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

A 57-year-old man with lung cancer was reported. Primary tumor was located at left S1+2, and directly invaded to chest wall (from 1st. rib to 4th rib). Hypercalcemia and delirium were observed. Whole body examination showed that no distant metastasis except for nodal swelling of left axillary region. Left upper lobectomy combined with chest wall resection was performed. Hilar, mediastinal and axillary nodes were also dissected. Histological examination revealed that nodal involvement was not present at neither hilar or mediastinal region, but was present in axillary node. It was thought that lymphatic extension had occurred from trough chest wall to axillary nodes but not through mediastinal rout. So systematic dissection of locally invaded region as well as hilar and mediastinal region was recommended in each cases.
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PMID:[A case of lung cancer with axillary nodal involvement]. 820 93

The prognostic significance of the expression of neural cell adhesion molecule (NCAM), a neuroendocrine antigen in lung cancer, was analyzed by an indirect immunoperoxidase method in 97 surgically treated patients. Reactivity of MOC-1 and S-L 11.14, both cluster-1 monoclonal antibodies directed against NCAM, was positive in all nine small-cell lung cancers and in 16 of 88 (18%) non-small-cell lung cancers. For the latter group, this expression demonstrated a phenotypic heterogeneity that was mainly observed in poorly differentiated squamous cell carcinomas and in stage N2 non-small-cell lung cancers. Patients with NCAM-positive non-small-cell lung cancer proved to have a shorter survival than those with NCAM-negative disease. In Cox's model for multivariate analysis, nodal status and histology were the main independent determinants of prognosis. We therefore concluded that NCAM expression in non-small-cell lung cancer is correlated to nodal status and that it indicates a poor prognosis. These findings confirm that the diversification of lung cancer phenotype leads to tumor progression and brings a negative prognosis to surgically resected non-small-cell lung cancer. However, nodal status remains the most important prognostic variable, suggesting that NCAM expression is only one of numerous biological events that promote tumor progression.
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PMID:Neural cell adhesion molecule and prognosis of surgically resected lung cancer. 821 27

Nineteen cases of isolated squamous cell carcinoma in situ (CIS) of the bronchus were described clinicopathologically from among 149 male heavy smokers with roentgenographically occult lung cancer discovered mainly by mass screening performed from 1982 to 1991. All 19 patients had positive sputum cytology tests and negative chest x-ray films and underwent lobectomy (except one who had segmentectomy because of poor lung function). Prior to operation, localization was accomplished by one to eight bronchoscopies using repetitive brush cytology and biopsy. Five cases were bronchoscopically invisible. Polypoid protuberance was noted in three cases, micronodular swelling in three, thickening of spur in five, and mucosal granularity in three. Histology by serial block sectioning showed that there was no nodal involvement in any cases; the maximum length or diameter was 12 mm. Thirteen tumors were < or = 4 mm, four of which were confined to the spur where they occurred. Follow-up data showed a favorable prognosis. Segmentectomy or sleeve resection of bronchus without mediastinal lymph node dissection may be adequate for CIS.
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PMID:Clinicopathological analysis of 19 cases of isolated carcinoma in situ of the bronchus. 823 30

Technetium-99m sestamibi (MIBI) is a routinely used myocardial perfusion imaging agent. We have studied groups of patients with differentiated thyroid carcinoma, in order to evaluate the usefulness of this agent in localising regional neck and nodal disease and metastases. There are three groups of patients. Group 1 consisted of patients with known nodal disease or metastases (22 patients) and with raised serum thyroglobulin levels (Tg). Group 2 comprised patients with normal I-131 scans and normal Tg levels (nine patients). Non-thyroid malignancies (six patients) comprised an additional group 3. In group 1, the MIBI scan showed 47 sites of metastases, while the I-131 scan revealed 49 sites. The MIBI scan was positive in two patients where the I-131 scan was negative, while in two other patients, the MIBI study was negative whereas the I-131 scan was positive. In group 2, 6/9 patients had no disease, 2/9 had thyroid remnants, and 1/9 had a fresh primary lung tumour, unrelated to the earlier thyroid cancer. All of them had normal MIBI scans. In group 3, two patients with lung cancer and two with breast cancer and metastases had normal MIBI scans. A further two patients with nasopharyngeal cancer (NPC) had mildly increased MIBI localisation in neck nodes and bone metastases. In summary, Tc-99m sestamibi appears to be as good as I-131 in search for thyroid carcinoma metastatic spread, especially nodal disease and this tracer does not localise well in the primary or metastases of other cancers.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Role of technetium-99m sestamibi in localisation of thyroid cancer metastases. 825 57

