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Query: UMLS:C0684249 (lung carcinoma)
 23,830 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective study was undertaken in 1990 of 188 patients with the diagnosis of non small cell carcinoma of the lung referred to the Department of Radiation Oncology in 1984. Most patients (178/188) received a course of radiotherapy. This was definitive in 23, palliative in 148 (primary site in 113, metastases in 16, primary plus metastases in 19) and postoperative in 7. This report is a 5 year followup of the 171 patients treated by radiation alone, to assess factors that influence survival. Tumour histology was 50% squamous, 23% adenocarcinoma, 16% large cell and 4% unspecified, non small cell carcinoma. In 8% no histological diagnosis was obtained. The most common symptoms were cough (44%), dyspnoea (43%), chest pain (37%), haemoptysis (33%) and systemic symptoms (36%). Tumour stage (TNM) was assessed retrospectively as I(5%), II(8%), IIIA(18%), IIIB(22%) and IV(28%). A subgroup of 31 cases (18%) of uncertain staging (I-III) was analysed separately and in 2 cases (1%) no staging information was available. Palliative intent of treatment and poorer performance status were related significantly to increasing stage of disease. The effects of palliative treatment were recorded in 79 cases; in 71 there was a reduction in symptoms. The median survival from diagnosis was 8 months (range < 1-72). Using univariate and multivariate analyses, significant and independent prognostic factors for improved survival were good performance status, absence of systemic symptoms, lower tumour stage and curative intent of treatment (higher radiation dose). However the 5-year survival was only 2%. Long-term survival was associated predominantly with early stage disease but not with the type or intent of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Non small cell carcinoma of the lung. A retrospective study. Presented at the 41st annual meeting of the Royal Australasian College of Radiologists, September 1990, Perth. 128 99

Between 1976 and 1989, 53 out of 60 patients with large cell carcinoma of the lung underwent potentially curative surgery, i.e. macroscopically and microscopically complete resection. For better comparison, all tumors were classified according to the TNM staging system of the UICC 4th edition of 1987. Following potentially curative surgery, in stage I the mean survival time was 19 months and the five-year survival rate 30.1%, in stage II 8 months and 10%, and in stage IIIa 6.5 months and 0%, respectively. The differences in the long term prognosis between the tumor stages are significant. No significant differences could be demonstrated between II and IIIa in terms of the mean survival times. The prognosis for patients with potentially curatively resected squamous cell carcinoma is significantly better than that for patients with large cell carcinoma.
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PMID:Large cell carcinoma of the lung: a contribution on prognosis after potentially curative resection. 165 78

This article is the first in a planned series from the Section on Lung Cancer of the ACCP addressing the important and clinically relevant aspects of what is now the most common malignancy in the world, lung cancer. This initial report addresses the problem of staging of lung cancer. Staging, or identifying the anatomic extent of disease according to the AJCC TNM classification scheme, is the first clinical activity in caring for a patient with known or presumed lung cancer because the results determine appropriate types of therapy. This is, therefore, a critically important aspect of the patient's care which forms the foundation for subsequent treatment. In addition, consistent use of this system, based on appropriate clinical and pathologic staging, in stratifying patients in clinical reports is mandatory; otherwise, meaningful comparisons and conclusions are impossible.
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PMID:Clinical staging of patients with non-small cell lung cancer. 216 30

To determine the accuracy of computed tomography (CT) of the chest in the staging of lung cancer, we studied 418 patients with primary pulmonary carcinoma between 1979 and 1986. Each had a preoperative scan performed before detailed operative staging. Each CT scan was analyzed for components of the current TNM staging system. Computed tomography sensitivity and specificity for mediastinal lymph node metastasis were 84.4% and 84.1%, with corresponding positive and negative predictive accuracies of 68.7% and 92.9%, respectively. When TNM stages were derived from CT scans, only 190 of 418 (45.4%) completely agreed with operative staging. An additional 53 of 418 (12.7%) predicted the correct stage, although components of the TNM system were incorrect. In 94 of 418 scans (22.5%) CT overestimated the stage, whereas in 81 (19.4%) CT downgraded the stage. Computed tomography suggested metastatic lesions in liver, lung, adrenal gland, bone, or abdominal lymph nodes in 40 of 373 scans (10.7%); only five of 40 (12.5%) had documented metastasis. In summary, CT of the chest cannot accurately stage primary lung carcinoma according to the TNM classification. Because the negative predictive accuracy for mediastinal lymph node metastasis remains high (92.9%), invasive staging can be deferred for definitive thoracotomy when no lymphadenopathy is evident on CT. The high negative predictive accuracy for scans of the chest and upper abdomen makes CT a useful tool for exclusion of metastatic disease.
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PMID:Can computed tomography of the chest stage lung cancer? Yes and no. 198 65

The techniques used for the investigation of a patient with lung carcinoma are determined by the mode of presentation of the disease. The first step is based on the clinical examination and the chest X-ray (frontal and lateral view). The pathological examination of the tumor represents the second step. Depending on the operability of the patient at this stage of the investigation, further evaluation will (or will not) be performed to determine the extension of the tumor, using TNM staging system. Any candidate for surgery has to be bronchoscoped in order to evaluate the endobronchial spread of the tumor and to look for additional lesions. Transverse tomography of the thorax is the central part of any staging procedure. The choice among the other methods of investigation depends on the site of the tumor in the thorax. Mediastinoscopy is only needed in case of a lesion of unknown nature located in the anterior mediastinum or in addition to CT scan when there is a suspicion of mediastinal involvement. Transthoracic needle aspiration is best performed on peripheral lesions. In small cell lung carcinoma, the preoperative work-up should be very systematic even in the absence of clinical or laboratory abnormality. Whereas in certain cases the investigation of a patient with lung carcinoma can be limited to a clinical examination and a chest X-ray, any candidate for surgery has to be submitted to a detailed TNM staging.
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PMID:[Choice of examination methods in bronchial cancer]. 218 71

