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

Radiotherapy can be used in patients with lung carcinoma as a radical treatment or as a palliative, depending on the clinical stage of malignancy, the histological type involved, and the patient's general status. The Author lists tumors that are amenable to radical radiotherapy (after or without surgery, as long as they meet certain requisites of the TNM classification system: thus microcytoma and bronchial stump recurrency after lobectomy or pneumonectomy), and tumors in which radiotherapy, while admittedly of mere symptomatic value, can yield satisfactory short-term results such as reduction of the tumor mass, resolution of atelectasis, or alleviation of a mediastinal syndrome. The paper concludes with a brief description of contraindications to the radiotherapy of pulmonary malignancy, side effects observed in the course of irradiation, and post-irradiation damages, the latter with special regard to sclerosis.
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PMID:[Radical and palliative radiotherapy of tumors of the lung]. 616

Thirty-four patients with an aortic window lesion were carefully staged with gallium scans and mediastinoscopy according to the TNM classification system for carcinoma of the lung. All were in Stage III. Twenty-five patients had non-oat cell carcinomas (15 squamous cell, eight adeno-, two large cell) and nine had oat cell carcinomas. Quantitative ventilation-perfusion lung scans were particularly helpful in verifying the subaortic location of the tumor by showing a less than 20% interference with pulmonary blood flow or ventilation secondary to left mainstem bronchus or pulmonary artery invasion. Decision for resectability in 13 Stage III M0 patients was based on the length of the uninvolved proximal left main pulmonary artery seen on pulmonary arteriogram. Eight patients (seven non-oat cell and one oat cell) had resection after radiation and prior to chemotherapy (after two cycles of chemotherapy and prior to radiation therapy for the oat cell) with a resultant survival rate better than those of M0 and M1 non-oat cell or oat cell patients without resection. The survival rates of nine non-oat cell M0 patients, nine non-oat cell M1 patients, and eight oat cell patients, all without resection, were not statistically different. This similarity in survival rates is explained by the observation that 38% of the non-oat cell M1, 71% of the non-oat cell M0, and 63% of the oat cell patients died from complications of their primary tumor. Patients with aortic window lesions, irrespective of their histology, have an extremely poor prognosis due to the high incidence of lethal complications of their primary tumor. Complete resection when feasible, as judged by pulmonary arteriography, provides the best control of the primary tumor and, as a consequence, gives longer survival.
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PMID:Bronchogenic carcinoma located in the aortic window. The importance of the primary lesion as a determinant of survival. 627 31

In an attempt to define the role of initial surgical resection in patients with undifferentiated small cell carcinoma of the lung, we reviewed the experience of the Veterans Administration Surgical Oncology Group (VASOG). One hundred forty-eight patients with small cell carcinoma of the lung had undergone a potentially "curative" resection. This represented 4.7% of "curative" resections carried out in four major prospective adjuvant chemotherapy trials. In the early trials (101 patients), 16 patients (15.8%) died within the first 30 postoperative days. These patients have been excluded from the analysis of long-term survival, since in the more recent trials postoperative deaths were excluded prior to randomization. In the 132 patients remaining, the 5 year survival rate by the life-table method was 23.0%. The tumor of each was classified pathologically by the TNM system. Five-year survival rates for each category were as follows: T1 N0 M0 59.9%, T1 N1 M0 31.3%, T2 N0 M0 27.9%, T2 N1 M0 9.0%, and any T3 or N2 3.6%. The effect of postoperative adjuvant chemotherapy was evaluated in each of the trials. No beneficial effect of the adjuvant therapy was noted with a one or two course regimen of either nitrogen mustard or cyclophosphamide, but possible benefit, although not significant, was noted in a prolonged intermittent chemotherapy trial of cyclophosphamide either alone or alternating with methotrexate. In the most recent trial of prolonged intermittent courses of 1-(2-chlorethyl)-3-cyclohexyl-l-nitrosourea (CCNU) and hydroxyurea, a 5 year survival rate of 80.8% was noted in those receiving adjuvant chemotherapy as compared to a 38.1% in the control group. We conclude that resection is definitely indicated in patients with T1 N0 M0 lesions and probably indicated in those with T1 N1 M0 or T2 N0 M0 lesions. Primary surgical resection is contraindicated in patients with any other TNM category.
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PMID:Surgical resection in the management of small cell carcinoma of the lung. 628 13

In 1978, after having conducted clinical field trials, the TNM Committee of Union Internationale Contre le Cancer (UICC) decided on an uniform system for the classification of lung cancer. The Japan Joint Committee of Lung Cancer (JCC) has continued to conduct field studies recommended by UICC, and since then has completed its third series carried out at 149 participating institutions. In this third series, the case records of 4,931 lung cancer patients were submitted for analysis. A clinical staging system of these findings was then set up, arranged in the TNM classification. As a result of this work, some improvements were made in the staging system. And JCC will now propose these changes, given as follows, to UICC for consideration: Occult Cancer: TX N0 M0 Stage I: T1 N0 M0, T2 N0 M0 Stage II: T0 N1 M0, T1 N1 M0, T2 N1 M0 Stage III: T3 N0 M0, T3 N1 M0, Any T N2 M0 Stage IV: Any T, Any N M1 The factors influencing the prognosis of patients with lung cancer (Yoshimura et al., 1982 (b)) (which include age, sex, histological type, modality of treatment and type of clinical staging used) were then re-evaluated. The results of this evaluation suggest an improved 5-year survival rate when using multi-modality treatment.
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PMID:A clinical statistical study of lung cancer patients in Japan with special reference to the staging system of TNM classification: a report from the Japan Joint Committee of Lung Cancer associated with the TNM System of Clinical Classification (UICC). 638 14

