scholarly journals Pulmonary Nodules in Patients With Nonpulmonary Cancer: Not Always Metastases

2016 ◽  
Vol 2 (3) ◽  
pp. 138-144 ◽  
Author(s):  
Rafael Caparica ◽  
Milena Perez Mak ◽  
Claudio Henrique Rocha ◽  
Pedro Henrique Isaacsson Velho ◽  
Publio Viana ◽  
...  
Keyword(s):  
Metastatic Disease ◽  
Lung Tumor ◽  
Pulmonary Nodules ◽  
Hematologic Malignancies ◽  
Scar Tissue ◽  
Second Primary ◽  
Single Institution ◽  
Lung Cancers ◽  
Patients With Cancer ◽  
Solid Malignancies

Introduction The differential diagnosis of pulmonary nodules (PNs) includes metastases, lung cancers, infectious diseases, and scar tissue, among others. Because data regarding whether and when to perform a PN biopsy in patients with cancer are scarce, clinicians tend to assume that PNs are metastatic disease based solely on imaging. The current study evaluated the findings of PN biopsies in a population of patients with cancer and sought to determine the variables that correlated with higher odds of metastatic disease. Patients and Methods We conducted a retrospective, single-institution study that included consecutive patients with nonpulmonary solid malignancies who underwent PN biopsy from January 2011 to December 2013. Imaging and clinical variables were analyzed by logistic regression to determine the correlation between such variables and the odds of metastatic disease. Patients with previously known metastatic disease or primary hematologic malignancies were excluded. Results Two hundred twenty-eight patients were included in the study. Metastatic disease was found in 146 patients (64%), 60 patients (26.3%) were diagnosed with a second primary lung tumor, and 22 patients (9.6%) had no cancer on biopsy. On multivariate analysis, the presence of multiple PNs (> 5 mm) and cavitation/necrosis were the only variables associated with higher odds (P < .05) of metastatic disease. We registered six (2.6%) procedure complications demanding active interventions, and no procedure-related death occurred. Conclusion Multiple PNs (> 5 mm) and cavitation were the two characteristics associated with the highest chances of metastatic disease. Our findings demonstrate that PNs should not be assumed to be metastases without performing a biopsy. This assumption may lead to high rates of misdiagnosis. Tissue sampling is fundamental for accurately diagnosing patients with cancer.

Use of Tunneled-Cuffed Central Catheters in Patients with Cancer: A Single-Center Experience

2018 ◽  
Vol 23 (1) ◽  
pp. 23-29
Author(s):  
Irappa Madabhavi ◽  
Apurva Patel ◽  
Asha Anand ◽  
Pritam Kataria ◽  
Nagaveni Kadakol ◽  
...  
Keyword(s):  
Lymphoblastic Leukemia ◽  
Tertiary Care ◽  
Hematologic Malignancies ◽  
Venous Access ◽  
Cytotoxic Agents ◽  
Observational Research ◽  
Common Indication ◽  
Hickman Catheter ◽  
Patients With Cancer ◽  
Solid Malignancies

Abstract Background: Effective and reliable venous access is among the cornerstones of modern medical therapy in oncology. Materials and Methods: This was a prospective observational study of collected data of patients with a diagnosis of any cancer, at a tertiary care oncology hospital in Ahmadabad, Gujarat, India, during a 2-year period. Results: A Hickman catheter was inserted in 200 patients and most commonly used in solid malignancies (n = 103; 51.5%), followed by hematologic conditions (n = 93; 48.5%). Among solid malignancies, hepatoblastoma (n = 21; 10.5%) was the most common indication, whereas in hematologic malignancies acute lymphoblastic leukemia was the most common indication (n = 56; 28%) for Hickman catheter insertion. Hickman catheters were inserted most commonly in the right side (n = 170; 85%) of the venous system. The various complications in the Hickman study group in descending order were 28 patients (14%) developed arrhythmias, 15 patients (7.5%) developed infection, 12 patients (6%) developed bleeding, 8 patients (4%) developed pneumothorax, 7 patients (3.5%) developed catheter blockage, and 6 patients (3%) required premature catheter removal. The median time of Hickman catheter in situ was 207 days. Conclusions: The most disturbing aspect of treatment of patients with cancer is multiple painful venipunctures made for administration of cytotoxic agents, antibiotics, blood products, and nutritional supplements. The focus of this prospective observational research was to study the various indications for Hickman catheter in different solid and hematologic malignancies as well as the various complications and outcomes in pediatric and adult cancer patients.

