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

This review was initiated to assess the outcome of treatment with radical radiation therapy with curative intent for elderly patients diagnosed to have Stage I non-small cell lung cancer (NSCLC). The study involved a retrospective review of 347 patients with T1 and T2N0M0 tumours treated at the Queensland Radium Institute (QRI) during the period 1985-1992. The main reasons for not proceeding to surgery included poor performance status, old age or refusal to submit to surgery. The median age for the group was 70 years with the range being 34-90 years. Patients in this group were all treated by a standard technique involving external beam radiation therapy to a dose of 50 Gray Minimum Tumour Dose in 20 fractions over 4 weeks. When the study group was divided into those patients aged < 70 years and those patients age > or = 70 years, the overall survival at 5 years was 22 and 34%, respectively (median survival 22 months for age < 70 years, and 26 months for age > or = 70 years). The same division in terms of recurrence free survival yielded 5-year survival rates of 18% for the age < 70 years group and 30% for the age > or = 70 years group with the median survival being 17 months in both sub-groups. Both the difference in overall survival and recurrence free survival between the two age groups approached, but did not reach, statistical significance at the P < 0.05 level of significance. Further sub-division into 5-year age groups failed to confirm the hypothesis that older age groups had a poorer outcome. The 75-79-year group showed better survival than other age groups with the 5-year overall survival for this group being 53%, while the 5-year recurrence free survival was 45%. We conclude from this large series of Stage I NSCLC that radical radiation therapy with curative intent may be a viable alternative to surgery in those elderly patients who either refuse surgery or are judged to be unfit for operation. In view of the fact that comparable results can be achieved in elderly lung cancer patients at the price of minimal toxicity, a nihilist approach to treatment in the elderly can no longer be justified.
Lung Cancer 2001 Apr
PMID:The curative treatment by radiation therapy alone of Stage I non-small cell lung cancer in a geriatric population. 1128 31

In recent years limited operations including wedge resection, segmentectomy and simple lobectomy are getting increased as a treatment of choice for non-small cell lung cancer (NSCLC). However, surgery for lung cancer should be emphasized in terms of postoperative quality of life as well as complete resection or radical resection of the tumor. There have been few number of randomized controlled trials as to limited operation of lung cancer. Thus this kind of procedures such as wedge resection and segmentectomy for stage I NSCLC, and thoracoscopic lobectomy for stage I lung cancer, is not generally evaluated as an alternative treatment to the standard operation at the present time. In this paper current status of limited surgery for lung cancer is reviewed mainly based on recent literatures and results obtained from our experience in Institute of Development Aging and Cancer, Tohoku University.
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PMID:[Limited surgery for bronchogenic carcinoma]. 1151 36

Thrombomodulin (TM) is an important modulator of intravascular coagulation. TM exists on endothelial cells and on several types of tumor cells, especially squamous cell carcinoma cells. Tumor cell TM is thought to be associated with progression and metastasis of the tumor. To evaluate the prognostic significance of TM in lung cancer, we examined TM expression and vascular invasion in surgical specimens obtained from 90 patients with completely resected stage I non-small cell lung cancer (NSCLC). In addition, we correlate these pathologic data to other clinicopathologic data, including the outcome of the patients. Squamous cell carcinomas had a significantly higher incidence (P<0.0001) of TM expression (22/36 cases, 61%) than adenocarcinomas (9/54 cases, 17%). In 36 squamous cell carcinoma patients, both vascular invasion (P=0.0153; risk ratio 6.507) and TM non-expression (P=0.0282; risk ratio 3.584) were significant for a poor prognosis. Univariate analysis of patient survival rates also revealed that vascular invasion and TM expression were significant prognostic factors (P=0.0036 and 0.012, respectively). Further, combination analysis of vascular invasion and TM expression in the squamous cell carcinoma patients showed that the 5-year survival rate was 90% in patients with TM expression and without vascular invasion, but 21% in patients with vascular invasion and without TM expression (P=0.0004). Since our results suggest that vascular invasion and TM expression are independent prognostic factors of stage I squamous cell carcinoma of the lung, and since the two factors play different roles in the metastatic process of cancers (promotion of metastasis by vascular invasion and inhibition of metastasis by TM expression), the combination evaluation of vascular invasion and TM expression may be very significant in evaluating the prognosis of patients with completely resected stage I squamous cell carcinoma.
Lung Cancer 2001 Dec
PMID:Prognostic significance of thrombomodulin expression and vascular invasion in stage I squamous cell carcinoma of the lung. 1171 34

