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

Three thousand patients with primary carcinoma of the lung entered in the Armed Forces Central Medical Registry are reported. Forty-one per cent had squamous cell, 28.5 per cent adenocarcinoma, 25.2 per cent small cell/undifferentiated, and 4.9 per cent miscellaneous cell types. When first seen, 71.1 per cent had no organ metastases and 50.6 per cent no lymph node metastases. Over-all survival rate was 18.2 per cent at 5 years and 14.5 per cent at 10 years. Survival following definitive resection, palliative resection, definitive radiation, palliative radiation, and chemotherapy was determined both in the presence of mediastinal nodal involvement and in the absence of mediatinal nodal involvement. Where resection for cure could be carried out, 5 year survival rates of 48.8 per cent were possible. The factors affecting this improved outlook in our military population are discussed and, in general, appear to be related to a ready accessibility of medical care and the necessity, because of global commitments, of establishing an early diagnosis. Cell type ecerted some influence on survival, but the major determinant appeared to be the absence of involved nodes at the time of the operation.
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PMID:Results of treatment of primary carcinoma of the lung. Analysis of 3,000 cases. 18 64

Primary lung carcinoma adjacent to the trachea and paratracheal nodal metastasis without evidence of the primary tumor or airway invasion require invasive surgical procedures to obtain adequate diagnostic tissues. Adequate diagnostic tissue was obtained in 3 of 5 patients with paratracheal masses by means of a bronchoscopic needle aspiration technique. There were no complications.
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PMID:Bronchoscopic needle aspiration biopsy of paratracheal tumors. 67 57

739 regional lymph nodes from 94 patients with stage I non-small cell lung carcinoma (NSCLC) were studied by immunohistochemistry. These lymph nodes, contained no metastasis as assessed by conventional histopathology, were recut. A series consecutive sections from the original blocks were immunostained with polyclonal and monoclonal antibodies to keratins, carcinoembryonic antigen (CEA) and human milk fat globulin membrane antigen (HMFG-2). Single tumor cells or small clusters of tumor cells, not visible on routine examination, were readily detected. The actual number of lymph nodes that contained occult tumor cells was 123 (16.6%) from 53 patients (56.4%). The majority of 102 immunostaining positive nodes were distributed in the hilar (29%) and peribronchial (25%) regions. Our data indicate that: 1. a series consecutive sections and immunohistochemistry may greatly increase the diagnostic yield of occult micrometastases in lymph nodes. 2. the high incidence of occult metastases in NSCLC may be of importance in relation to their rapid dissemination and high death rate. 3. the high frequency of occult nodal metastases in NSCLC raises questions in regard to our presently used criteria for staging, prognosis and treatment of ostensibly stage I disease. 4. perhaps resections of hilar and peribronchial lymph nodes will have an important clinical significance in prevention of wide dissemination of tumor cells.
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PMID:[An immunohistochemical study of occult micrometastases in regional lymph nodes of patients with stage I non-small cell lung carcinoma]. 128 90

The usefulness of squamous cell carcinoma (SCC) antigen as a tumor marker was investigated in 72 patients with histologically verified non-small cell lung carcinoma (NSCLC). Increased level of SCC-Ag was observed in 41%, mostly in patients with squamous cell carcinoma (69%). Positive serum SCC-Ag was correlated with lymph node metastases and with the stage of disease. The positive rate of SCC-Ag observed in patients without and with nodal metastases was 52.9% and 84.2%, respectively. Positive SCC-Ag level was observed in 50% of Stage I, 71.4% of Stage II and 78.9% of Stage III patients with squamous cell carcinoma of the lung. The study proved that preoperative SCC-Ag determination in patients with squamous cell carcinoma of the lung and the course of levels of this marker during postoperative follow-up was of importance. A high preoperative and postoperative SCC-Ag value suggested a worse prognosis.
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PMID:Evaluation of squamous cell carcinoma antigen (SCC-Ag) in the diagnosis and follow-up of patients with non-small cell lung carcinoma. 133 26

