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

The knowledge of pretreatment factors playing a role in the evolution of a lung cancer is important for the choice of a therapeutic option in an individual patient but is also crucial when performing clinical research. The purpose of this paper is to review the prognostic parameters recognized in three distinct populations. For small cell lung cancer, disease extent and performance status are the most discriminant well known factors. Age, sex, lactic dehydrogenase serum level and mediastinal involvement provide complementary information. For non small cell lung cancer, operability status is the variable responsible for the greatest heterogeneity. TNM classification, histology, age and sex and probably knowledge of some biological values are useful data to improve accuracy in the prognosis of operable patients. For patients unresectable at diagnosis, disease extent and performance status are the most important prognostic factors to which age, sex and some biological parameters could be added.
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PMID:[Prognosis of bronchial cancer in 1995]. 770 Nov 68

Preoperative tumor staging in patients with non-small-cell lung cancer is important for selecting those patients with localized disease who are likely to benefit from surgical resection. The TNM staging system of the American Joint Committee on Cancer is the most widely accepted and used classification system for preoperative and postoperative staging [1] (Table 1). Small-cell carcinoma has a very different biologic behavior and is classified and treated differently; it will not be discussed in this imaging review. Chest radiography is the preferred initial imaging technique for patients with known or suspected lung cancer because of its availability, low cost, low radiation dose, and sensitivity [2]. CT and MR imaging of the chest and abdomen are often used to stage a known or suspected lung carcinoma. Various nuclear medicine procedures may be used to aid in the staging process and to assess the patient's medical status for surgery, including cardiac and pulmonary function. This article reviews the major imaging techniques that are currently used to stage primary non-small-cell carcinoma of the lung. Although evaluation of distant metastatic disease is highly important in these patients, discussion of the imaging methods used for this purpose is beyond the scope of this article.
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PMID:Preoperative staging of non-small-cell carcinoma of the lung: imaging methods. 775 72

Immunohistochemical detection of the p53 gene product by monoclonal antibodies has been shown to be associated with a poor clinical outcome in carcinomas of the breast and stomach. Because the prognostic relevance of p53 immunostaining in lung cancer is still under debate, we studied the expression pattern and clinical significance of such staining in 73 patients with operable non-small-cell lung cancer. p53 expression was detected on frozen sections with the use of monoclonal antibody p1801, which recognizes both the wild-type and mutant gene product (alkaline phosphatase-anti-alkaline phosphatase method). A tumor was considered p53 positive if more than 1% of the tumor cells were stained. The p53 expression pattern was compared with clinicopathologic parameters, and analysis of follow-up, based on the data of 65 patients, was done by a log rank test (median observation time, 780 days). Nuclear p53 staining was detected in 33 of 73 non-small-cell lung cancers (45.2%). Comparison with clinicopathologic parameters demonstrated that the p53 protein was detected more frequently in younger patients (younger than 50 years, p = 0.014), whereas no correlation was found with sex, tumor differentiation, tumor histologic type, or TNM stage. Surprisingly, follow-up analysis revealed that p53 staining was associated with an increased rate of disease-free survival, especially in patients with early stage tumor disease (p = 0.004) and in male patients (p = 0.023). Counter to previous studies in other solid tumors, immunocytochemical detection of p53 expression does not predict a poor clinical outcome in non-small-cell lung cancer. In early-stage lung cancer it might be associated with an improved disease-free survival, which suggests that the majority of the detected protein inherits the wild-type tumor suppressor function.
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PMID:Immunohistochemical detection of P53 protein is not associated with a poor prognosis in non-small-cell lung cancer. 777 84

Using labelled streptavidin-biotin (LSAB) method, we examined the expression of nucleoside diphosphate kinase(NDPK), the product of metastasis suppressor gene nm23, in human lung cancer. Of 88 patients tested, 48 (54.5%) showed positive staining. The positive staining rate was higher in adenocarcinoma (28/42, 66.7%) than in squamous cell carcinoma (20/46, 43.5%; P < 0.05). Higher incidence of positive staining was also found in squamous cell carcinoma without hilar or mediastinal lymph node metastasis (16/27, 59.3%) than in that with hilar or mediastinal lymph node involvement (4/19, 21.1%; P < 0.05). NDPK/nm23 was equally expressed in adenocarcinoma irrespective of lymph node status. In both cell types of carcinoma, expression of NDPK/nm23 was not correlated with tumor cell differentiation, nor was it correlated with the P-TNM staging. Our results suggest that NDPK/nm23 may play different roles in the pathogenesis and metastasis of human pulmonary squamous cell carcinoma and adenocarcinoma. Its expression levels are inversely correlated with lymph node metastasis in squamous cell carcinoma.
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PMID:[NDPK/nm23 expression and its correlation with lymph node metastasis in human lung cancer]. 780 57