We considered 33 patients to have a multiple primary lung cancer (MPLC) at our hospital from January 1986 to August 2001. We used the criteria of Martini and Melamed for MPLC. Sixteen patients developed metachronous cancer within 0.8 to 9.4 years of the first operation (mean 4.2 years), while 17 patients had synchronous cancers. The most common histologic pair was squamous cell carcinoma-squamous cell carcinoma (45%). The next was adenocarcinoma-adenocarcinoma (21%). Stage I lesions occupied 80% of all lesions. Nine patients underwent lobectomy, while 9 patients underwent surgery including a limited operation. Eleven patients had non-surgical local treatment including photodynamic therapy (PDT), brachytherapy, and radiation therapy. Five-year survival for patients with synchronous and metachronous disease from second operation was 36.1% and 40.1%, respectively. Survival of patients including only stage I non-small cell lung cancer (NSCLC) lesions was significantly better compared with those including stage II or III NSCLC and SCLC lesions (p = 0.002). Therefore it is very important to perform close follow-up surveillance for early detection of cancer.
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PMID:[Therapy for multiple primary lung cancers]. 1179 7

The MTA1 gene is a recently identified metastasis-associated gene which has been implicated in the signal transduction or regulation of gene expression. We examined the mRNA expression levels of the MTA1, the human homologue of the rat mta1 gene in non-small cell lung cancer (NSCLC). Expression of MTA1 messenger RNA was evaluated by reverse transcription polymerase chain reaction (RT-PCR) in 74 non-small cell lung carcinoma samples using LightCycler. The data was analyzed in reference to clinicopathological data. There was no relationship between MTA1 gene expression and age and gender. MTA1/GAPDH mRNA level in stage II-IV NSCLC (3.465+/-3.675) was significantly higher than the level in stage I NSCLC (1.614+/-2.434, P=0.0153). MTA1/GAPDH mRNA levels in T4 NSCLC (4.377+/-4.169) was significantly higher than the level in T1 NSCLC (1.966+/-2.148, P=0.0351) and in T2 NSCLC (2.048+/-1.899, P=0.0269), respectively. MTA1/GAPDH mRNA level in NSCLC with lymph node metastasis (4.242+/-3.758) was significantly higher in NSCLC without lymph node metastasis (P=0.0169). Our results show that the expression of the MTA1 gene is closely related to invasiveness and metastasis in NSCLC. The gene MTA1 could thus potentially provide information on the mechanism of cancer invasion and metastasis.
Lung Cancer 2002 Feb
PMID:Expression of the MTA1 mRNA in advanced lung cancer. 1180 87

The outcomes of patients with stage I non-small-cell lung cancer (NSCLC) vary greatly, with a 5-year survival rate of approximately 60%. This study evaluated a number of molecular markers that may aid in predicting prognosis in stage I NSCLC after surgical resection. Immunohistochemical (IHC) staining of p53, HER-2/neu, bcl-2 proteins was performed on paraffin-embedded sections from 85 stage I NSCLC patients who underwent surgery and were followed up for 32 to 44 (median, 39.0; mean, 37.1) months postoperatively. Differences in survival rates were evaluated by log rank test. The prevalence of p53, HER-2/neu, and bcl-2 expression in stage I NSCLC is 59%, 29%, and 46%, respectively. HER-2/neu expression is seen more frequently in adenocarcinomas, and bcl-2 is seen more frequently in squamous carcinomas. p53 and HER-2/neu expression in stage I NSCLC is associated with significantly short survival. Patients whose tumors were both p53 and HER-2/neu positive had the worst outcome, with a survival rate of only 20%, compared with 80% in those whose tumors were both p53 and HER-2/neu negative (P = .0003). The survival rates were 54% in patients who were p53 positive but HER-2/neu negative and 50% in those who were in p53 negative, HER-2/neu positive. The differences among these 4 groups were statistically significant (P =.001). Bcl-2 does not seem to be a prognostic factor for survival. Multivariate analysis showed that overexpression of p53 and HER-2/neu, presence of angiolymphatic invasion, and tumor size > 3.0 cm were independent factors predicting poor survival. p53 and HER-2/neu by IHC staining appear to be valuable prognostic markers in stage I NSCLC patients after surgery. The worst outcome was seen in patients who expressed both p53 and HER-2/neu, suggesting that these patients might benefit from additional adjuvant therapy.
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PMID:Prognostic value of immunohistochemical expressions of p53, HER-2/neu, and bcl-2 in stage I non-small-cell lung cancer. 1182 80