A study was conducted to determine the bronchoscopic and chest roentgenographic findings associated with a positive TBNA. One hundred fifty-seven of 465 patients who were diagnosed for the first time as having carcinoma of the lung had a positive aspirate. Bronchoscopic findings associated with a positive TBNA of N2 nodes were carinal widening and endobronchial disease, especially of the right upper lobe. Mediastinal adenopathy noted on chest roentgenograms and subcarinal nodes on CAT scans were associated with a positive aspirate as well. In 34 of 465 patients, TBNA was the only means of establishing the diagnosis of pulmonary malignancy. A useful, simple and safe procedure, TBNA can be used to stage the mediastinum in patients with lung cancer and is most likely to be positive with endobronchial and nodal disease. It can also facilitate therapeutic decision-making in patients whose surgical candidacy is marginal.
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PMID:Bronchoscopic and roentgenographic correlates of a positive transbronchial needle aspiration in the staging of lung cancer. 195 1

Seventy-four patients from January 1975 through December 1982, with clinical Stage III Mo non-small cell carcinoma of the lung were treated at our Medical Center with a course of pre-operative radiation therapy to be followed by surgical resection. Radiation therapy consisted of delivering a total dose of 40 Gy with 200 cGy per fraction over a period of 4 weeks to the primary tumor in the lung and the regional lymph nodal areas. Surgical resection was attempted 4 weeks later. Fifty-eight percent of the patients had squamous cell carcinoma whereas the remaining had other histologies like adenocarcinoma, large cell carcinoma, or a combination thereof. All the patients except two were followed up to a minimum of 5 years or until death. Sixty-four patients (82%) had T3 tumors whereas mediastinal nodal involvement was found in 41 patients (55%). Fifteen patients (20%) did not have the operation because of tumor progression, patient's refusal or death. All but two surgically treated patients had tumor resection. Of these 19% had histologically negative specimens, 9 patients (16%) had microscopic disease only, and 37 patients had gross residual disease at the time of surgery. The actuarial 5-year survival and recurrence-free survival rates for the entire group were 20% and 24%, respectively. Patients with a pathologic response had an actuarial recurrence-free survival rate of 53% at 5 years whereas only 17% of those with gross residual disease at surgery had remained recurrence-free at 5 years. One-half of the patients with clinically uninvolved nodes were living recurrence-free at 5 years whereas only 20% of the patients with N2 disease did so. The patterns of failure according to the histology and stage of the disease will be presented.
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PMID:Preoperative radiation therapy in regionally localized stage III non-small cell lung carcinoma: long-term results and patterns of failure. 216 53

From 1953 to 1985, a total of 1289 patients with primary carcinoma of the lung underwent surgical treatment. Of these 116 (8.9%) had small-sized (less than or equal to 2 cm in diameter) peripheral type lung cancer lesions. This study had three purposes: 1) to analyse how small-sized lung cancer lesions were detected; 2) to evaluate the reliability of diagnosis of small-sized cancer lesions; and 3) to evaluate pre- and post-prognostic factors of such patients compared with patients with peripheral type lung cancer lesions 2.1-3 cm in diameter. Of the 115 patients with small-sized lung cancer lesions were detected in the course of mass surveys. Cytopathological diagnosis in 75% of the patients resulted from transbronchial brushing cytology. The 5-year survival rate of patients who underwent resection of small-sized peripheral type lung cancer lesions was 70% (2.1-3 cm; 52%). Various factors such as histologic type, nodal involvement, pleural involvement, pathological stage, and success of the operation were shown to significantly affect survival. A comparison of two groups, i.e., those with lesions smaller than 2 cm in diameter and those with lesions 2.1-3 cm in diameter, showed the rate of lymph node metastasis to be significantly different. Of the patients with peripheral lung cancer lesions smaller than 2 cm who underwent surgery, 21% had peribronchial, hilar, or mediastinal lymph node metastasis. On the other hand, lymph node metastasis was seen in 43% of cases with peripheral lung cancer lesions 2.1-3 cm in diameter who underwent surgery.
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PMID:[Analysis of patients with resected small-size (less than or equal to 2 cm in diameter) peripheral type lung cancer lesions]. 223 79

