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

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

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

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

The staging of lung cancer involves assessment of the anatomic extent of disease based on the best available data. Such a definition of neoplastic burden facilitates the systematic analysis and meaningful communication of diagnostic, therapeutic, and prognostic information. Clinical staging involves the best estimate of extent of disease before performance of surgical resection or biopsy procedures (or both). Surgical-pathologic staging is based on the histopathologic analysis of resected specimens, including determining the extent of local and regional disease. During the past 50 years, two major classification schemes for staging of lung cancer have evolved--one for non-small-cell lung cancers (the TNM system, indicating the status of primary tumor [T], regional lymph node [N], and metastatic [M] involvement) and the other for small-cell carcinoma of the lung (based on limited versus extensive disease). In this report, we review the evolution of the current staging systems used for primary lung cancer and their prognostic implications.
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PMID:Staging systems of lung cancer. 838 91

CEA, SCC and CYFRA 21-1 were measured in samples of serum coming from 105 'Non small cell lung cancer' (NSCLC) patients. The present study has been carried out to compare these markers, to analyse their prognostic significance and to determine the best combination of tumor markers. The median value and interquartile range were: CYFRA 21-1: 2,3 ng/ml, CEA: 3,7 ng/ml, SCC: 1,2 ng/ml. CEA demonstrated higher values in adenocarcinomas (P = 0.04). SCC and CYFRA 21-1 were comparable in the different histologic groups. CYFRA 21-1 and CEA values were dependant on tumor stage. Advanced tumors (T3 and T4) demonstrated higher serum CYFRA 21-1 level (P = 0.0006). CYFRA 21-1 was higher than 3,3 ng/ml in 36% of patients. CEA was higher than 5 ng/ml in 38% of patients and SCC was higher than 2 ng/ml in 27% of patients. Patients with a high CEA and CYFRA21-1 serum level had a shorter survival than those with a normal serum level. In a Cox regression analysis four variables (TNM stage, age, CYFRA 21-1 and CEA level) were found to be significant in the prediction of survival; CYFRA 21-1 level had the lowest P value (P = 0.0002). The current study suggests the use of a combination of CEA and CYFRA 21-1 in the clinical care of NSCLC.
Lung Cancer 1995 Oct
PMID:CEA, CYFRA21-1 and SCC in non-small cell lung cancer. 858 97

The authors studied the influence on survival of 21 clinical, anatomical, haematological and biochemical factors evaluated, at diagnosis, of 411 patients (pts) with advanced Non Small Cell Lung Cancer (NSCLC) followed in our department between 1984 and 1990. Most of the patients were male (347--84.4%) and only 64 (15.6%) were females. Median age was 62 years, but was slightly higher in females. Only 34 patients were aged under 45 years. Squamous cell carcinoma (215 pts--52%) and adenocarcinoma (152 pts--37%) were the most frequent histologic types. Performance status was poor--only 103 (25%) continued active; 120 (29%) spent at least half of the time in bed; 188 (46%) were severely limited. After staging, 179 (44%) presented locally advanced disease (stage IIIB) and 232 (56%) metastatic dissemination (stage IV). Therapy was defined by the oncologic group according to individual characteristics and based on clinical grounds. Anti-neoplastic therapy was performed in 225 (55%), chemotherapy alone in 121 (30%), radiation therapy alone in 67 (16%), and sequential combined treatment (chemotherapy and thoracic radiation) in 37 (9%). Until 1987, the main chemotherapy regimen was MACC (Metrotrexate + Adriamycine + Cyclophosphamide + Lomustin), afterwards VP(M) (Cisplatin + Vimblastin + Mitomycine). Radiation therapy was performed using Co60, 2 Gy/day, 5 days a week, for 4 weeks (approximately 45 Gy total). The response rate was poor--four complete responses (2%), 42 (19%) partial responses. The overall median survival was 4.3 months and only 5% of patients were alive after 18 months of follow up. Prognostic importance of each characteristic studied was initially done by unifactorial analysis, followed by multifactorial analysis according to two methods: Cox proportional hazards model and recursive partitioning amalgamation--RECPAM. Regardless of the method used, the main determinants of survival were found to be performance status (Zubrod), weight loss and serum albumin. Other factors such as the staging (presence or absence of metastasis), lymphocytes, lactic dehydrogenase, and hoarseness were also significant. It is noteworthy that age and histological type were irrelevant; sex and hoarseness only proved important when integrated within a multifactorial model. The overall prognostic evaluation and therapeutic decision of advanced NSCLC patients could be improved by combining the prognostic value of TNM with that of performance status, weight loss and serum albumin. These prognostic guidelines must be taken into account when designing new clinical trials.
Lung Cancer 1995 Dec
PMID:Survival predictors in advanced non-small cell lung cancer. 871 65

