Left pneumonectomy for primary lung cancer with Trousseau’s syndrome

2021 ◽  
Vol 14 (3) ◽  
pp. e240927
Author(s):  
Hideomi Ichinokawa ◽  
Yusuke Nagasaki ◽  
Yutaro Koike ◽  
Kenji Suzuki
Keyword(s):  
Lung Cancer ◽  
Pathological Condition ◽  
Tumour Size ◽  
Primary Lung Cancer ◽  
Advanced Lung Cancer ◽  
Cerebral Stroke ◽  
Malignant Tumours ◽  
Stage Iiia ◽  
Trousseau’S Syndrome ◽  
Left Pneumonectomy

Trousseau’s syndrome is a paraneoplastic syndrome and a pathological condition that causes cerebral stroke symptoms due to hypercoagulation associated with malignant tumours. There have been many cases of advanced lung cancer, but few reports have described surgery for lung cancer with Trousseau’s syndrome. We encountered a 76-year-old man suspected of having Trousseau’s syndrome associated with lung cancer. He was transferred to our hospital on the second day after the onset. After admission, he was treated with heparin and edaravone, and his condition improved. On the 12th day after the onset, we performed left pneumonectomy and lymph node dissection (ND2a-2). The final pathological results were adenocarcinoma, pathological stage was T4 (tumour size: 77 mm, pulmonary artery invasion) N1(#11, #12u) M0, stage IIIA. He has been recurrence free for 23 months since the surgery. In the future, we need to follow his condition carefully.

scholarly journals Salvage surgery for primary lung cancer complicated with Trousseau’s syndrome after chemotherapy: a case report

2020 ◽  
Vol 4 ◽  
pp. 3-3
Author(s):  
Toshinari Ema ◽  
Hiroshi Neyatani ◽  
Yasutaka Mochizuka ◽  
Kazuyo Yasuda ◽  
Saki Yamamoto ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Case Report ◽  
Salvage Surgery ◽  
Primary Lung Cancer ◽  
Trousseau’S Syndrome

Regional Variation in Lung Cancer Stage at an Irish Rapid Access Lung Clinic

2021 ◽  
Vol 8 (10) ◽  
pp. 5687-5691
Author(s):  
Ghaith Qsous ◽  
N. McVeigh ◽  
M. Tolan ◽  
S . Manoj ◽  
D.G. Healy
Keyword(s):  
Lung Cancer ◽  
Regional Variation ◽  
Tumour Size ◽  
Primary Lung Cancer ◽  
Stage Ii ◽  
Stage Iii ◽  
Lymph Node Status ◽  
Rapid Access ◽  
Group 2 ◽  
Group 1

Introduction: Regional variation in cancer outcomes is undesirable. We aim to evaluate regional variation in lung cancer in Ireland focusing on stage at presentation. Methods: A retrospective study was performed on patients who underwent surgical resection of primary lung cancer from June 2013 to March 2020. Patients included attended the St. Vincent’s University Hospital rapid access lung clinic (RALC). Patients were divided into two groups depending on regional variability with Dublin and Wicklow assigned as Group 1 and the remainder assigned to Group 2. Pathological tumour size and lymph node status were compared between the two groups. Results: Complete data was available on 152 patients. Group 1 (n=97) had significantly lower median tumour size (24.74 mm) compared to Group 2 (31.72 mm) (P = 0.026). Patients in group 1 had significantly lower stage (stage II 13.4%, stage III 9.3%) compared to Group 2 (stage II 29%, stage III 16.3%) (P = 0.013). Group 1 showed a lower incidence of squamous cell carcinoma (21.6%) compared to Group 2 (30.9%). Conclusion: Regional variation in cancer presentation is evident in this study. Larger tumors and more advance stage are associated with a more rural location. This is seen in a clinic service with equal access of both populations to diagnostic modalities and treatment, suggesting differences at presentation rather than evaluation.  

Simultaneous in Situ Detection of Protein Expression of Multiple Tumor Markers of CTC and Heteroploid of Chromosome 8 in Primary Lung Cancer

2021 ◽  
Author(s):  
Hanqing Yao ◽  
Zhengdong Wang ◽  
Junjun Yang ◽  
Xingxiang Xu ◽  
Yong Song
Keyword(s):  
Lung Cancer ◽  
Peripheral Blood ◽  
Primary Lung Cancer ◽  
Small Cell ◽  
Chromosome 8 ◽  
Clinical Staging ◽  
Advanced Lung Cancer ◽  
Multiple Tumor ◽  
Positive Rate