#12u nodes are peribronchial lymph nodes around the upper lobe bronchus which should not be routinely dissected in cases with middle lobe carcinoma or lower lobe carcinoma. In this paper, #12u were examined histologically in 152 lung cancer cases. As a results, 14 of 152 (9.2%) had nodal diseases in #12 nodes. #12u nodes were involved in 3 of 30 N1 diseases (10%), and in 11 of 35 N2 diseases (31.4%). There was a case which had no nodal involvement except for #12u node. And in three cases, we found only one nodal metastasis except for #12u nodes. If we did not dissect #12u nodes, these cases will be relapse in near future. Thus, for curative operation, #12u nodes should be dissected as a standard operation.
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PMID:[Incidence of nodal involvement of #12u nodes (lymph nodes around the upper lobe bronchus) in cases with right middle lobe, right lower lobe, and left lower lobe carcinoma]. 827 24

During the past 20 years, 1,064 cases of non-small cell lung cancer underwent resectional surgery in which all accessible mediastinal lymph nodes were dissected. Among 288 patients with histologically proven N2 disease, 182 underwent complete dissection of the mediastinal lymph nodes; 77 had one-level and 105 had multi-level metastases. Fifteen percent of the patients having primary lesions with a maximal diameter between 21 and 30 mm had N2 disease. Nodal metastases to the lower mediastinum from upper lobe cancer (nonregional metastasis) were frequently observed as were metastases of lower lobe cancer to the upper mediastinum. In addition, there were often skip metastases to the nonregional parts of the mediastinum without regional nodal involvement in the mediastinum. Among left-lung cancer patients, the group that underwent nodal dissection after mobilization of the aorta by dividing the Botallo's ligament frequently had a verified metastatic node at the tracheo-bronchial angle (#4) which might not have been detected without that procedure. In addition, many N2 and N3 diseases were detected by additional dissection through a median sternotomy. 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 and the size of the primary tumor.
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PMID:[Clinical significance of extended mediastinal lymph node dissection on the basis of clinicopathological analysis of nodal involvement in bronchogenic carcinoma]. 827 31

Sleeve lobectomy is a lung-saving procedure indicated for central tumors for which the alternative is a pneumonectomy. The relation between survival and nodal status is controversial because, in most series, the presence of N1 disease adversely affects the prognosis with few or no long-term survivors. During the period 1972 to 1992, 142 patients underwent sleeve resection for lung cancer at our institution. Mean age (+/- standard deviation) was 60.7 +/- 9.1 years (range 11 to 78 years), and indications for operation were a central tumor in 112 patients (79%), a peripheral tumor in 18 patients (13%), and compromised pulmonary function in 12 patients (8%). Histologic type was predominantly squamous (72.5%) followed by nonsquamous (24.6%) and carcinoid tumors (2.8%). Resection was complete in 124 patients (87%) and incomplete in 18 (13%), and the operative mortality was 2.1% (n = 3). Follow-up was complete for the 139 remaining patients. Including operative deaths, survivals at 5 and 10 years for all patients were 46% (95% confidence intervals 38% to 55%) and 33% (95% confidence intervals 24% to 42%), respectively. For patients with N0 status (n = 73), 5- and 10-year survivals were 57% (95% confidence intervals 45% to 69%) and 46% (95% confidence intervals 32% to 60%); for patients with N1 status (n = 55), these rates were 46% (95% confidence intervals 32% to 60%) and 27% (95% confidence intervals 14% to 40%) (p = 0.13). No patient with N2 status (n = 14) survived 5 years. Local recurrences occurred in 23% of cases, but the prevalence was not statistically different between patients with N0 disease (16.6%) and N1 disease (23.1%) (p = 0.43). These data suggest that sleeve resection is an adequate operation for patients with resectable lung cancer and N0 N1 status. The presence of N2 disease significantly worsens the prognosis and may contraindicate the use of the procedure.
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PMID:Survival related to nodal status after sleeve resection for lung cancer. 830 77