Revisions in stage grouping of the TNM subsets (T=primary tumor, N=regional lymph nodes, M=distant metastasis) in the International System for Staging Lung Cancer have been adopted by the American Joint Committee on Cancer and the Union Internationale Contre le Cancer. These revisions were made to provide greater specificity for identifying patient groups with similar prognoses and treatment options with the least disruption of the present classification: T1N0M0, stage IA; T2N0M0, stage IB; T1N1M0, stage IIA; T2N1M0 and T3N0M0, stage IIB; and T3N1M0, T1N2M0, T2N2M0, T3N2M0, stage IIIA. The TNM subsets in stage IIIB-T4 any N M0, any T N3M0, and in stage IV-any T any N M1, remain the same. Analysis of a collected database representing all clinical, surgical-pathologic, and follow-up information for 5,319 patients treated for primary lung cancer confirmed the validity of the TNM and stage grouping classification schema.
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PMID:Revisions in the International System for Staging Lung Cancer. 1178 Jan 80

This analysis of 32 pairs of human squamous cell lung carcinomas and normal matched control DNA demonstrates that loss of heterozygosity (LOH) is infrequent at the nm23-H1 locus, affecting only 2 of the 18 informative cases. Both LOH cases were in the tumor stage IIIA. One tumor was of poor and the other of moderate histological grade. These and an additional 34 tumor samples were also analyzed immunohistochemically for the presence of nm23-H1 protein. Of the 66 cases tested for the presence of nm23-H1 protein 54 were negative. Eight samples exhibited up to 35% positive cells (with weak immunostaining intensity) and four between 35% and 70% (moderate immunostaining intensity); no sample showed more than 70% positive cells. Noncancerous lung parts contained no nm23-H1 protein. nm23-H1 expression was independent of TNM stage, grade, tumor size, and patient's survival. Two samples with LOH were negative for nm23-H1 protein. We therefore conclude that neither loss of heterozygosity of the nm23-H1 gene nor the intensity of specific protein expression are related to squamous cell lung carcinoma development and progression.
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PMID:Squamous cell lung carcinomas: the role of nm23-H1 gene. 929 29

CYFRA 21-1 (CYFRA) is a newly-developed tumor marker which is useful in evaluating non-small cell lung carcinoma, especially the squamous cell type. The purpose of this study was to assess the clinical value of CYFRA in patients with nasopharyngeal carcinoma (NPC). Serum levels of CYFRA (CIS bio-International, France) were measured in 80 patients with untreated NPC. The histologic diagnosis of all patients was confirmed by biopsy. Twenty two (27.5%) of the tumors were classified as undifferentiated carcinoma, and 58 (72.5%) as squamous cell carcinoma. All patients with malignancy were classified according to the International Union Against Cancer (UICC) TNM classification system. In addition, 77 patients without evidence of neoplasm were included as controls. The cut-off value of CYFRA, determined at the 95th percentile of the standard Gaussian variate of controls, was 2.48 ng/ml. The results show that (1) the mean values of serum CYFRA in patients with NPC were significantly higher than those in the control subjects, (2) the overall diagnostic sensitivity of CYFRA in patients with NPC is 58.75%, (3) there was no significant difference between the CYFRA concentrations in patients with squamous cell carcinoma and those in patients with undifferentiated carcinoma, and that (4) there was good correlation between CYFRA values and the tumor stage. There is a statistical difference between T1-T2 patients and T3-T4 patients, and between N0 to N1 patients and N2 to N3 patients. Our results suggest that the CYFRA test may have a potential clinical role as a valuable test in patients with NPC.
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PMID:The value of CYFRA 21-1, a new tumor marker, in nasopharyngeal carcinoma. 960 97

The ability to detect occult regional and systemic metastases in patients with operable lung carcinoma could have a significant impact on the management of the disease. Here, we review the literature, including studies from our own laboratory, regarding the clinical significance of the presence of occult metastases in patients with lung cancer. The accumulated evidence strongly suggests that the detection of occult regional and systemic metastases is an important predictor of disease progression. The use of this method should be considered in the future design of lung cancer clinical trials, at the very least. The detection of occult metastases should have an impact on lung cancer management; to reflect this, we propose a change in the TNM staging system to indicate the presence or absence of occult regional (lymph node) and systemic (bone marrow) metastases. The proposed change is TNnMm, where n and m are occult nodal and bone marrow metastases status.
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PMID:Detection of occult metastases in lung carcinomas: progress and implications for lung cancer staging. 988 45


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