We clinically examined cases of death from pathologic stage I non-small cell lung cancer with the aim of improving the 5-year survival rate after surgery for this condition. The subjects were 70 patients with p-stage IA (20 cases of death) and 59 patients with p-stage IB (26 cases of death) from among those who underwent surgery for p-stage I non-small cell lung cancer between 1986 and 2000. 1) Of 30 patients who died from p-stage I lung cancer, 20 had distant metastases and 10 had recurrence in the thoracic cavity. Of 16 patients who died from other diseases, 5 had respiratory organ disease, 5 had cancers of other organs and 6 had circulatory organ disease. 2) Of 30 patients who died from p-stage I lung cancer, 20 (66.7%) had distant metastases, with lung metastasis occurring most frequently, in 10 of them (33.3%). The most common cause of death of patients with p-stage IB lung cancer was recurrence in the thoracic cavity. 3) The mean durations of survival (mean +/- standard deviation) after surgery for lung cancer of the patients who died from p-stage I lung cancer (30 patients) were 36.3 +/- 22.2 months for the 20 patients with distant metastases and 26.2 +/- 14.3 months for the 10 patients with recurrence in the thoracic cavity, the difference between groups was 10 months, but was not significant. 4) The 5-year survival rate in 45 patients who underwent p-stage IA mediastinal lymph node dissection was 83.1% whereas that in 25 patients without p-stage IB mediastinal lymph node dissection was 50.9% showing a significant difference of 32.2% (p < 0.01). 5) The patients in p-stage IA who died from other diseases were all men (10 patients). The mean durations of survival after surgery for lung cancer in the patients who died from other diseases were 35.2 +/- 19.0 months in the patients with respiratory organ disease, 37.0 +/- 23.9 months in those with cancers of other organs and 60 +/- 19.1 months in those with circulatory organ disease. 6) The 5-year survival rate after surgery in all cases of death was 76% in the patients in p-stage IA and 61.4% in those in p-stage IB. The 5-year survival rates in the patients excluding those who died from other diseases were 85% in the patients in p-stage IA (60 patients) and 60.3% in those in p-stage IB (53 patients) (p < 0.01). 7) To improve the 5-year survival rate in the patients with p-stage IA lung cancer, it is necessary to prevent death from other diseases in men. It is still possible to improve the 5-year survival rate in the patients with p-stage IB lung cancer by raising the accuracy of mediastinal lymph node dissection during surgery.
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PMID:[Cases of death after surgery for pathologic stage I non-small cell lung cancer]. 1184 46

Since carbon beam therapy for non-small cell lung cancer (NSCLC) was initiated in October 1996, seven trials have been conducted; three have already closed and the remaining four are ongoing. The local control rate, cause-specific survival rate, and overall survival rate of 141 patients with clinical stage I NSCLC were 82%, 58%, and 42%, respectively. Radiation pneumonia was rare (2.1%) and not serious. In the phase II clinical study, the local control rate achieved in 50 patients was 100%, with no radiation pneumonia, resulting in a 60% overall survival rate. Carbon beam therapy could be an alternative to surgery, especially for lung cancer patients of advanced age and/or with complications. For locally advanced lung cancer treated with carbon beam therapy, excellent local control comparable to that in stage INSCLC has been demonstrated and offers hopeful prospects for the treatment of lung cancer.
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PMID:[Heavy-ion therapy for non-small cell lung cancer]. 1190 89

Caspase-3 is a cysteine protease that plays an important role in the process of apoptotic cell death. Whereas many studies on the clinical significance of apoptosis in the therapy of malignant tumors have been reported, little has been studied clinically on caspase-3. In the present study, the clinical significance of caspase-3 expression in resected nonsmall-cell lung cancer (NSCLC) and its correlation with incidence of apoptosis were examined. A total of 118 consecutive patients who had undergone complete resection for pathologic Stage I NSCLC were retrospectively reviewed. Caspase-3 expression was examined immunohistochemically using a polyclonal antibody that recognized uncleaved caspase-3. The 5-year survival rate for patients with strong expression of caspase-3 (66.6%) was significantly lower than that for patients with weak expression (82.1%, P = 0.021). Expression of caspase-3 was not correlated with incidence of apoptosis, proliferative activity, or p53 status. Multivariate analysis confirmed that strong expression of caspase-3 was a significant factor to predict poor prognosis. These results suggest that enhanced expression of "uncleaved" caspase-3, that is, inactivated caspase-3, was correlated with poor prognosis in resected NSCLC.
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PMID:Clinical significance of caspase-3 expression in pathologic-stage I, nonsmall-cell lung cancer. 1199 86

Lung cancer is the leading cause of death from cancer in most developed nations. The most common type of lung cancer is of non-small cell histology, representing approximately 80% of the total. Despite aggressive treatments in early stages and improvement of polychemotherapy outcomes in advanced disease, the five years survival rate for lung cancer remains under 15%. Fortunately, our improved knowledge of tumor biology and mechanisms of oncogenesis suggests several new potential targets for clinical research in cancer therapy. A substantial body of evidence indicates that cyclooxigenase (COX)-2 and prostaglandins (PGs) play an important role in tumorigenesis. Mechanisms involved in COX-2 participation in tumorigenesis and tumor growth include xenobiotic metabolism, angiogenesis stimulation, inhibition of immune surveillance and inhibition of apoptosis. COX-2 is frequently overexpressed in bronchial premalignancy, lung adenocarcinoma and squamous cell carcinoma and COX-2 overexpression is a marker of poor prognosis in surgically resected stage I non-small cell lung cancer. Treatment with COX-2 inhibitors reduces the growth of NSCLC cells in vitro and in xenograft studies. Recent studies have defined some of the mechanisms involved in COX-2 participation in NSCLC development and diffusion. These evidences support the hypothesis that selective COX-2 inhibitors (coxibs) may prove beneficial in the prevention and treatment of NSCLC.
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PMID:Selective cyclooxygenase-2 inhibitors and non-small cell lung cancer. 1236 71


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