T2 N0 M0 according to TNM staging. Of the 152 cases, 46 were discovered by regular physical check-up without symptoms and 106 by patient complaints. 130 cases underwent lobectomy, 14 cases pneumonectomy, and 8 cases sectional or wedge cut. Comparison of the 5-year survival rate after the operation was: T1 N0 M0 > T2 N0 M0; squamous > adenomatous; lobectomy > pneumonectomy (P > 0.005); cases detected by regular check-up > those with symptoms (P < 0.005). The 5-year survival rate of stage I lung cancer was 64.6%. There is no difference from the result of those in 1960s and 1970s. More effective combination therapy is needed to increase the survival rate.
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PMID:[Results of surgical treatment of stage I non-small cell lung cancer]. 826 68

The Lung Cancer Study Group has performed a number of postoperative adjuvant trials in patients with resectable non-small-cell lung cancer (NSCLC). Adjuvant cyclophosphamide, doxorubicin, and cisplatin (CAP) chemotherapy was compared with immunotherapy in the treatment of 130 patients with stage II or III adenocarcinoma or large cell undifferentiated carcinoma. Careful intraoperative staging was performed in all patients. Disease-free interval was significantly prolonged in the chemotherapy group (p = 0.032). After 7.5 years of follow-up, the difference in time to recurrence and cancer deaths remains statistically significant. Another study compared CAP chemotherapy plus radiotherapy with radiotherapy alone in advanced stages II and III resected NSCLC. Again, the chemotherapy arm had significantly increased disease-free survival. In a third study, patients with high-risk stage I NSCLC were randomized after surgery to CAP chemotherapy or observation. In this study there was no difference in recurrence-free survival or overall survival.
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PMID:Postoperative chemotherapy for non-small-cell lung cancer. 838 Jan 31

We are only beginning to understand the importance of lung cancer tumor biology in relation to prognosis and response to therapy. Many of the biologic and genetic changes we have described are preliminary observations and require further confirmation before clinical use. However, information concerning three oncogenes may soon prove to be helpful in the clinical arena: the myc genes in SCLC, and the ras genes and c-erbB-2 in NSCLC. In general their presence identifies poor patient response to therapy and poor survival. These markers are currently being used in a clinical setting at some research centers, but are not recommended for general diagnostic or prognostic use without further confirmation of their utility. Incorporation of this information with that learned by standard staging procedures may result in improved understanding of patient prognosis and challenge current concepts of lung cancer treatment. For example, surgically resected stage I NSCLC patients may benefit from adjuvant therapy if found to have these adverse biologic factors, and require more stringent follow-up after therapy. Finally the understanding of the pathogenesis of lung cancer may enable the development of novel therapy directed against these growth pathways. Our ultimate goal is to derive a therapeutic and prognostic paradigm involving both molecular-genetic and clinical factors to arrive at an optimal staging model and treatment plan.
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PMID:Oncogenes and growth factors in human lung cancer. 846 46

About 25-40% of the patients with stage I non-small cell lung cancer are not curable by surgery alone. Over the past years many studies on prognostic parameters in patients with lung cancer have been published in order to identify those patients, who require an adjuvant therapy. The critical assessment of these reports especially of those based on a certain geno- or phenotype of the primary tumor demonstrates that a number of different methods have been used and that the results are sometimes inconsistent. Therefore, a final conclusion seems not to be justified at this time. Recent reports describing sensitive immunocytochemical assays for the detection of early disseminated tumor cells in regional lymph nodes or bone marrow seem to be encouraging. These assays might be useful to identify patients at risk and the repeated analysis of bone marrow samples could be applied in follow-up studies to monitor the efficiency of adjuvant systemic therapies against minimal residual disease. In conclusion, the analysis of a single prognostic parameter seems to be insufficient to identify all patients at risk in stage I lung cancer. Thus, the establishment of a standardized profile of several risk factors based on a prospective, multicenter evaluation appears to be mandatory.
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PMID:[Prognostic factors in stage I of non-small-cell bronchial carcinoma]. 901 34

The indications for a video-assisted lobectomy are currently ill-defined. Clinicians recommend based on the extent of lymph node involvement. Fifty-nine patients with clinical stage I non-small cell lung cancer underwent lobectomies with systemic lymph node dissections through a standard thoracotomy (Group C), and 26 patients underwent lobectomies with lymph node dissections using the video-assisted procedure (Group V). The number of dissected lymph nodes at all node levels were compared between the two groups. There was no significant difference between groups in the total number of dissected lymph nodes in patients with right lung cancer. The number of dissected hilar and interlobar lymph nodes, however, was less in Group V than that in Group C (hilar: 1.2 +/- 0.4 vs. 2.8 +/- 0.6, interlobar: 1.1 +/- 0.4 vs. 2.1 +/- 0.4). The total number of dissected lymph nodes in patients with left lung cancer was significantly less in Group V than that in Group C (18.5 +/- 0.3 vs. 28.7 +/- 2.4). In addition, the number of dissected lymph nodes in pratracheal, pretracheal, tracheobronchial, subcarinal, hilar, and interlobar lymph nodes were significantly less in the group V than those in Group C. Although there was no significant difference in the actual survival rates between the groups in this preliminary study, a sufficiently small number of dissected lymph nodes in the video-assisted lobectomy may have resulted in inaccurate staging and poor prognosis in these patients.
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PMID:[Lymph node dissection during a video-assisted lobectomy is inferior to that in a standard lobectomy]. 939 80

Video-assisted thoracic surgery (VATS) has enabled more complex procedures previously requiring thoracotomy to be accomplished in lung cancer management. VATS today can be employed in the evaluation of idiopathic (and known) malignant pleural effusions, mediastinal adenopathy, indeterminate pulmonary nodules, and compromise resection and lobectomy of peripheral stage I non-small cell lung cancer. Thus, VATS is becoming an accepted approach to a variety of intrathoracic problems, although its absolute indications for patients with lung cancer have yet to be firmly defined. This article reviews the authors' current experience with VATS procedures in the treatment of patients with lung cancer.
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PMID:The role of thoracoscopy in lung cancer management. 943 83


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