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El Ouazzani H, Menchafou I, Achachi L, El Ftouh M, El Fassy Fihry MT. [Delay in the diagnosis of primary bronchial cancer. Study carried out in the pneumology unit of Ibn Sina university hospital, Rabat (Morocco)]. REVUE DE PNEUMOLOGIE CLINIQUE 2010; 66:335-341. [PMID: 21167440 DOI: 10.1016/j.pneumo.2010.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Revised: 01/26/2010] [Accepted: 02/08/2010] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Primary bronchial cancer (PBC) is a major public health problem. The diagnosis is often late resulting in a poor prognosis. PURPOSE To determine the factors leading to a late diagnosis. PATIENTS AND METHODS All PBCs diagnosed between 01 January and 31 December were included. The factors studied were: "age, sex, smoking, place of residence, socioeconomic level, clinical signs, diagnostic means, histological types, the stages and date of treatment". The date of the first symptom (D1s), the date of care (Dpch), the date of the diagnosis (Ddg) and the date of the beginning of treatment (Dttt) were used to determine the delay before care. RESULTS One hundred and three cases of PBC were included. The medium delay before hospitalisation (D1s to Dpch) was 76 days, the delay before the diagnosis (Dpch to Ddg) was 25 days, the time before treatment (Ddg to Dttt) was 27 days, the time between hospitalisation and treatment (Dpch to Dttt) was 69 days, the overall delay (D1s to Dttt) was 160 days. The time before the diagnosis was longer in cases with a low socioeconomic level (30 days vs. 21 days, p: 0.06). The time before treatment was shorter for small cell carcinomas (SCC) (23 days vs. 31 days: p: 0.06). The time between hospitalisation and treatment was shorter for stages IIIB and IV of NSCBC (60 days vs. 67 days, p: 0.03). The overall delay was shorter for SCC (152 days vs. 168 days, p: 0.001). CONCLUSION The study confirms the problem of a delay in diagnosis. The effect of these delays on the prognosis has not been demonstrated and requires further study.
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MESH Headings
- Adenocarcinoma/diagnosis
- Adenocarcinoma/epidemiology
- Adenocarcinoma/pathology
- Adenocarcinoma/therapy
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Bronchogenic/diagnosis
- Carcinoma, Bronchogenic/epidemiology
- Carcinoma, Bronchogenic/pathology
- Carcinoma, Bronchogenic/therapy
- Carcinoma, Large Cell/diagnosis
- Carcinoma, Large Cell/epidemiology
- Carcinoma, Large Cell/pathology
- Carcinoma, Large Cell/therapy
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/epidemiology
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/therapy
- Developing Countries
- Female
- Health Services Accessibility/statistics & numerical data
- Hospitals, University
- Humans
- Lung Neoplasms/diagnosis
- Lung Neoplasms/epidemiology
- Lung Neoplasms/pathology
- Male
- Middle Aged
- Morocco
- Neoplasm Staging
- Patient Admission/statistics & numerical data
- Smoking/adverse effects
- Smoking/pathology
- Socioeconomic Factors
- Uncompensated Care/statistics & numerical data
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Xie XY, Shen J, Xu LY, Li EM, Shen ZY. Bronchogenic and alveologenic tumors in mice induced by N-nitrosopiperidine. Biochem Cell Biol 2010; 88:775-82. [PMID: 20651851 DOI: 10.1139/o10-019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to explore the histogenesis and carcinogenesis of pulmonary cancer induced by N-nitrosopiperidine (NPIP) in mice. NPIP is a form of N-nitrosamine found in tobacco smoke, which has been shown to be a genotoxic chemical as well as a mutagenic compound for inducing chromosome aberrations and severe clastogenicity. In this study, 80 BALB/C strain mice were injected with 0.2 mmol/kg NPIP intraperitoneally for 8 weeks, and experiments were conducted for a further 16 weeks. For the control group, 40 mice were injected with an equal volume of 0.9% NaCl. Pulmonary tissues and tumors in the NPIP-treated group were examined by light microscopy and transmission electron microscopy and compared with the control group at 4-week intervals. The mRNA levels of p53 (mutant), bcl-2, c-myc, ras, and subunits of telomerase - telomerase reverse transcriptase (TERT) and an RNA component, TR - were assayed by mPCR or RT-PCR. Twenty-two mice in the experimental group were found to develop pulmonary tumors, but none in the control group. All tumors found in the experimental group originated from alveolar type II epithelial cells. In addition, 6 of the 22 mice also developed tumors of bronchogenic origin. The expression of p53, bcl-2, c-myc, ras, and the subunits of telomerase were found to increase in all pulmonary tissues and tumors formed thereafter upon NPIP treatment. In summary, NPIP-induced mouse lung tumors exhibited morphological changes during carcinogenesis, which may be the consequence of overexpression of some genes associated with the development of carcinoma and changes in subunits of telomerase. This mouse model of lung tumor formation may be a useful tool to delineate the histogenesis and carcinogenesis of human pulmonary cancer.