Abstract Background Past studies have shown that circulating tumor cells (CTCs) play an important role in the clinical staging, efficacy monitoring and prognosis evaluation of lung cancer. Methods In this study we investigated the expression of CK18 and Vimentin on the surface of CTC and the aneuploidy of chromosome 8 in peripheral blood of 24 patients with metastatic primary lung cancer which were detected by subtraction enrichment and immunofluorescence in situ hybridization (SE-iFISH), and their correlation with clinicopathological features, curative effect and prognosis was analyzed. Results The positive rate of CTC was 95.83% (23/24). There was a certain correlation between the positive rate of CTC and smoking and a correlation between the number of CTC and the histopathological type of patients. The number of monoploid, diploid, triploid and polyploid CTC had no statistical correlation with progression-free survival (PFS) or overall survival (OS). However, a tetraploid CTC count of two or more was an unfavorable predictor of response and a tetraploid CTC count ≥ 1 is an unfavorable prognostic predictor of poor OS. The positive rate of CK18 + CTC in all 24 patients was 4.35% (1/23). Meanwhile, 7 out of these 24 patients were also tested for Vimentin, and the positive rate of Vimentin + CTC was 85.71% (6/7). Small-cell (≤ 5µm) CTC was found in 6 of these 7 patients and it accounted for 11.83% (11/93) of the total CTC. The tumor marker phenotype of small-cell CTC was CK18 - Vimentin +. In addition, circulating tumor microthrombi (CTM) were found in 2 of these 7 patients (28.57%). Conclusion SE-iFISH has a high detection rate of CTC in peripheral blood of patients with metastatic primary lung cancer, and it can identify small-cell CTC. Tetraploid CTC count ≥ 2 can predict poor PFS in patients with advanced lung cancer. Tetraploid CTC count ≥ 1 may predict poor OS in patients with advanced lung cancer. CTM can predict poor prognosis in patients with lung cancer.

scholarly journals The advanced lung cancer inflammation index predicts outcomes of patients with non-small cell lung cancer following video-assisted thoracic surgery

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110624
Author(s):  
Zhaohui Han ◽  
Zhonghui Hu ◽  
Qingtao Zhao ◽  
Wenfei Xue ◽  
Guochen Duan
Keyword(s):  
Lung Cancer ◽  
Thoracic Surgery ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Advanced Lung Cancer ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Optimal Cutoff ◽  
Cancer Inflammation

Objective The advanced lung cancer inflammation index (ALI) predicts overall survival (OS) in patients with advanced lung cancer. However, few studies have tested ALI’s prognostic effect in patients with non-small cell lung cancer (NSCLC) following video-assisted thoracic surgery (VATS), especially patients at stage III. This study investigated the relationship between ALI and outcomes of patients with NSCLC following VATS. Methods We retrospectively examined 339 patients with NSCLC who underwent VATS at Hebei General Hospital, China. Preoperative clinical and laboratory parameters were collected and analyzed. Optimal cutoff values of potential prognostic factors, including ALI, were determined. Kaplan–Meier and Cox regression analyses were used to determine each factor’s prognostic value. Results The median OS was 31 months. The optimal cutoff value for ALI was 41.20. Patients with high ALI (≥41.20) displayed increased OS (33.87 vs. 30.24 months), higher survival rates, and milder clinical characteristics. Univariate and multivariate analyses showed a significant correlation between ALI and the prognosis of patients with NSCLC, including those at stage IIIA, who underwent VATS. Conclusions Low ALI correlated with poor outcomes in patients with NSCLC following VATS. Preoperative ALI might be a potential prognostic biomarker for patients with NSCLC following VATS, including patients at stage IIIA.

scholarly journals Carinal Resection and Reconstruction for Locally Advanced Primary Lung Cancer: Institutional Report

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Yuji Matsumura ◽  
Muneo Minowa ◽  
Osamu Araki ◽  
Yoko Karube ◽  
Masayuki Chida
Keyword(s):  
Lung Cancer ◽  
Locally Advanced ◽  
Primary Lung Cancer ◽  
Advanced Lung Cancer ◽  
Anastomotic Site ◽  
Operative Death ◽  
Carinal Resection ◽  
Significant Difference ◽  
Locally Advanced Lung Cancer ◽  
The One

Carinal resection and reconstruction for lung cancer, termed carinaplasty, is a rare operation, and the procedure remains challenging and few reports have been presented. We analyzed complications, local control, and manner of recurrence in patients who underwent a carinaplasty and compared the results to those who underwent an ordinary bronchoplasty. Among 766 patients who underwent surgery for primary lung cancer at our institutions, 82 bronchoplasty procedures were performed, while 6 of those who received a bronchoplasty underwent a carinaplasty. Three of 6 patients who received a carinaplasty underwent the montage method, and other 3 patients underwent the one-stoma method. There were no operative deaths in patients who underwent a carinaplasty, while there was 1 operative death in the group of patients who underwent an ordinary bronchoplasty. Complications in the anastomotic site were observed in 33% in the carinaplasty group and 5.3% in the ordinary bronchoplasty group (P=0.011). There was no significant difference in regard to local recurrence between the groups (P=0.620). In conclusion, our results show that a carinaplasty is a technically demanding but useful procedure to avoid a pneumonectomy in patients with locally advanced lung cancer.

scholarly journals Is microwave ablation more effective than radiofrequency ablation in achieving local control for primary pulmonary malignancy?