In order to improve the management of lung cancer at various stages, we analyzed results of treatment in 928 of 1024 patients who were registered at our Hospital Tumor Registry of 1952-1983 with a pathological diagnosis of TNM for carcinoma of the lung after pulmonary resection. The 5-year-survival rate was 43% in 928 patients excluded the cases who were lost follow-up or succumbed within post-operative 1 month. The 5-year-survival rate was 77% for the stage I, 54.7% for the stage II, 17% for the stage III and 4% for the stage IV. The 5-year-survival rate by therapeutic modality was as follows: 52% for the group with chemotherapy, 35% for the one without adjuvant therapies, 29% for the one with irradiation and 15% for the one with radiochemotherapy. Patients with adenocarcinoma who underwent curative surgery showed improvement of survival by postoperative chemotherapy. No increase in survival time was noticed in the irradiated group with N2.
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PMID:[Adjuvant therapy in resectable non-small cell lung cancer]. 243 89

A checklist used by the radiologist interpreting images on lung carcinoma patients for tumor staging is described. The checklist data is subsequently entered into a user friendly microcomputer program which radiologically stages lung carcinoma according to the updated TNM system, maintains an upgradable relational database and generates printed reports for tumor board meetings.
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PMID:Radiologic staging of lung carcinoma: a report generator and database system. 248 54

From 1981 to 1986, 17 patients with resected small cell lung carcinoma (SCLC) staged as I or II according to the new TNM classification were recruited for a prospective study to evaluate the effectiveness of surgery and postoperative chemotherapy (plus locoregional radiotherapy only when a nonradical resection was accomplished) in the treatment of early stages of the disease. Six patients received full protocol chemotherapy (6 courses) and 8 a mean of 79.1% of the planned courses. Three patients received non adjuvant treatment. Locoregional radiotherapy for residual disease was administered in 2 cases. One patient died for myelosuppression due to chemotherapy and 10 for recurrences of cancer, all within the 20th postoperative month. Metastases accounted 80% of overall recurrences. Six patients were alive and tumor-free at 18, 22, 39, 44, 47 and 51 months from resection. Actuarial observed 3-year survival was 32%.
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PMID:Surgical resection in the treatment of stages I-II of small cell lung carcinoma (SCLC). 254 May 77

From this and other studies, it is clear that the determination of tumor cell type is dependent on cellular and architectural patterns which are fraught with considerable interobserver and even intraobserver variations. Even though determination of cell type is semiobjective at best, previous reports have sought to determine prognosis solely on the basis of cell type or subtype while other studies have made attempts to define the prognosis of the disease based on even less precise terms. In seeking an answer to the question of which is more important for prognosis of lung cancer, cell type or TNM stage, the findings reported herein support the hypothesis that the TNM stage is the single most important factor for survival. This conclusion is substantiated by the following observations: 1. When cell type is stratified by stage, no significant differences can be determined in survival according to tumor cell type. 2. There is a minor difference (not statistically significant) in survival for tumor cell type when considering resected stage I tumors (67 of 99) in terms of adenocarcinomas which had a survival of 38 percent at 5 years versus squamous cell carcinomas which had a survival of 23 percent at 5 years. The numbers of cases in this study were not sufficiently large to comment on the possible difference between surgically resected large cell and small cell carcinomas. 3. TNM staging is a highly significant predictor in the survival of patients with lung cancer. The significance for survival by stage remains even if the data are stratified by the cell type diagnosis. These conclusions apply to the total group of 124 patients, and also to the subgroup of 99 surgically resected patients. Many reports have attempted to determine survival of carcinoma of the lung in terms of cell type without regard to its stage. Consequently, comparison of data from various institutions is difficult. We believe TNM staging of the disease not only allows reasonable comparison of data obtained from different institutions, but also, affords a useful and accurate means of assessing the extent of the disease and its prognosis.
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PMID:Tumor cell type versus staging in the prognosis of carcinoma of the lung. 282 2

Pretreatment classification of patients with small cell carcinoma of the lung into categories of "limited" and "extensive" disease is inadequate; it does not identify the few having a good prognosis for disease control. Available reports from the literature were analyzed for (1) histologically verified TNM stage; (2) adequate treatment by current standards; and (3) number and percent of patients remaining in complete remission at 30 months after the start of treatment. Long-surviving patients by histologically verified stage were as follows: Stage I, 5 of 6 patients (83%); Stage II, 3 of 4 (75%); T3 without N2 or M1, 2 of 4 (50%); and N2 with any T value but without M1, 1 of 16 (6.2%). Long survivors with most distant involvement in the supraclavicular nodes were the following: ipsilateral, 3 of 22 (13.6%); contralateral, 2 of 40 (5%). Histologically verified M1 elsewhere allowed less than 1% long survivors. Indirect evidence of M1 by abnormal bone scan allowed less than 5%. Contrary to general usage, TNM staging of patients with small cell carcinoma of the lung promises to correlate closely with the probability of long disease-free survival.
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PMID:Effect of histologically verified TNM stage on disease control in treated small cell carcinoma of the lung. 298 62


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