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MESH Headings
- Adenoma/chemically induced
- Adenoma/genetics
- Adenoma/pathology
- Adenoma/ultrastructure
- Animals
- Carcinoma, Bronchogenic/chemically induced
- Carcinoma, Bronchogenic/genetics
- Carcinoma, Bronchogenic/pathology
- Carcinoma, Bronchogenic/ultrastructure
- Carcinoma, Squamous Cell/chemically induced
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/ultrastructure
- Female
- Gene Expression Regulation, Neoplastic
- Genes, bcl-2
- Genes, myc
- Genes, p53
- Genes, ras
- Lung Neoplasms/chemically induced
- Lung Neoplasms/genetics
- Lung Neoplasms/pathology
- Lung Neoplasms/ultrastructure
- Male
- Mice
- Mice, Inbred BALB C
- Nitrosamines
- Pulmonary Alveoli/drug effects
- Pulmonary Alveoli/metabolism
- Pulmonary Alveoli/pathology
- Pulmonary Alveoli/ultrastructure
- Telomerase/genetics
- Telomerase/metabolism
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Ampil FL, Baluna R. Is "routine" cranial irradiation in hemiplegic lung cancer patients with brain metastases justified? J Palliat Med 2010; 13:794-5. [PMID: 20636143 DOI: 10.1089/jpm.2010.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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29
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Böttger C, Warth A, Nawroth PP, Isermann B. [Neuroendocrine carcinoma of the lung: a diagnostic and therapeutic challenge]. ACTA ACUST UNITED AC 2010; 105:237-41. [PMID: 20455040 DOI: 10.1007/s00063-010-1049-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 53-year-old female patient presented with cough and hoarseness for 3 years. Based on a biopsy of a bronchial tumor, a small cell neuroendocrine tumor of the lung was diagnosed and chemotherapy with etoposide and cisplatin was initiated. As the tumor progressed under chemotherapy, the bronchial biopsy was reevaluated and further biopsies of liver and adrenal metastases were obtained. The diagnosis was corrected, and an atypical neuroendocrine bronchial carcinoma was diagnosed. Under octreotide therapy, the patient remained stable for 1 year, when a discrete progress of the primary tumor in the lung was observed. Treatment with the mTOR (mammalian target of rapamycin) inhibitor everolimus was then initiated. Based on this case, the diagnostic criteria, prognostic factors and therapeutic options of neuroendocrine bronchial carcinomas are discussed.
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MESH Headings
- Adrenal Gland Neoplasms/diagnosis
- Adrenal Gland Neoplasms/drug therapy
- Adrenal Gland Neoplasms/pathology
- Adrenal Gland Neoplasms/secondary
- Adrenal Glands/pathology
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/metabolism
- Bone Neoplasms/diagnosis
- Bone Neoplasms/drug therapy
- Bone Neoplasms/secondary
- Calcitonin/metabolism
- Carcinoma, Bronchogenic/diagnosis
- Carcinoma, Bronchogenic/drug therapy
- Carcinoma, Bronchogenic/pathology
- Carcinoma, Bronchogenic/secondary
- Carcinoma, Medullary/diagnosis
- Carcinoma, Medullary/drug therapy
- Carcinoma, Medullary/pathology
- Carcinoma, Neuroendocrine/diagnosis
- Carcinoma, Neuroendocrine/drug therapy
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Neuroendocrine/secondary
- Cell Division/physiology
- Female
- Humans
- Ki-67 Antigen/metabolism
- Liver/pathology
- Liver Neoplasms/diagnosis
- Liver Neoplasms/drug therapy
- Liver Neoplasms/pathology
- Liver Neoplasms/secondary
- Lung/pathology
- Lung Neoplasms/diagnosis
- Lung Neoplasms/drug therapy
- Lung Neoplasms/pathology
- Middle Aged
- Neoplasm Staging
- Neoplasms, Multiple Primary/diagnosis
- Neoplasms, Multiple Primary/drug therapy
- Neoplasms, Multiple Primary/pathology
- Octreotide/administration & dosage
- Paraneoplastic Syndromes/diagnosis
- Paraneoplastic Syndromes/drug therapy
- Paraneoplastic Syndromes/pathology
- Sirolimus/administration & dosage
- Thyroid Gland/pathology
- Thyroid Neoplasms/diagnosis
- Thyroid Neoplasms/drug therapy
- Thyroid Neoplasms/pathology
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Menzel C, Hamer OW. [Characterization and management of incidentally detected solitary pulmonary nodules]. Radiologe 2010; 50:53-60. [PMID: 19882335 DOI: 10.1007/s00117-009-1929-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
How to deal with solitary pulmonary nodules (SPN) which are incidentally detected by computed tomography (CT) is an increasingly important task in the era of modern multislice CT. This paper reviews the morphological and functional characteristics and their value for discrimination between benign and malignant SPNs. In particular, the importance of nodule size, growth rate, margin morphology, density, calcifications or fatty components within the nodules, the significance of cavitations or aerobronchograms, enhancement patterns at dynamic contrast-enhanced CT and findings on positron emission tomography (PET) are discussed. The Bayesian analysis to calculate the probability of malignancy is presented. Finally, flow charts demonstrate the national and international recommendations for nodule management.