2019 ◽  
Vol 29 (2) ◽  
pp. 283-286
Author(s):  
Maria Theresa Tsakok ◽  
Daniel Jones ◽  
Alice MacNeill ◽  
Fergus Vincent Gleeson
Keyword(s):  
Lung Cancer ◽  
Radiofrequency Ablation ◽  
Local Control ◽  
Microwave Ablation ◽  
Meta Analysis ◽  
Tumour Size ◽  
Primary Lung Cancer ◽  
Current Evidence ◽  
Recurrence Rates ◽  
Level Of Evidence

Abstract A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was ‘Is microwave ablation (MWA) more effective than radiofrequency ablation (RFA) in achieving local control for primary lung cancer?’. Altogether, 439 papers were found, of which 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Both are thermal ablative techniques, with microwave ablation (MWA) the newer technique and radiofrequency ablation (RFA) with a longer track record. Lack of consensus with regard to definitions of technical success and efficacy and heterogeneity of study inclusions limits studies for both. The only direct comparison study does not demonstrate a difference with either technique in achieving local control. The quality of evidence for MWA is very limited by retrospective nature and heterogeneity in technique, power settings and tumour type. Tumour size and late-stage cancer were shown to be associated with higher rates of local recurrence in 1 MWA study. RFA studies were generally of a higher level of evidence comprising prospective trials, systematic review and meta-analysis. The recurrence rates for MWA and RFA overlapped, and for the included studies ranged between 16% and 44% for MWA and 9% and 58% for RFA. The current evidence, therefore, does not clearly demonstrate a benefit of MWA over RFA in achieving local control in primary lung cancer.

Second pulmonary resection for a second primary lung cancer: analysis of morbidity and survival

2020 ◽  
Author(s):  
Walid Abid ◽  
Agathe Seguin-Givelet ◽  
Emmanuel Brian ◽  
Madalina Grigoroiu ◽  
Philippe Girard ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Median Overall Survival ◽  
Pulmonary Resection ◽  
Early Stage ◽  
Wedge Resection ◽  
Tumour Size ◽  
Primary Lung Cancer ◽  
Second Primary ◽  
Second Primary Lung Cancer

Abstract OBJECTIVES Evaluating morbidity and survival of patients operated on for a second primary non-small-cell lung cancer (NSCLC). METHODS Retrospective collection of data from patients operated on for a second NSCLC between 2009 and 2018. RESULTS Fifty-two patients met the inclusion criteria. At the time of second pulmonary resection, the median time between the 2 surgeries was 25 months (5–44.5 months). Patients’ median age was 65 years (61–68 years). Median tumour size was 16 mm (10–22 mm). Thoracoscopy was used in 75% of cases. The resection was a pneumonectomy (n = 1), bilobectomy (n = 1), lobectomy (n = 15), segmentectomy (n = 32) or wedge resection (n = 3). The length of stay was 7 days (5–9 days). Mortality was null and morbidity was 36.5%, mainly from grade I–II complications according to the Clavien–Dindo classification. The median follow-up was 28 months (13–50 months). The median overall survival was 67 months (95% confidence interval 60.8–73.1 months). Survival at 5 years and specific survival were 71.1% and 67.7%, respectively. CONCLUSIONS A second surgical resection of either synchronous or metachronous NSCLC has a morbidity that is not superior to the morbidity of the first operation. The new tumour is usually diagnosed at an early stage. An anatomical sublobar resection is most likely the best compromise. It might also be considered for the first operation when there is a suspicious synchronous lesion that may require surgery at a later stage.

scholarly journals Diagnostic yield and safety of C-TBNA in elderly patients with lung cancer

Open Medicine ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. 477-481 ◽  
Author(s):  
Carolina Vitale ◽  
Antonio Galderisi ◽  
Angelantonio Maglio ◽  
Paolo Laperuta ◽  
Rosa Maria Di Crescenzo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Diagnostic Yield ◽  
Age Groups ◽  
Primary Lung Cancer ◽  
Advanced Lung Cancer ◽  
Invasive Technique ◽  
Minor Bleeding ◽  
Transbronchial Needle Aspiration ◽  
Safe Alternative

AbstractConventional transbronchial needle aspiration (C-TBNA) is a minimally invasive technique used primarily in the diagnosis and staging of lung cancer. Currently lung cancer is mostly considered a disease of the elderly and the management of this disease in older patients is a growing concern.In this study we aimed to assess the diagnostic yield and safety of C-TBNA in elderly patients.A retrospective review of 88 consecutive C-TBNA procedures for nodal staging in suspected or confirmed primary lung cancer or pathological confirmation in suspected advanced lung cancer was performed. Patients were divided into less than 70 (<70yrs) or 70 and older (≥70yrs) age groups for analysis. There were no significant differences either in the diagnostic yield (69% in patients aged < 70 yrs and 74% patients aged ≥ 70 yrs (p=0.5) nor in the complication rate (respectively 8.8% in patients aged < 70 yrs and 6.9% in patients aged ≥ 70 yrs (p=0.7) between the two age groups. Reported complications were minor bleeding and poor tolerance; no major complications were observed.Based on our experience, C-TBNA represents a useful and safe alternative procedure for the diagnosis and staging of lung cancer in elderly patients.

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