The relationship between tumor size and nodal involvement of resected roentgenographically occult squamous cell carcinoma in 127 cases was documented. Survival and recurrent patterns were analyzed. Intrabronchial invasion was observed in 103 cases and extrabronchial invasion in 24 cases. One hundred and nineteen cases (94%) had N0 diseases, six (5%) N1 diseases and two (2%) N2 diseases. One hundred and one cases were in early stage and 26 in non-early stage. Nodal involvement was observed in two (2%) of the 103 cases with intrabronchial invasion and in six (25%) of the 24 cases with extrabronchial invasion. Nodal involvement was noted in none (0%) of 55 cases in whom longitudinal extension of tumors was within 10mm, but was noted in four (9%) of 46 cases in whom it was 11 to 20mm and in four (15%) of 26 cases in whom it was 21 to 55mm. Death from primary lung cancer occurred in three (12%) of the non-early cases, but in none (0%) of the early cases. Death from multiple metachronous lung cancer occurred in one (4%) of the non-early cases and in three (3%) of the early cases. Nodal and extrabronchial involvement reduced survival. Recurrence often involved hilar, mediastinal, supraclavicular nodes, and surgical margin of bronchus.
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PMID:[Resected roentgenographically occult bronchogenic squamous cell carcinoma tumor size, survival and recurrence]. 834 Dec 46

Many surgical studies show a significant stratification of survival following resection of esophageal cancer based upon accurate pathologic staging. However, investigators are moving away from single modality therapy toward multimodality trials for the treatment of this disease. This presents a problem in staging of patients before therapy is begun. Chemotherapy and/or radiation therapy may alter the local tumor characteristics and nodal metastases, thus confounding evaluation of treatment results. Although CT scanning and transesophageal ultrasound help in assessing nodal status, they have not reached the precision necessary for study purposes. Pretherapy nodal staging using video-assisted exploration may provide the same level of accuracy as mediastinoscopy does for lung cancer.
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PMID:Laparoscopy/thoracoscopy for staging: II. Pretherapy nodal evaluation in carcinoma of the esophagus. 835 87

Lung cancer remains the most common fatal malignancy, so even modest therapeutic advances are potentially beneficial to large numbers of patients. For patients with regional nodal metastases identified at thoracotomy, adjuvant chemotherapy may be of benefit and additional clinical trials are in progress. Locally advanced disease is present in over a third of patients at diagnosis. For patients with marginally resectable tumors, the preliminary results of the neoadjuvant chemotherapy trials are encouraging and may result in an improvement in the 15% 5-year survival in this group. For patients with locally advanced and unresectable tumors, several but not all studies suggest that the combination of chemotherapy and radiation produces better results than radiation alone. Additional trials are needed to clarify these results. In addition, better methods are needed to maintain local control of unresected tumors. Hyperfractionated radiation schedules and concurrent administration of radiosensitizing chemotherapy drugs appear to be the most promising leads. Effective systemic treatment for patients with disseminated disease remains elusive. Several new classes of drugs, especially taxol and the topoisomerase I poisons, are being introduced and have rekindled hope for improved treatment of this large group of patients.
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PMID:Chemotherapy and radiation for the treatment of non-small-cell lung cancer. A critical review. 838 60


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