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Blouquit-Laye S, Regnier A, Beauchet A, Zimmermann U, Devillier P, Chinet T. Expression of endothelin receptor subtypes in bronchial tumors. Oncol Rep 2010; 23:457-463. [PMID: 20043107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
The importance of endothelin-1 (ET-1) in cell growth, migration and stimulation of angiogenesis suggests that ET-1 may play a role in tumor progression. The expression of the ET-1 receptors ETA (ET(A)R) and ETB (ET(B)R) was analyzed by immunohistochemistry in fragments of human lung carcinomas. Samples were obtained from 11 patients with adenocarcinoma (ADK), 12 with squamous cell carcinoma (SCC) and 8 patients with small cell carcinoma (SCLC). Morphologically normal airway areas adjacent to the tumors served as controls. ADK and SCC samples had ET(A)R and ET(B)R levels similar to normal tissues; however, the ET(A)R/ET(B)R ratio was higher in ADK than in SCC. We also observed the presence of endothelin receptors in SCLC, although the ET(A)R levels and the ratio ET(A)R/ET(B)R were lower than in normal tissue and in other carcinomas. In conclusion, both ET(A)R and ET(B)R are present in lung carcinomas but at different levels, according to the histological type of tumor.
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32
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Bolgova LS, Iaroshchuk TM. [Histogenesis of lung cancer]. VOPROSY ONKOLOGII 2010; 56:469-476. [PMID: 20968029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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33
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Uong IZ, Uong E, Ksia TI, Kakhkhorov ZN, Razakov AP. [Clinical treatment outcome of grade III, non-small cell bronchogenic carcinoma using "whole-body" gamma-knife system]. VOPROSY ONKOLOGII 2010; 56:55-57. [PMID: 20361616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The results of treatment of 80 patients with non-small cell lung cancer using the Chinese-made "Whole-Body" gamma-knife system were analyzed. Primary focus and involved lymph nodes were exposed. Neither gap between primary focus and involved lymph node or nodes, nor organs of the mediastinum were exposed. Exposure regimens were: STD = 4 Gy (2.5 - 10 Gy) 5 times a week; TTD=48 Gy (27-52 Gy) per primary focus and 4 Gy (3-6 Gy) 5 times a week; TTD = 43.5 Gy (30-52 Gy) per lymph nodes (105.6 - 150 Gy = equ.). Complete response was observed in 27.5% (22/80), partial - 42.5% (34/80). Overall survival was 61.3% among those sick for one year; 41.5%--2 years and 20.75%--3 years (mean survival time--20 months).