scholarly journals Radiomics Study for Discriminating Second Primary Lung Cancers From Pulmonary Metastases in Pulmonary Solid Lesions

2022 ◽  
Vol 11 ◽  
Author(s):  
Feiyang Zhong ◽  
Zhenxing Liu ◽  
Wenting An ◽  
Binchen Wang ◽  
Hanfei Zhang ◽  
...  
Keyword(s):  
Clinical Data ◽  
Pulmonary Metastases ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Pulmonary Nodules ◽  
Second Primary ◽  
Imaging Features ◽  
Clinical Value ◽  
Discriminative Ability ◽  
Lung Cancers

BackgroundThe objective of this study was to assess the value of quantitative radiomics features in discriminating second primary lung cancers (SPLCs) from pulmonary metastases (PMs).MethodsThis retrospective study enrolled 252 malignant pulmonary nodules with histopathologically confirmed SPLCs or PMs and randomly assigned them to a training or validation cohort. Clinical data were collected from the electronic medical records system. The imaging and radiomics features of each nodule were extracted from CT images.ResultsA rad-score was generated from the training cohort using the least absolute shrinkage and selection operator regression. A clinical and radiographic model was constructed using the clinical and imaging features selected by univariate and multivariate regression. A nomogram composed of clinical-radiographic factors and a rad-score were developed to validate the discriminative ability. The rad-scores differed significantly between the SPLC and PM groups. Sixteen radiomics features and four clinical-radiographic features were selected to build the final model to differentiate between SPLCs and PMs. The comprehensive clinical radiographic–radiomics model demonstrated good discriminative capacity with an area under the curve of the receiver operating characteristic curve of 0.9421 and 0.9041 in the respective training and validation cohorts. The decision curve analysis demonstrated that the comprehensive model showed a higher clinical value than the model without the rad-score.ConclusionThe proposed model based on clinical data, imaging features, and radiomics features could accurately discriminate SPLCs from PMs. The model thus has the potential to support clinicians in improving decision-making in a noninvasive manner.

scholarly journals A Study of Use of “PORT” Catheter in Patients with Cancer: A Single-Center Experience

2017 ◽  
Vol 11 ◽  
pp. 117955491769103 ◽  
Author(s):  
Irappa Madabhavi ◽  
Apurva Patel ◽  
Malay Sarkar ◽  
Asha Anand ◽  
Harsha Panchal ◽  
...  
Keyword(s):  
Hematologic Malignancies ◽  
Underlying Disease ◽  
Catheter Insertion ◽  
Cytotoxic Agents ◽  
Observational Research ◽  
Study Group ◽  
Port Catheter ◽  
Port Placement ◽  
Patients With Cancer ◽  
Solid Malignancies