In the Czech Republic, lung cancer is the most frequent malignant tumor in men. In 1990 the incidence was 99.6/100,000 for men and 15.8/100,000 for women. Neither diagnostic nor therapeutic approaches have changed significantly in the last 10 years. Patients undergoing lung resection have a chance of long-term survival. In this retrospective study, the authors analysed the data of 252 patients undergoing the operation for non-small cell lung cancer (NASCL) in the period 1985-1990. Of all patients who in that period had lung cancer diagnosed in our clinic, only 22% were operated on. Lobectomy was the most frequent type of operation (45%), and exploratory thoracotomy was carried out in 13%. The epidermoid type of cancer was the most frequent one (62%). Comparing cTNM with pTNM, concordant results were found in 55% of the series, 39% were clinically underestimated and 6% overestimated. By the time of the evaluation (31 December 1992), 78% of all patients who had undergone surgery during the study period had died. The most frequent cause of death was lung cancer metastasis. In the subseries of patients who died within 1 month after surgery (10% of all patients), the most frequent cause of death was pneumonia. The survival curve shows the best prognosis for patients in the Ist TNM stage, with 40% surviving 5 years. The authors consider the results of this study to favour aggressive surgical treatment of NSCLC patients.
Lung Cancer 1994 Sep
PMID:The results of surgical treatment of non-small cell lung cancer at the Pneumological Clinic in Prague, Czech Republic 1985-1990. 781 6

There is consensus regarding a pretreatment minimal staging protocol for non-small cell lung cancer. We adopted the new TNM-classification and staging system. For the preoperative mediastinal exploration CT scan (with contrast) and mediastinoscopy are complemental explorations. We avoid to operate on patients with multiple involved mediastinal lymph nodes (N2) or with involved contralateral (N3) or supraclavicular lymph nodes (N3). The final goal is a complete or potentially curative resection including mediastinal lymphadenectomy. The survival of the patient is mainly dependent of the N-status. When N2 disease is unsuspectedly discovered at operation, complete resection with mediastinal lymphadenectomy is performed. The subgroup with the best prognosis is the group with negative mediastinoscopy, lobectomy for central tumor and minimal N2, intracapsular. Multimodal therapy is investigated via multi-institutional trials. Chest wall involvement by lung cancer (T3) does not imply a hopeless prognosis. En-bloc resection of lung and partial chest wall is performed if possible. The 5 year survivors share common features: asymptomatic before operation, non-smokers, no riberosion, squamous cell carcinoma, chest wall resection limited to two ribs and N0-status. For Pancoast-tumors (T3) we follow the Paulson treatment protocol. After the usual staging, the candidates for surgery receive preoperative radiotherapy, followed by complete en-bloc resection, and eventual postoperative radiotherapy in case of incomplete resection. Careful follow-up of all patients operated for lung cancer is necessary, as the incidence of a metachronous lung cancer is as high as 10% for the long survivors. When a second or third primary lung cancer appears, reoperation is the treatment of choice in the absence of metastases or other contraindications. In most cases a complete curative resection is possible. Pulmonary resections have to be complete, but as conservative as possible, eventually with broncho- and angioplasty.
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PMID:Present views of the surgical treatment of non-small cell lung cancer. 789 46

The survival rate analysis of 130 patients with non-small-cell lung cancer who did not receive any specific anticancer therapy showed no statistically significant differences in the survival rates between various TNM combinations classified into stage groups II, IIIa, IIIb, and IV, as proposed by Mountain in 1989 and adopted by the American Joint Committee on Cancer. Following these findings, based on survival probabilities, two distinctive staging groups could be distinguished. The first stage group was composed of only the T1, 2N0, M0 combination, and the second of all other TNM combinations. In a purely biologic sense of tumor growth, the lymph node involvement appeared to be the crucial factor determining the length of survival.
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PMID:Survival analysis of untreated patients with non-small-cell lung cancer. 798 3

