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

A national survey of the patterns of care for carcinoma of the lung sponsored by the Commission on Cancer of the American College of Surgeons has documented continuing changes in epidemiology, treatment, and outcome. The project consisted of a long-term study of 15,219 patients whose diagnosis was made in 1981 and a short-term study of 19,074 patients whose diagnosis was made in 1986. The male/female incidence ratios have continued to decrease and the decrease has moved into the older age groups. Although the percentage of adenocarcinoma is increasing at the expense of squamous carcinoma, the latter is still the most prevalent histologic type. The accuracy of percutaneous needle biopsy and transbronchial biopsy of lung nodules reported from this group of 941 hospitals was high and equal to that reported by single institutions. The percentage of patients having a resection did not increase from 1981 to 1986, but for smaller lesions a move was apparent toward more lung-sparing resections. Little change has occurred in the use of adjuvant radiotherapy, particularly in stage III disease, where approximately 50% of the patients received postoperative irradiation. An improvement in the overall 5-year survival when compared with Surveillance, Epidemiology, and End Results data was noted. Whether this is a true improvement in survival or is the result of selection because of an unrecognized change in the pattern of care for patients with a carcinoma of the lung is unknown.
J Thorac Cardiovasc Surg 1990 Dec
PMID:National survey of the pattern of care for carcinoma of the lung. 224 6

Two cases of primary osteosarcoma of the lung are presented. In one case, the radiologic, clinical, and cytologic findings led to a preoperative diagnosis of undifferentiated carcinoma of the lung. In the second case, a lung nodule was discovered during postchemotherapy follow-up in a patient with lymphoma. Fine needle aspiration in the second case showed lymphoma, and further chemotherapy was instituted; however, persistent growth of the nodule prompted a resection. Microscopic examination of the resected tumors in both cases revealed histologic features of high-grade osteosarcoma. Flow cytometric analyses of the primary tumors showed abnormal hyperdiploid deoxyribonucleic acid populations in accordance with those seen in high-grade malignant neoplasms. Immunohistochemical studies supported a mesenchymal origin for these tumors. These tumors shared clinical features with other reported cases of primary osteosarcoma of the lung such as large size at diagnosis, occurrence in older individuals, and aggressive behavior.
J Thorac Cardiovasc Surg 1990 Dec
PMID:Primary osteosarcoma of the lung. Report of two cases and review of the literature. 224 8

Fifty patients with lesions of the trachea or bronchi have been treated with the neodymium-yttrium-aluminum-garnet laser. Forty-three patients had advanced carcinoma of the lung with pulmonary infection or abscess distal to an obstructing bronchial lesion or else had hemoptysis. Benign lesions were seen in seven patients. A total of 72 laser treatments were administered for obstruction and/or hemoptysis. There was no significant morbidity and only one hospital death occurred, which was unrelated to the laser therapy. Among the 43 patients with malignant disease, obstructive complications and hemoptysis were controlled in 39. All those with benign lesions have been significantly improved. Presently 22 patients with malignant disease remain alive and are symptomatically improved. The longest survival after successful laser treatment has been 73 weeks, and 34 survived longer than eight weeks. This laser is a very effective means of managing patients with benign lesions and offers significant palliation for patients with hemoptysis and advanced obstructing carcinoma of the trachea or main-stem bronchus.
J Thorac Cardiovasc Surg 1986 Jan
PMID:Management of benign and malignant lesions of the trachea and bronchi with the neodymium-yttrium-aluminum-garnet laser. 241 64

The value of computed tomography (CT) in predicting direct mediastinal infiltration of stage T4N0-1 lung carcinoma was evaluated prospectively in 11 patients with surgical and histological proof. Furthermore, its role in twelve non-operated patients was assessed retrospectively. The radiologic signs detected independently by two radiologists correlated in 90%. Mediastinal infiltration was verified in 7 of 11 patients (63%). Only in 3 out of the 12 patients treated non-surgically was CT the only criterium for inoperability. In all other patients additional findings, such as scintigraphy, radiologic or bioptic proof of distant metastases, supported inoperability. The limited specificity of CT (63%) demands aggressive staging procedures before any patient is excluded from surgery, the only potentially curative treatment.
Thorac Cardiovasc Surg 1987 Dec
PMID:Mediastinal infiltration of lung carcinoma (T4N0-1): the positive predictive value of computed tomography. 244 5