Background: Effective and reliable venous access is one of the cornerstones of modern medical therapy in oncology. Materials and methods: This is a prospective observational study, which collected data of patients who require “PORT” catheter insertion for any cancer, at a tertiary care oncology hospital in Ahmadabad, Gujarat, India, during a 2-year period. Aims and objectives: The main objective of this study was to study the various complications and outcomes related to “PORT” catheters. Results: “PORT” catheter was inserted in 100 patients and was most commonly used in solid malignancies (n = 86, 86%), followed by hematologic malignancies (n = 14, 14%). Among the solid malignancies, breast cancer (38, 38%) was the most common underlying disease, whereas among the hematologic malignancies, acute lymphoblastic leukemia (6, 6%) was the most common underlying disease for “PORT” catheter insertion. Chemotherapy was started on the first day of “PORT” catheter in 74% of patients in the “PORT” study group. The various complications developed in the “PORT” study group in the descending order are as follows: 4 patients (4%) developed early infection (⩽30 days after “PORT” placement), 4 (4%) late infection (⩾30 days after “PORT” placement), 4 (4%) bloodstream infection, 2 (2%) local skin infection at the “PORT” insertion site, 2 (2%) dislodgment of the “PORT” catheter, 2 (2%) fracture of the “PORT” catheter, and 1 recurrent pleural effusion. One patient (1%) developed thrombosis as the complication of “PORT” catheter insertion. Conclusions: The most disturbing aspect of treatment for a patient with cancer is multiple painful venipunctures made for administration of cytotoxic agents, antibiotics, blood products, and nutritional supplements. The focus of this prospective observational research is to study the various underlying diseases for which “PORT” catheter is needed in different solid and hematologic malignancies and the various complications and outcomes in pediatric and adult patients with cancer.

scholarly journals Preoperative virtual simulation for synchronous multiple primary lung cancers using three-dimensional computed tomography lung reconstruction: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Weichun Wu ◽  
Yimin Wu ◽  
Gang Shen ◽  
Guofei Zhang
Keyword(s):  
Computed Tomography ◽  
Thoracoscopic Surgery ◽  
Three Dimensional ◽  
Primary Lung Cancer ◽  
Pulmonary Nodules ◽  
Term Survival ◽  
Lung Cancers ◽  
Multiple Primary ◽  
Feasible Alternative

Abstract Background As the positions and sizes of nodules in synchronous multiple primary lung cancer (SMPLC) patients differ, the development of surgical strategies to maximize long-term survival and preserved postoperative pulmonary function in SMPLC patients for whom surgical resection is an alternative strategy presents challenges. Case presentation We provide a case managed through video-assisted thoracoscopic surgery (VATS) resection using three-dimensional computed tomography lung reconstruction (3D-CTLR) to reconstruct lobes containing pulmonary nodules to preoperatively simulate and intraoperatively guide the extent and method of resection. Conclusion The successful attempt demonstrates a technically simplified, feasible alternative to preoperative plans utilizing less invasive VATS to manage SMPLC.

scholarly journals Risks of second primary cancer among patients with major histological types of lung cancers in both men and women

2010 ◽  
Vol 102 (7) ◽  
pp. 1190-1195 ◽  
Author(s):  
S-C Chuang ◽  
G Scélo ◽  
Y-C A Lee ◽  
S Friis ◽  
E Pukkala ◽  
...  
Keyword(s):  
Second Primary ◽  
Primary Cancer ◽  
Second Primary Cancer ◽  
Men And Women ◽  
Lung Cancers ◽  
Histological Types

scholarly journals Tobacco Smoke–Induced Lung Cancer in Animals—A Challenge to Toxicology (?)

2007 ◽  
Vol 26 (4) ◽  
pp. 339-344 ◽  
Author(s):  
Hanspeter Witschi
Keyword(s):  
Lung Cancer ◽  
Tobacco Smoke ◽  
Lung Tumor ◽  
Distant Metastases ◽  
Female Rats ◽  
Chemopreventive Agents ◽  
Lung Cancers ◽  
Malignant Lesions ◽  
Product Modification ◽  
Rats And Mice