The records of 103 patients undergoing thoracotomy for carcinoma of the lung between 1985 and 1988 were reviewed. All patients underwent a uniform staging protocol in the construction of a clinical evaluative stage (cTNM). Using information obtained at thoracotomy supplemented by pathological examination a more accurate stage was constructed (pTNM). We have evaluated the accuracy of cTNM staging using the pTNM staging constructed following thoracotomy. In 46.6% patients cTN and pTN concurred. When comparing T subsets alone 81.6% patients remained unchanged. On comparing nodal staging alone 55.3% patients remained unchanged. Pre-operative evaluation underestimated far more commonly than it overestimated. Mediastinal node involvement was not overestimated since any suggestion of such involvement was confirmed by mediastinal exploration. Construction of a cTNM stage remains a crude evaluation, but we remain convinced that the major aspect of pre-operative evaluation is the exclusion of gross mediastinal gland involvement by mediastinal exploration.
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PMID:The accuracy of clinical evaluative intrathoracic staging in lung cancer as assessed by postsurgical pathologic staging. 233 66

From October 1979 to December 1982, 126 patients with locally advanced unresectable or inoperable Stage II (7 patients), Stage IIIA (81 patients), and Stage IIIB (38 patients) non-small cell carcinoma of the lung were treated in a prospective randomized trial using five cycles of CAP (Cytoxan, Adriamycin, and cisplatin), T-CAP (triazinate plus CAP), or V-CAP (VP-16 plus CAP) chemotherapy with thoracic radiation therapy (TRT). TRT consisted of 40 Gy in 10 fractions (split-course) with cycles 3 and 4 of chemotherapy. The treatment field included the primary tumor, ipsilateral hilum, mediastinum, and ipsilateral supraclavicular fossa. All patients were followed until death or for a minimum of 5 years for survivors. The evaluable subgroup consisted of 102 patients who completed TRT. Median and 5-year survivals for the entire group were 14.0 months and 10%, respectively; for the evaluable subgroup, they were 14.8 months and 12%, respectively. There was a trend toward better survival with V-CAP plus TRT than with CAP plus TRT (p = 0.08). Median and 5-year survivals were 16.2 months and 18%, respectively, with V-CAP plus TRT. Of eight prognostic variables analyzed for their association with survival, only Eastern Cooperative Oncology Group performance status (0,1 versus 2) (p = 0.02) and weight loss (less than or equal to 10% versus greater than 10%) (p = 0.05) were significant. Sex, age, T stage, N stage, overall stage, and histologic type were not significantly associated with survival. Failure analysis revealed 83 patients (81%) with identifiable first failures. The median time to first failure was 9.8 months, and the median survival after first failure was 4.7 months. Failure patterns included local failure alone (19%), local and distant (20%), and distant alone (43%). Nineteen percent of patients had no documented progression. Total failure patterns were local in 39% and distant in 63%. Twenty-three patients (23%) had failure in the brain; they accounted for 31% of all distant failures. In 20 of these patients (20% of all patients), this was the only site of failure. There were eight (8%) initial nodal failures in 96 untreated contralateral supraclavicular fossae. No initial failures were seen in any of 101 untreated contralateral hila. The data suggest the following: (a) Combined treatment with V-CAP and TRT yielded excellent results (median survival, 16.2 months; 5-year survival, 18%).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Results of combination chemotherapy and thoracic radiation therapy for unresectable non-small cell carcinoma of the lung. 255 4

A retrospective review was carried out to assess the possible adverse immunosuppressive effect of exploratory thoracotomy on the survival of patients with non-small cell carcinoma of the lung with N2 nodal metastases. Between 1960 and 1982, 48 patients with non-small cell bronchogenic carcinoma underwent exploratory thoracotomy; lung resection was not done because mediastinal lymph nodes were involved. The survival of these patients was compared with that of 64 patients in whom N2 disease was established by mediastinoscopy alone and who did not undergo thoracotomy. There were no significant differences with respect to age, sex, tumour type and adjunctive radiotherapy. There were slightly more T4 tumours in the thoracotomy group (50% versus 30%). The hospital stay was longer in the thoracotomy group (2.3 +/- 1.1 versus 1.5 +/- 0.9 months [mean +/- SD]). However, follow-up studies showed that, although these patients had a more traumatic procedure, the actuarial survival curves for the two groups were virtually identical, and the 12-month survival rates were less than 20% for both groups. The median survival was 6.0 months for the thoracotomy group and 7.0 months for the mediastinoscopy group. These findings failed to demonstrate an adverse immunosuppressive effect of thoracotomy on lung cancer patients.
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PMID:Does the surgical trauma of "exploratory thoracotomy" affect survival of patients with bronchogenic carcinoma? 276 36


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