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Greisen O. Deoxyribonucleic acid content in bronchogenic carcinoma with special reference to polypoid cell nuclei. A preliminary report. ACTA PATHOLOGICA ET MICROBIOLOGICA SCANDINAVICA 2009; 77:177-86. [PMID: 5377770 DOI: 10.1111/j.1699-0463.1969.tb04222.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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35
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Tarkkanen A, Merenmies L, Mäkinen J. Embolism of the central retinal artery secondary to metastatic carcinoma. Acta Ophthalmol 2009; 51:25-33. [PMID: 4739673 DOI: 10.1111/j.1755-3768.1973.tb08242.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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36
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Hansen OP, Hansen M, Hansen HH, Rose B. Multiple endocrine adenomatosis of mixed type. ACTA MEDICA SCANDINAVICA 2009; 200:327-31. [PMID: 10717 DOI: 10.1111/j.0954-6820.1976.tb08240.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A case of multiple endocrine adenomatosis (MEA) of mixed type is presented. The syndrome, observed in a 65 year-old female, consisted of multiple neurofibroadenomatosis, medullary thyroid carcinoma, multiple adenomata of the parathyroids, adrenal cortical adenoma and small cell anaplastic bronchogenic carcinoma. Thus, it was composed of type 1 as well as of type 2 MEA. On the basis of another seven cases, collected from the literature, the MEA syndrome of mixed type is reviewed with special reference to the phylogenetic origin of the cells of the APUD system.
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Lonsdale-Eccles AA, Carmichael AJ. Opioid antagonist for pruritus of cholestasis unmasking bony metastases. Acta Derm Venereol 2009; 89:90. [PMID: 19197552 DOI: 10.2340/00015555-0538] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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38
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Sandmeyer LS, Cosford K, Grahn BH. Metastatic carcinoma in a cat. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2009; 50:95-96. [PMID: 19337623 PMCID: PMC2603664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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39
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Agrawal NN, Ghogare MS, Bansod YV. Unusual presentation of bronchogenic carcinoma. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2009; 57:84-86. [PMID: 19753769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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40
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Tamasova M, Varesinska M, Suchankova M, Naji M. Multiple malignity in patients with bronchogenic carcinoma. 3 case reports. BRATISL MED J 2009; 110:672. [PMID: 20017464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Quaia E, Baratella E, Pizzolato R, Bussani R, Cova MA. Radiological-pathological correlation in intratumoural tissue components of solid lung tumours. Radiol Med 2008; 114:173-89. [PMID: 19082781 DOI: 10.1007/s11547-008-0354-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Accepted: 02/11/2008] [Indexed: 01/15/2023]
Abstract
The aim of this paper is to describe the intratumoural tissue components of solid lung tumours evidenced by macroscopic and/or microscopic examination of the autopsy or surgical specimen and visible on computed tomography (CT) without and with contrast material administration. Seven intratumoural tissue components can be identified both at CT and at pathology: (1) solid component, (2) haemorrhagic component, (3) coagulation necrosis, (4) liquefaction necrosis, (5) parenchymal consolidation, (6) diffuse peripheral component and (7) fibrotic component. Necrotic and haemorrhagic components are typically observed in malignant lesions, whereas solid and fibrotic components may be seen both in solid lung malignancies and in benign lesions.
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Ioachimescu O, Corlan E. [New data in staging and prognosis of bronchopulmonary carcinoma. Part II: volumetric analysis of pulmonary nodules]. PNEUMOLOGIA (BUCHAREST, ROMANIA) 2008; 57:209-220. [PMID: 19186683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Pulmonary nodules discovered incidentally or in the context of the work-up for symptomatic conditions represent an area of major interest. By definition, a pulmonary nodule is defined as a well-circumscribed round or oval lesion, measuring less than 3 cm in maximal diameter. The impact of newer technologies on our capacity to detect pulmonary nodules has increased significantly in the last decade, from the utilization of high-performance computed tomographic (CT) scanners, to the development of more functional imaging techniques, such positron emission tomography (PET) scanners. The latter still has a suboptimal resolution for nodules less than one centimeter in size, hence the use of high-resolution, multi-detector CT scanners has become a more frequent clinical problem for these nodules. In this review we describe the latest developments in the CT technology, such as volumetric reconstruction and characterization of the pulmonary nodules and how this can impact the modern diagnostic and therapeutic modalities.