A patient with carcinoma of the lung underwent a left lower lobectomy. For technical difficulties the pulmonary vein was not ligated prior to extensive manipulations of the involved lobe. Following the pulmonary surgery the patient sustained a massive aortic occlusion by a tumor embolus, that was removed by bilateral femoral embolectomies. Three additional documented episodes of peripheral arterial emboli subsequently took place, two of which were tumoral. One tumor embolus into the carotid artery territory eventually caused metastatic spread in the brain. All peripheral emboli were successfully treated by embolectomy. This unique display of multiple tumor emboli, following lung resection for carcinoma, reemphasises the significance of early interruption of the pulmonary vein, in an attempt to reduce the incidence of tumor emboli.
J Cardiovasc Surg (Torino)
PMID:Multiple tumor emboli after lung resection. 254 22

This study is based on a retrospective analysis of 163 patients with stage III non-small cell lung cancer randomized to one of three Lung Cancer Study Group postoperative resection-adjuvant treatment protocols. All patients underwent rigorous surgical/pathologic staging including required removal and examination of bronchopulmonary, hilar, subcarinal, and paratracheal lymph nodes. Patients were grouped as follows: group I, only subcarinal nodes diseased (N = 40); group II, only high paratracheal nodes diseases (N = 32); group III, only mid-mediastinal nodes diseased (N = 48); and group IV, subcarinal nodes plus nodes from any other site diseased (N = 43). Patient deaths and tumor recurrences were recorded. The death rate was highest for patients with metastases to subcarinal nodes plus nodes in another site (group IV). Pairwise comparisons of the survival rates of patients in each group disclosed a significant difference between group III and IV (p less than 0.02). In view of this observation, the Lung Cancer Study Group recommends that all patients have rigorous mediastinal lymph node staging done at the time of pulmonary resection to establish prognosis and criteria for study of adjuvant treatment interventions.
J Thorac Cardiovasc Surg 1988 May
PMID:Should subcarinal lymph nodes be routinely examined in patients with non-small cell lung cancer? The Lung Cancer Study Group. 283 10

From 1974 through 1983, 125 patients underwent operation at Memorial Sloan-Kettering Cancer Center for non-small cell carcinoma of the lung invading the chest wall. (Excluded are those with superior sulcus tumors or distant metastases at presentation.) Eighty patients were male and 45 were female. Ages ranged from 33 to 88 years (median 60 years). Histologically, the tumors were epidermoid carcinoma in 46%, adenocarcinoma in 46%, and large cell carcinoma in 8%. All patients underwent thoracotomy (pneumonectomy 19, bilobectomy seven, lobectomy 75, wedge resection 10, and no pulmonary resection 14), with an operative mortality of 4%. At thoracotomy, mediastinal lymph node dissection was routinely performed, and the postsurgical stage was T3 N0 M0 in 53%, T3 N1 M0 in 13%, and T3 N2 M0 in 34%. Extrapleural resection was performed in 66 patients. En bloc resection of chest wall and lung was performed in 45 patients with an operative mortality of 2%. Complete resection of tumor was possible in 77 patients (62%). Extension of tumor beyond the parietal pleura significantly decreased resectability. The median survival of 48 patients having incomplete resection was 9 months, despite perioperative interstitial and external radiation. The actuarial 5 year survival rate (Kaplan-Meier) of 77 patients having complete resection was 40%. This percentage was not significantly influenced by the patient's age or sex or by tumor size or histologic type. Lymphatic metastases significantly reduced survival, with a 5 year actuarial survival rate of 56% for patients with T3 N0 M0 disease and 21% for those with T3 N1 M0 or T3 N2 M0 disease (p = 0.005). The extent of tumor invasion of the chest wall appeared to influence survival, but in the absence of lymphatic metastases the difference at 5 years was not significant. Complete resection offers a significant chance for long-term survival in lung cancer directly extending into parietal pleura and chest wall. Extrapleural resection or en bloc chest wall resection can be performed with a low operative mortality and an expected 5 year survival in excess of 50% in the absence of lymphatic metastases.
J Thorac Cardiovasc Surg 1985 Jun
PMID:Chest wall invasion in carcinoma of the lung. Therapeutic and prognostic implications. 298 19