A prospective nonrandomized phase II trial was performed from June 1989 to Oct 1990 using concurrent chemotherapy and split course radiotherapy in the treatment of inoperable, locally advanced non-small-cell lung cancer (NSCLC). Eligibility criteria consisted of NSCLC, inoperable stage IIIA or IIIB excluding T3N0 or T3N1 of TNM classification, with pleural effusion, age 75 y.o. or less, PS0-2, with measurable lesion, previously untreated, normal bone marrow, adequate renal and hepatic function, PaO2 > or = 70 torr, and with no other active neoplastic disease. Patients were treated with 50 Gy of radiation in 25 fractions to the chest, together with 100 mg/m2 cisplatin and 8 mg/m2 mitomycin-C on day 1 and 29 and vindesine 3 mg/m2 on days 1, 8, 29, 36. Sixty-five patients were entered into this trial and 61 were eligible. There were 4 ineligible patients (1 stage II, 2 stage IV, 1 malignant lymphoma). Fifty-seven patients received 2 or more courses of chemotherapy, with dose modification in 42 patients. Only 5 patients received less than 50 Gy radiation dose. Fifty-three patients had a partial response for an overall response rate of 87% (95% CI 78-95%). Median duration of response was 276 days. Median survival time (MST) was 450 days. One, 2, and 3 year survival were 60%, 37%, and 28%, respectively. In IIIa (13 patients), MST was 358 days and 1, 2, and 3 year survival were 50%, 50%, and 42%, respectively. In IIIB (48%), MST was 450 days and 1, 2, and 3 year survival were 63%, 33%, and 25%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Radiotherapy and chemotherapy for locally advanced non-small-cell lung cancer: report of a clinical trial and review of the literature. South Osaka Lung Cancer Chemotherapy Study Group]. 800 68

In this epidemiological study, the incidence of lung cancer from 1981 to 1985 was evaluated in one district in the Central Bohemia Region with a population of 44,000. A total of 157 patients were identified as having lung cancer, the male:female ratio was 10:1, and 91% were smokers. Up to 78% of patients were detected because of their complaints, 17% at preventive examination, and 5% at autopsy. The calculated incidence for men was 129/100,000, for women 13/100,000. An average of 42 days elapsed from the time of the initial complaints or the preventive examination to the first visit with a pneumologist. From this visit to the establishment of the diagnosis an average of 28 days elapsed. In 79% of the patients, the diagnosis was confirmed histo- or/and cytologically, but mostly only by cytological examination; 15% of the whole group (23 patients) received surgery, four of whom underwent explorative thoracotomy alone; 18% had radiotherapy only; 12% received radiotherapy in combination with chemotherapy; 9% had chemotherapy alone; and 46% received symptomatic therapy only. In April 1992, the authors reviewed the series of patients and evaluated survival in different subgroups according to method of detection, morphological type, and TNM stage. Of the patients undergoing resection, 37% survived 5 years. In 13 patients, who died after successful resection, the cause of death was analysed. The majority succumbed to progression and dissemination of lung cancer. The authors conclude that prolonged survival could be demonstrated for resected patients, for patients at stages I and II, and for patients with squamous type of cancer.
Lung Cancer 1994 Mar
PMID:Epidemiological studies on lung cancer in the Bohemia region. 807 75

Major pulmonary resections are generally performed through long thoracotomies which cause important functional and cosmetic sequelae. The progress in videoendoscopic surgery has allowed the authors to perform 31 pulmonary resections (28 lobectomies, 1 segmentectomy and 2 pneumonectomies) by thoracoscopic approach. Seven patients had benign pulmonary disease, 3 patients had pulmonary metastases and 21 cases suffered from a primary lung cancer TNM stage I. In all cases of malignancy hilar lymphadenectomy was performed. No major postoperative complications were observed. Functional and cosmetic results were always excellent.
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PMID:Major videothoracoscopic pulmonary resections. 808 99


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