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Kästel M, Schuh A. [Coin lesion in the lung]. MMW Fortschr Med 2008; 150:41-43. [PMID: 18988335 DOI: 10.1007/bf03365551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Sahoo RC, Acharya PR. Pleural effusion of a dual etiology. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2008; 56:55-56. [PMID: 18476299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Prosch H, Strasser G, Sonka C, Oschatz E, Mashaal S, Mohn-Staudner A, Mostbeck GH. Cervical ultrasound (US) and US-guided lymph node biopsy as a routine procedure for staging of lung cancer. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2007; 28:598-603. [PMID: 17602370 DOI: 10.1055/s-2007-963215] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
PURPOSE To assess the value of routine ultrasound evaluation and US-guided fine-needle aspiration biopsy of supraclavicular lymph nodes for the diagnosis, staging and treatment of patients with lung cancer. MATERIALS AND METHODS 300 consecutive patients with lung cancer were evaluated with high-resolution ultrasound for the presence of pathological lymph nodes (criteria: short-axis >or= 5 mm, rounded shape, missing echogenic hilum). Suspicious lymph nodes were biopsied under ultrasound guidance if the result could influence further patient management RESULTS In 41 of 257 NSCLC patients (16 %) and 15 of 43 (35 %) SCLC patients, enlarged lymph nodes were detected, in particular in patients with a CT stage N2 or N3 (NSCLC) or extensive disease (SCLC). 16 lymph node biopsies were positive for malignancy, 4 biopsies were negative for malignancy or not diagnostic. US had a higher sensitivity for the detection of pathological lymph nodes than CT. CONCLUSION Routine ultrasound evaluation of supraclavicular lymph nodes reveals suspicious lymph nodes in a high number of patients with lung cancer. High-resolution US is superior to CT in the detection of pathological lymph nodes. Ultrasound-guided biopsy proves malignancy and thereby a N3 or M1 stage. Thus, more invasive and expensive diagnostic procedures can be avoided.
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Laporta M, Bárcena M. Clinical snapshot. Bronchial carcinoma, phalangeal invasion and bone resorbed with stratified squamous epithelium. COMPENDIUM (YARDLEY, PA) 2007; 29:691-692. [PMID: 18210979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Dietl B, Marienhagen J, Schaefer C, Pohl F, Kölbl O. [Frequency and distribution pattern of distant metastases in patients with ENT tumors and their consequences for pretherapeutic staging]. Strahlenther Onkol 2007; 183:138-43. [PMID: 17340072 DOI: 10.1007/s00066-007-1611-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2006] [Revised: 06/12/2006] [Indexed: 11/26/2022]
Abstract
PURPOSE To address the following questions: which parameters influenced the frequency of distant metastases in patients with locally advanced ear-nose-throat (ENT) tumors, which was the distribution pattern of metastases, and what were the diagnostic consequences for pretherapeutic staging? PATIENTS AND METHODS 600 patients (526 men, 76 women, median age 56 years) with ENT tumors (squamous cell carcinoma histology) were studied retrospectively. The distribution of primary tumor site and stage (AJCC) was as follows: oropharynx: n = 161 (26.8%), hypopharynx: n = 187 (31.2%), oral cavity: n = 89 (14.8%), larynx: n = 118 (19.7%), cancer of unknown origin: n = 13 (2.2%), others: n = 32(5.3%), I: n = 24 (4%), II: n = 49 (8.2%), III: n = 89 (14.8%), IV: n = 438 (73%). 270 patients (45%) received radiochemotherapy, 330 (55%) postoperative radiotherapy. The following parameters were analyzed in association with distant metastases: tumor localization, T- and N-category, primary treatment, local tumor control, and second neoplasms. RESULTS 114/600 patients (19%) developed distant metastases, 29/600 (4.9%) at presentation, 50% within 9.3 months after diagnosis of the primary tumor. Distant metastases were most frequent in stage IV (24.2%), carcinoma of the hypopharynx (25.7%), local recurrence (24.3%), and second neoplasm (31.7%) with the following distribution pattern: pulmonary 61/114 (53.5%), pleural 15/114 (13.1%), osseous 45/114 (39.5%), hepatic 14/114 (12.3%), cerebral 8/114 (7%), cutaneous 14/114 (12.3%). 34/114 patients (29.8%) presented monotopic, 80/114 (70.2%) polytopic metastases. 82/600 (13.6%) patients additionally had second neoplasms, 20 corresponding with synchronous or metachronous bronchial tumors. CONCLUSION With locally advanced ENT tumor stage IVa/b, carcinoma of the hypopharynx, local recurrence or second neoplasms, at least a pretherapeutic CT of the thorax should be performed because every seventh patient (88/600) developed metastases or second primary tumors within the thoracic space during the course of disease. Regarding the side effects and costs of curative therapy, the definition of generally accepted guidelines for the systemic staging of locally advanced ENT tumors should be undertaken.