Tobacco smoke is a known human carcinogen that primarily produces malignant lesions in the respiratory tract, although it also affects multiple other sites. A reliable and practical animal model of tobacco smoke–induced lung cancer would be helpful for in studies of product modification and chemoprevention. Over the years, many attempts to reproduce lung cancer in experimental animals exposed to tobacco smoke have been made, most often with negative or only marginally positive results. In hamsters, malignant lesions have been produced in the larynx, but not in the deeper lung. Female rats and female B6C3F1 mice, when exposed over lifetime to tobacco smoke, develop tumors in the nasal passages and also in the lung. Contrary to what is seen in human lung cancers, most rodent tumors are located peripherally and only about half of them show frank malignant features. Distant metastases are extremely rare. Male and female strain A mice exposed to 5 months to tobacco smoke and then kept for another 4 months in air respond to tobacco smoke with increased lung tumor multiplicities. However, the increase over background levels is comparatively small, making it difficult to detect significant differences when the effects of chemopreventive agents are evaluated. On the other hand, biomarkers of exposure and of effect as well as evaluation of putative carcinogenic mechanisms in rats and mice exposed to tobacco smoke allow detection of early events and their modification by different smoke types or chemopreventive agents. The challenge will be to make such data broadly acceptable and accepted in lieu of having to do more and more long term studies involving larger and larger number of animals.

scholarly journals Mobile Low-Dose Computed Tomographic (LDCT) Scanning combined with Remote Reading: a feasible approach to lung cancer screening among rural population

2021 ◽  
Author(s):  
Bojiang Chen ◽  
Jun Shao ◽  
Jinghong Xian ◽  
Pengwei Ren ◽  
Wenxin Luo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Rural Areas ◽  
Pulmonary Nodules ◽  
Lung Cancer Screening ◽  
Western China ◽  
Control Group ◽  
Local Hospital ◽  
Lung Cancers ◽  
Computed Tomographic

Abstract BackgroundLow-dose computed tomographic (LDCT) screening has been proven to be powerful in detecting lung cancers in early stage. However, it’s hard to carry out in less-developed regions in lacking of facilities and professionals. The feasibility and efficacy of mobile LDCT scanning combined with remote reading by experienced radiologists from superior hospital for lung cancer screening in deprived areas was explored in this study.MethodsA prospective cohort was conducted in rural areas of western China. Residents over 40 years old were invited for lung cancer screening by mobile LDCT scanning combined with remote image reading or local hospital-based LDCT screening. Rates of positive pulmonary nodules and detected lung cancers in the baseline were compared between the two groups.ResultsAmong 8073 candidates with preliminary response, 7251 eligibilities were assigned to the mobile LDCT with remote reading (n = 4527) and local hospital-based LDCT screening (n = 2724) for lung cancer. Basic characteristics of the subjects were almost similar in the two cohorts except that the mean age of participants in mobile group was relatively older than control (61.18 vs. 59.84 years old, P < 0.001). 1778 participants with mobile LDCT scans with remote reading (39.3%) revealed 2570 pulmonary nodules or mass, and 352 subjects in the control group (13.0%) were detected 472 ones (P < 0.001). Proportions of nodules less than 8 mm or subsolid were both more frequent in the mobile LDCT group (83.3% vs. 76.1%, 32.9% vs. 29.8%, respectively; both P < 0.05). In the baseline screening, 26 cases of lung cancer were identified in the mobile LDCT scanning with remote reading cohort, with a lung cancer detection rate of 0.57% (26/4527), which was significantly higher than control (4/2724 = 0.15%, P = 0.006). Moreover, 80.8% (21/26) of lung cancer patients detected by mobile CT with remote reading were in stage I, remarkedly higher than that of 25.0% in control (1/4, P = 0.020).ConclusionMobile LDCT combined with remote reading is probably a potential mode for lung cancer screening in rural areas.Trial registrationNo. of registration trial was ChiCTR-DDD-15007586 (http://www.chictr.org).

scholarly journals Pulmonary cavitation in patients with thyroid cancer receiving antiangiogenic agents

