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

The radiographic evaluation and staging of bronchogenic carcinoma remains one of the greatest challenges to the thoracic radiologist and one of his or her most important responsibilities. With lung cancer now the most common malignant tumor in both men and women, there will be a continued need for radiologists to guide clinicians to the appropriate diagnostic and staging procedures, to help plan curative surgery, and to assess the response to therapy or progression of disease. The article reviews the radiographic approach to lung cancer diagnosis and staging with an emphasis on the use of computed tomography and magnetic resonance imaging for the evaluation of the primary tumor and mediastinal and hilar lymph node metastases.
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PMID:The radiologic staging of lung cancer. 177 46

The effects of expermentally induced hyper- and hypothyroidism on the growth and development of spontaneous pulmonary metastases of Lewis lung carcinoma (3LL) cells were studied in a murine system. Progression of 3LL tumors growing in mice was associated with significant reduction in the serum levels of T3 and T4. Subcutaneous (s. c.) injections (3 times/week) of T3 resulted in a hyperthyroid state with elevated T3 and reduced T4, whereas treatment with T4 induced a hyperthyroid state with elevated T3 and T4 levels. On the other hand, treatment with methimazole induced hypothyroidism with reduced T3 and T4 levels. Under these experimental conditions, treatment with T3 significantly inhibited spontaneous pulmonary metastases, and prolonged survivals of the mice. Methimazole suppressed primary and metastatic tumor growth and prolonged survival. In contrast, treatment with T4 enhanced primary tumor growth and development of pulmonary metastases of 3LL cells. Alveolar macrophages showed enhanced cytotoxicity against 3LL tumor cells after injections of thyroid hormones (T3 and T4) for 4 weeks. The NK activities of spleen cells of mice treated with T4 or methimazole were much lower than those of control mice, and were not affected by treatment with T3. These results imply that changes in thyroid functions may have important influence on natural host defenses against primary and metastatic lung cancer in humans.
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PMID:Effects of experimental hyper- and hypothyroidism on natural defense activities against Lewis lung carcinoma and its spontaneous pulmonary metastases in C57BL/6 mice. 194 98

Among the patients showing evidence of cerebral metastases without previously known cancer history, lung cancer has been found 37 times as the primary tumor in our institution. There were 34 men and three women and all but two were heavy smokers. Only one presented at diagnosis with thoracic symptoms but the chest radiograph was abnormal in 34. The histologic type of the primary tumor was obtained in 32 cases as a result of thoracic investigations and in five cases from metastatic tumor tissue. The primary tumor appeared to be non-small cell lung carcinoma in 26 cases and small cell lung carcinoma in 11 cases. These results show that patients treated with surgery (20 cases) have a better survival (median 10 months versus 4.5) than the others, and among surgically treated patients only those treated with bifocal resection (eight patients) are long-term survivors. Also, in four of six patients, objective regression of the neurologic symptoms was seen after radiation therapy alone. Central nervous system relapse was seen in 12 patients, but in none of the patients treated with postoperative radiation therapy. Conventional chemotherapy (11 patients) induced objective responses only in the small cell type and proved to be too toxic when used simultaneously with radiation therapy in inoperable patients.
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PMID:Cerebral metastases as first symptom of bronchogenic carcinoma. A prospective study of 37 cases. 202 60

Effusion-type lung cancer with postoperative T1N2-3M0 and primary tumor diameter less than 3 cm was regarded as small sized progressive lung cancer. There were 8 cases of pT1N2-3, with a 3-years survival rate of 37.5%, and, 5 years survival rate of 25.0%. There were 5 cases of effusion-type lung cancer with primary tumor diameter less than 3 cm, who were treated with panpleuropneumonectomy. Their 3 years survival rate was 51.9%. In small sized progressive lung cancer in total, the 3 years survival rate was 40.7%, and the 5 years survival rate was 29.1%. In comparison there were 29 cases of pT2N2-3, with a 3 years survival rate of 40.9% and a 5 years survival rate of 37.0%. There was no significant difference concerning the survival rate between T1 and T2 groups, T2 and pleuropneumonectomy group, and between small progressive lung cancer group and T2 group. Therefore, there seems to be a less correlation between progressive lung cancer and T-factor disease prognosis. It was suggested to improve the prognosis by extending lymph node dissection even in progressive lung cancer.
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PMID:[Surgical indication of T1-2N2-3M0 lung cancer based on the prognosis]. 203 48