Thirty-five patients with Stage I carcinoma of the lung were tested postoperatively to assess lymphoproliferative responses. Depressed lymphocyte proliferation (LP) responses to alloantaigen in the mixed leukocyte culture (MLC) as measured by thee relative proliferation index (RPI) were associated with a significantly shorter disease-free interval. In this group of patients, the immunologic responses predicted subsequent clinical course better than the TNM classification or the histological type of the tumor, and therefore this procedure appears promising for improved staging of patients with early stages of lung cancer (stage I lung cancer and T1N0M0). The depressed response to alloantaigen was a more sensitive discriminator of disease recurrence than PHA alone or even conbined with PHA.
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PMID:Association of depressed postoperative lymphoproliferative responses to alloantigens with poor prognosis in patients with stage I lung cancer. 644 14

Eight hundred sixty-five patients with a microscopically curative resection for carcinoma of the lung were accepted for study, none of whom were excluded from analysis. Adjuvant therapy was randomly assigned about the tenth to 14th postoperative day; 432 patients (treated) were to receive CCNU and hydroxyurea for one year, while 433 patients (controls) were to receive no adjuvant therapy. Toxic reactions to therapy were reported, but only 1% were severe enough to require stopping therapy. No evidence of improved survival or delayed recurrence of disease was seen in treated patients as a whole or when examined by cell type and by postsurgical TNM category. On the contrary, survival beyond the second year of follow-up may have been impaired by the drugs when administered to patients without evidence of tumor spread to the lymph nodes.
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PMID:Prolonged intermittent adjuvant chemotherapy with CCNU and hydroxyurea after resection of carcinoma of the lung. 674 80

The 5-year-survival of 128 primary lung cancer patients was studied between 1970 and 1976. In all patients mediastinoscopy was carried out without any mortality or morbidity. Asymptomatic stage I (TNM classification) patients having a squamous cell carcinoma had the best 5 year survival: 46.3% as against 9.5% and 0% of the stage II and III patients. The resectability rate was 58.6% with a perioperative mortality of 7.5%. This suggests the importance of further evaluation of mass screening for lung carcinoma despite the statistical shortcomings of a retrospective study.
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PMID:Experience with mass screening for lung carcinoma. 684 66

Ninety-nine patients with Stage I or II lung carcinoma that was other than the small cell type and who survived for more than 30 days after a "curative" resection were followed for five years or until death if it occurred prior to the five-year anniversary. Recurrent disease developed in 44 patients. Clinical data and data from postmortem examination were reviewed in these 44 patients in an attempt to classify each recurrence as either initially local or distinct metastatic disease. The site of the first documented recurrence was local in 18 patients and distance metastases in 26. When the patients with recurrence were separated into TNM categories, it was apparent that in those patients without lymph nodes metastases demonstrated in the resected specimen (N0), the initial recurrence tended to be a distant metastases, whereas in those with such involvement (N1), the initial occurrence was more often local. In light of these data, selection of appropriate initial adjuvant therapeutic modalities may be different for each type of patient.
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PMID:Site of recurrence in patients with stages I and II carcinoma of the lung resected for cure. 724 57

The observation that the proteins encoded by ras genes play a central role in the signalling pathways used by cells to respond to growth factors and the fact that mutated ras proteins are constantly promoting cell division have led to a PCR-based hunt for additional clinical information. In the present study, K-ras analysis draws the following conclusions: (1) K-ras point mutation frequency was higher in the surgery group (10 of 24 patients) than in the chemotherapy-surgery group (3 of 20 patients). (2) Mutated K-ras was predominantly observed at codon 12 but five mutations appeared at codon 61. (3) Mutations were identified in the squamous cell carcinoma histological NSCLC subtype except in four cases corresponding to adenocarcinoma. (4) A multifarious pattern of substitutions, especially at codon 12, were noted with aspartic K 12 substitutions more prone to develop bone metastases. (5) Although a genotypic K-ras classification of NSCLC may not yet be formulated, our accumulated data (unpublished) suggest a trend toward it. (6) Patients with mutated K-ras tumors in the surgery group had no different survival than those with normal K-ras. However our pooled data as well as other authors' results assert that mutated K-ras constitute an additional prognostic datum that deserves to be included together with TNM classification. In the design of new preoperative (neoadjuvant) chemotherapy trials, stratification of tumors by K-ras status deserves to be further investigated in order to correlate with response, relapse and survival. Mutated K-ras genotype merits further research. Finally, the paradigm of uneven histological distribution and mutated K-ras spectra among researchers should serve as a stimulus to search for further contributions in this field.
Lung Cancer 1995 Apr
PMID:Mutated K-ras gene analysis in a randomized trial of preoperative chemotherapy plus surgery versus surgery in stage IIIA non-small cell lung cancer. 755 35

The article deals with the different aspects of classification in oncopulmonology. The authors introduce their correction and suggest to discuss in the form of polemics the clinico-anatomical systematization of malignant pulmonary tumors and the gradation of carcinoids, sarcomas, and small-cell carcinoma of the lung according to stages and the TNM system, and to systematize the operative interventions.
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PMID:[Classification and terminology of malignant lung neoplasms (polemic aspects]. 774 28


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