Fifty-one cases of small cell carcinoma of the lung were studied by electron microscopy in order to determine if ultrastructural subsets could be found and if these subsets predicted clinical behavior. All of these cases were considered bona fide small cell carcinoma of the lung by light microscopy. Tumors with ultrastructural features of epithelial differentiation were defined by the presence of well-formed, classic desmosomes joining adjacent cells and by additional features of squamous or glandular differentiation. Thirty-one tumors (60%) were considered "typical oat cell" by electron microscopy and 20 (40%) showed features of epithelial differentiation. Fifteen (75%) tumors with epithelial features were considered operable and nine (45%) were resected with curative intent. In contrast, 26 (84%) tumors considered typical oat cell by electron microscopy presented with extensive metastatic disease. The cancer-free 5-year actuarial survival rate of patients whose tumors showed features of epithelial differentiation was 25%. The actuarial survival rate of nine patients who underwent resection of tumors with epithelial features was 38% at 5 years. Only one patient whose tumor was considered typical of oat cell carcinoma by electron microscopy survived 5 years. Our current recommendation is to remove all clinically resectable pulmonary neoplasms with the expectation that these localized small cell tumors are likely to show epithelial features by electron microscopic analysis.
J Thorac Cardiovasc Surg 1985 Sep
PMID:Electron microscopy in selection of patients with small cell carcinoma of the lung for medical versus surgical therapy. 299 56

The efficacy of computed tomography and surgical mediastinal exploration in determining tumor resectability were retrospectively evaluated in 92 consecutive patients with non-small cell lung carcinoma. Status of mediastinal nodes was ultimately determined by surgical mediastinal exploration or thoracotomy. Patients were divided into three groups on the basis of chest roentgenography: Group I comprised 30 patients with peripheral T1 or T2 lesions with normal hilar and mediastinal shadows. Only one patient was found to have an involved node. Chest roentgenography had an accuracy rate of 96% and computed tomography, 93%. Thoracotomy is recommended without either computed tomography or surgical mediastinal exploration in this group. Group II comprised 47 patients with T1 or T2 lesions with an abnormal hilus, an abnormal mediastinal shadow, or either the hilus or mediastinum obscured by overlying parenchymal disease. Computed tomography revealed mediastinal nodes 1 cm or greater in size (abnormal node group) in 21 patients (45%) and smaller than 1 cm (normal node group) in 26 patients (55%). Surgical mediastinal exploration was performed in the abnormal node group and involved nodes were found in 17 of 21 patients (81%). In the normal node group, thoracotomy only was performed and no involved nodes were found. Computed tomography is recommended in all patients in Group II. Patients in the normal node group may be subjected to thoracotomy only and those in the abnormal node group should undergo surgical mediastinal exploration as the next diagnostic step before thoracotomy. Group III comprised 15 patients with grossly abnormal mediastinal shadows. Findings from computed tomography were abnormal in all 10 patients in whom it was done. Surgical mediastinal exploration was done in all 15 and yielded abnormal results in 14. It is recommended in this group that computed tomography is unnecessary and surgical mediastinal exploration should be the only diagnostic procedure. Thus, in potentially resectable non-small cell lung carcinoma, the use of computed tomography and surgical mediastinal exploration should be selective and should be determined by appropriate initial interpretation of the chest roentgenogram.
J Thorac Cardiovasc Surg 1987 Mar
PMID:Selective preoperative evaluation for possible N2 disease in carcinoma of the lung. 302 15

The disease-free, postresection, 2 year survival rate of patients with T1 N0 non-small cell lung cancer surgically/pathologically staged by the Lung Cancer Study Group is about 82%. This study of the rate of cancer recurrence and histopathologic types is based on 572 eligible patients who submitted to complete resection of T1 N0 lung cancer and rigorous, systematic mediastinal lymph node sampling. The initial pathologic interpretation and staging were reviewed by pathologists of the Lung Cancer Study Group Pathology Reference Center to assure uniformity. Review was completed for 82% of patients included in this report. Postoperative cancer recurrence was observed in 107 of the 572 eligible patients. Histopathologic classification was squamous carcinoma (226 patients) or nonsquamous, non-small cell carcinoma (346 patients). Cancer recurrences are more frequent and recurrence rates are higher in the patients with nonsquamous cancer. There is a greater probability of first recurrence in the brain in the nonsquamous carcinoma group. This study substantiates the observation that lung cancer recurrences are histopathologically dependent in the T1 N0 subgroup of Stage I non-small cell lung cancer, with higher rates occurring among patients with nonsquamous carcinoma.
J Thorac Cardiovasc Surg 1987 Sep
PMID:Postoperative T1 N0 non-small cell lung cancer. Squamous versus nonsquamous recurrences. The Lung Cancer Study Group. 304 Nov 24


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