Between 1974 and 1988, 115 patients admitted to our surgical unit underwent resection of nonsmall-cell lung cancer in the presence of mediastinal lymph node involvement (N2 disease). The overall 5 year survival rate was 18%, and the rates in patients with curative and noncurative operation were 26% and 9%, respectively (P less than 0.05). Based on the morphological evidence of N2 disease, the patients were placed in three groups: those with microscopic metastasis, moderate metastasis, and gross metastasis, the incidences being 29%, 28%, and 43%, respectively. The survival rates were 41%, 6%, and 16%, respectively. The difference among microscopic vs. moderate and microscopic vs. gross metastasis was statistically significant (P less than 0.01). Survival rates in patients with intranodal and extranodal invasion, as seen in the histologic examinations, were 34% and 11%, respectively (P less than 0.01). The incidence of gross metastasis and/or extranodal invasion was higher in those who underwent noncurative operation. Postoperatively adjuvant irradiation was not effective in prolonging the survival in patients with curative operation, but the local residual disease was controlled. Therefore, our working criteria are, if N2 lung cancer is present, a complete resection of the primary tumor and the mediastinal lymph nodes should be done. Patients with microscopic metastasis and intranodal invasion can expect a fairly long survival.
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PMID:Surgical treatment of patients with nonsmall-cell lung cancer and mediastinal lymph node involvement. 215 11

Two groups of lung cancer patients with solitary M1 disease are presented in whom lung resection was performed at the time of or after operative treatment of the metastasis. Nine patients had solitary brain metastasis prior to the resection of the primary tumor. Six died, with an average survival of 10 months post-thoracotomy, 3 survive after 15 to 31 months. The results are less favorable than suggested by the literature where often cases are included which have brain metastasis after lung cancer surgery. Another eight M1 situations in this series are predominantly lung cancers with pleural disease. Improvement of quality of life and substantial survival times have been observed, though most patients are still at risk after a survival of from 15 to 35 months. As to the histological features, adenocarcinoma was the most frequent type followed by the adenosquamous variant. Lung surgery should be considered in selected cases in spite of known or formerly treated solitary distant metastasis.
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PMID:Surgery in bronchial carcinoma with metastasis. 216 83

The purpose of this study was to assess the risk factors involved in the intrapulmonary, hilar and mediastinal lymph nodes metastases in seventy-eight patients with stage I, II or IIIA lung cancer postoperatively, which were resected from 1978 to 1988. In the histological type, the incidence of the mediastinal lymph nodes metastases in adenocarcinoma was higher than that in other types, such as squamous cell carcinoma and large cel carcinoma. In addition, the incidence of mediastinal lymph nodes metastases in the papillary type was significantly higher than that in the tubular type (p less than 0.05). The incidence of mediastinal lymph nodes metastases increased as invasion into the lymphatic duct and/or vessel was demonstrated (p less than 0.01, p less than 0.05). The proximal type, in which the cancer spread to the secondary segmental bronchus, metastasized to the hilar lymph nodes more frequently than the distal type, in which the cancer was located in the bronchus distal to the third segmental one. Although there was no significant relationship between the site of the cancer and the incidence of the metastatic lymph nodes, the hilar and superior mediastinal lymph nodes (#1-4, 3a, 3p) metastases were demonstrated regardless of the lobe in which the cancer was located. The primary tumor located in the left lower lobe of the lung tended to metastasize to the inferior mediastinal lymph nodes (#8, 9). Twenty-five out of 33 patients with the lymph nodes metastases had hilar metastatic lymph nodes. However, the mediastinal lymph nodes metastases were proved in 5 patients without any intrapulmonary and hilar lymph nodes metastases. No relationship between the histological differentiation, size of tumor, pT factor and the incidence of lymph nodes metastases was found.
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PMID:[Risk factors influencing lymph nodes metastasis in lung cancer with stage I, II or IIIA]. 217 32

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)
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PMID:A clinical-severity staging system for patients with lung cancer. 229 74

The location, frequency, and spread of metastases to the mediastinal lymph nodes were examined in 124 patients with histologically proven N2 disease who underwent pulmonary resection and total lymph node resection. There were one-level metastases in 47 percent of cases, two-level metastases in 29 percent, three-level in 12 percent, and 12 percent had four or more levels of metastases. Nodal metastases to the lower mediastinum from upper lobe cancer were frequently observed as were metastases of lower lobe cancer to the upper mediastinum. The frequency of the latter was higher than that of the former. About one third of squamous cell carcinoma and adenocarcinoma in the right upper lobe produced nodal metastases in the lower mediastinum. In addition, there were often skip metastases to the nonregional parts of the mediastinum without regional nodal involvement in the mediastinum. From the results of the present study, it appears that extensive mediastinal dissection should be recommended in surgery for lung cancer irrespective of the location of the primary tumor.
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PMID:Mediastinal spread of metastatic lymph nodes in bronchogenic carcinoma. Mediastinal nodal metastases in lung cancer. 233 99

Because pancreatic cancer often metastasizes to other sites, it may not be diagnosed until autopsy. Pulmonary metastases from the pancreas are not uncommon but unfortunately not often recognized. Dr Mishriki describes a patient with obstruction of the superior vena cava and metastatic pancreatic cancer that was misdiagnosed as primary lung cancer. Autopsy revealed the pancreas to be the primary tumor site.
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PMID:Pancreatic carcinoma presenting as primary lung cancer. 234 11


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