2020 ◽  
Author(s):  
Saumil Datar ◽  
Maria Cabanillas ◽  
Ramona Dadu ◽  
David Ost ◽  
Horiana Grosu
Keyword(s):  
Thyroid Cancer ◽  
Metastatic Disease ◽  
Kinase Inhibitors ◽  
Pulmonary Nodules ◽  
Primary Objective ◽  
Small Sample ◽  
Attractive Potential ◽  
Antiangiogenic Agents ◽  
Increased Risk ◽  
Clinical Consequences

Abstract Background: Thyroid malignancies are among the most common endocrine cancers worldwide. Owing to the angiogenic nature of these malignancies, tyrosine kinase inhibitors (TKIs) are an attractive potential treatment. However, TKIs have been associated with an increased risk of tumor cavitation, in turn linked to poor outcomes, in patients with malignancies in the lungs, where thyroid cancer commonly metastasizes. Method: We performed a retrospective cohort study of patients with thyroid cancer and evidence of metastatic disease to the lung that were treated with multi-targeted antiangiogenic TKIs. The primary objective of this study was to determine the incidence of pulmonary cavitation. The secondary objective was to evaluate the effect of pulmonary cavitation on survival. Results: Of the 83 patients with pulmonary nodules,10 developed cavitation during treatment. Of these 83 patients, two patients had to stop the treatment due to pneumothorax. Additionally, cavitation did not demonstrate any significant effect on survival. Conclusion: In patients with thyroid cancer and evidence of metastatic disease to the chest, the use of multi-targeted TKIs led to cavitations that were not uncommon but clinical consequences were marginal. Treatment was stopped only in two patients that developed pneumothorax, however the small sample is a strong limitation of our study.

scholarly journals Patterns of ICU admissions and outcomes in patients with solid malignancies over the revolution of cancer treatment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Clara Vigneron ◽  
Julien Charpentier ◽  
Sandrine Valade ◽  
Jérôme Alexandre ◽  
Samy Chelabi ◽  
...  
Keyword(s):  
Survival Rate ◽  
Adverse Events ◽  
Cancer Patients ◽  
Critically Ill ◽  
Metastatic Disease ◽  
Critical Conditions ◽  
Icu Admission ◽  
Solid Malignancies ◽  
Single Centre Study ◽  
Organ Failures

Abstract Background Major therapeutic advances including immunotherapy and targeted therapies have been changing the face of oncology and resulted in improved prognosis as well as in new toxic complications. The aim of this study is to appraise the trends in intensive care unit (ICU) admissions and outcomes of critically ill patients with solid malignancies. We performed a retrospective single-centre study over a 12-year period (2007–2018) including adult patients with solid malignancies requiring unplanned ICU admission. Admission patterns were classified as: (i) specific if directly related to the underlying cancer; (ii) non-specific; (iii) drug-related or procedural adverse events. Results 1525 patients were analysed. Lung and gastro-intestinal tract accounted for the two main tumour sites. The proportion of patients with metastatic diseases increased from 48.6% in 2007–2008 to 60.2% in 2017–2018 (p = 0.004). Critical conditions were increasingly related to drug- or procedure-related adverse events, from 8.8% of ICU admissions in 2007–2008 to 16% in 2017–2018 (p = 0.01). The crude severity of critical illness at ICU admission did not change over time. The ICU survival rate was 77.4%, without any significant changes over the study period. Among the 1279 patients with complete follow-up, the 1-year survival rate was 33.2%. Independent determinants of ICU mortality were metastatic disease, cancer in progression under treatment, admission for specific complications and the extent of organ failures (invasive and non-invasive ventilation, inotropes/vasopressors, renal replacement therapy and SOFA score). One-year mortality in ICU-survivors was independently associated with lung cancer, metastatic disease, cancer in progression under treatment, admission for specific complications and decision to forgo life-sustaining therapies. Conclusion Advances in the management and the prognosis of solid malignancies substantially modified the ICU admission patterns of cancer patients. Despite underlying advanced and often metastatic malignancies, encouraging short-term and long-term outcomes should help changing the dismal perception of critically ill cancer patients.

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