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MESH Headings
- Carcinoma, Bronchogenic/pathology
- Carcinoma, Bronchogenic/secondary
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/radiotherapy
- Carcinoma, Squamous Cell/secondary
- Combined Modality Therapy
- Disease Progression
- Female
- Humans
- Lung Neoplasms/pathology
- Lung Neoplasms/secondary
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Neoplasm Metastasis/pathology
- Neoplasm Staging
- Neoplasms, Multiple Primary/drug therapy
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/radiotherapy
- Neoplasms, Multiple Primary/surgery
- Neoplasms, Second Primary/pathology
- Otorhinolaryngologic Neoplasms/drug therapy
- Otorhinolaryngologic Neoplasms/pathology
- Otorhinolaryngologic Neoplasms/radiotherapy
- Otorhinolaryngologic Neoplasms/surgery
- Positron-Emission Tomography
- Retrospective Studies
- Tomography, X-Ray Computed
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Türüt H, Tastepe I, Kaya S, Sirmali M, Gezer S, Oz G, Findik G, Cetin G. Surgical results and prognosis of patients with primary bronchogenic carcinoma aged less than 36 years. Respirology 2007; 12:707-11. [PMID: 17875059 DOI: 10.1111/j.1440-1843.2007.01137.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE This study reports on the demographic features, clinico-pathological results and prognoses of patients aged less than 36 years diagnosed with non-small cell lung cancer (NSCLC). METHODS This is an observational study of patients with primary NSCLC who had a surgical procedure at a tertiary thoracic surgery centre in Turkey. Data collected were age, gender, history of smoking, symptoms, postoperative histopathological diagnosis, stage, surgical procedure and survival. RESULTS Of the 31 patients in the study, 27 were male (87%) and the median age was 32 years (10-35 years). Nineteen patients were smokers (61.2%). The most common presenting symptom was cough (n = 23, 67.7%). Histopathological diagnosis was squamous cell carcinoma (SCC, n = 17), adenocarcinoma (n = 12), lymphoepithelioma-like carcinoma (n = 1) and undifferentiated carcinoma (n = 1). Staging of the 17 patients with SCC (58.8%) was stage I and II (n = 10, 58%), and stage III (n = 7, 41%). Staging of the 13 patients with adenocarcinoma was stage IV (n = 2, 16%) and stage III patients (n = 8, 66%). Follow-up data were available on 22 patients (71%) and showed a median survival of 17.2 months. Two and 5-year survival rates were 54.5% and 45.5%, respectively. CONCLUSIONS SCC comprised a relatively high proportion of NSCLC in these younger patients. Aggressive multimodality treatment may achieve satisfactory 2- and 5-year survival rates in young patients with NSCLC who usually present with advanced disease.
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Jamnik S, Uehara C, da Silva VV. Location of lung carcinoma in relation to the smoking habit and gender. J Bras Pneumol 2007; 32:510-4. [PMID: 17435901 DOI: 10.1590/s1806-37132006000600007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2005] [Accepted: 02/15/2006] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To analyze the locations of lung carcinomas in relation to patient gender and smoking status. METHODS In order to test the hypothesis that lung carcinoma location (upper or lower lobe; left or right side) is correlated with smoking status and gender, we conducted a retrospective study of 697 patients with bronchogenic carcinoma treated at the Pulmonology-Oncology Outpatient Clinic of the Federal University of São Paulo. RESULTS We found that the bronchogenic carcinomas occurring in smokers were more frequently located in the upper lobes, whereas those occurring in nonsmokers were more frequently located in the lower lobes. In women, the neoplasms were more often seen in the lower lobes, especially in nonsmokers. Based on the available data, there were no differences in terms of the side affected (left or right). CONCLUSION Overall, bronchogenic carcinomas are predominantly found in the upper lobes. However, in nonsmokers, they occur more frequently in the lower lobes. In females, bronchogenic carcinomas present a tendency to occur more often in the lower lobes.
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Ioachimescu O, Corlan E. [New developments in staging and prognosis of bronchopulmonary carcinoma. Part I: Epidemiology and diagnostic investigations]. PNEUMOLOGIA (BUCHAREST, ROMANIA) 2007; 56:129-136. [PMID: 18019973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Lung cancer represents a major health problem globally and its surge in incidence is mainly attributed to the increase in the consumption of tobacco-related products. The poor prognosis of this condition is generally related to the advanced stage at the time of the diagnosis; therefore, accurate staging initially as well during the course of the disease seems to be of paramount importance. Unfortunately, in the last half-century, no major breakthroughs occurred in the field of the lung cancer therapy. Beyond the classic investigations and staging strategies, a plethora of new exploratory and staging techniques became available in the last several years. In this review (part I) we present the latest epidemiological data, major shifts in the disease presentation, histologic types and staging modalities and present their possible implications on the way we diagnose and, more importantly, how we treat this condition.
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