scholarly journals Susiaurėjusio stambiųjų bronchų ir trachėjos spindžio gydymas

2010 ◽  
Vol 8 (3) ◽  
pp. 0-0
Author(s):  
Renatas Aškinis ◽  
Saulius Cicėnas ◽  
Valdas Puodžiūnas ◽  
Arnoldas Krasauskas ◽  
Sigitas Zaremba
Keyword(s):  
Lung Cancer ◽  
Foreign Body ◽  
Cell Carcinoma ◽  
Early Postoperative Period ◽  
Small Cell ◽  
Tumour Resection ◽  
Airway Stenosis ◽  
Mediastinal Disease ◽  
Airway Stenting ◽  
Vilnius University

Renatas Aškinis1, Saulius Cicėnas1,2, Valdas Puodžiūnas1, Arnoldas Krasauskas1, Sigitas Zaremba11 Vilniaus universiteto Onkologijos instituto Krūtinės chirurgijos ir onkologijos skyrius, Santariškių g. 1, LT-08660 Vilnius El. paštas: [email protected] Vilniaus universiteto Medicinos fakulteto Reabilitacijos, sporto medicinos ir slaugos institutas Tikslas: Įvertinti endobronchinių intervencijų svarbą ir galimybes susiaurėjusiam trachėjos ir stambiųjų bronchų spindžiui gydyti. Ligoniai ir metodai: Vilniaus universiteto Onkologijos instituto Krūtinės chirurgijos ir onkologijos skyriuje 2005–2009 metais buvo atliktos 68 endobronchinės trachėjos ir stambiųjų bronchų intervencijos ligoniams, kurių kvėpavimo takų spindis susiaurėjęs: 28 (41 %) atliktas kvėpavimo takų protezavimas, 3 (4,4 %) – kvėpavimo takų tamponavimas dėl ūminio kraujavimo ir gresiančio pavojaus gyvybei, 35 (51 %) – endobronchinė naviko rezekcija ir kvėpavimo takų rekanalizacija, 2 (3,6 %) – pašalintas svetimkūnis iš kvėpavimo takų. Pacientų amžiaus vidurkis buvo apie 63 metus. Gydyta 50 (73,5 %) vyrų ir 18 (26,5 %) moterų, 33 (48,5 %) iš jų sirgo plaučių vėžiu. Rezultatai: Stambiųjų bronchų ir trachėjos spindis buvo susiaurėjęs dėl kelių priežasčių: 33 (48,5 %) ligoniams – dėl plaučių vėžio, 23 (33,8 %) – dėl kitų piktybinių ligų (sėklidžių vėžio, limfomos, inksto vėžio, krūties vėžio) metastazių ar gretimų organų naviko (skydliaukės vėžio, trachėjos vėžio, gerklų vėžio, stemplės vėžio, limfomos) įaugimo, 12 (17,7 %) – dėl nepiktybinių ligų (nepiktybinės trachėjos ligos, tuberkuliozės, nepiktybinės plaučių ligos, nepiktybinės tarpuplaučio ligos, dėl svetimkūnio). Atliekant endobronchinę naviko rezekciją, 35 ligoniams atnaujintas kvėpavimo takų spindis: 3 (8,6 %) – trachėjos, 32 (91,4 %) – stambiųjų bronchų. Dvidešimt aštuoniems ligoniams atlikta endobronchinė naviko rezekcija ir protezuoti kvėpavimo takai: 8 (28,5 %) – bronchų, 8 (28,5 %) – trachėjos, 12 (43 %) naudojant „Y“ protezą atlikta tracheobronchinė jungtis. Trisdešimt trims (48,5%) ligoniams endobronchinė intervencija atlikta dėl plaučių vėžio. Navikus rezekavus, 12 (37 %) ligonių nustatyta plokščialąstelinė karcinoma, 2 (6 %) ligoniams – nesmulkialąstelinė karcinoma, 5 (15 %) – adenokarcinoma, 4 (12 %) – smulkialąstelinė karcinoma, 4 (12 %) – atipinis karcinoidas, 6 (18 %) – tiriant rezekuotus audinius naviko diagnozė morfologiškai nepatvirtinta dėl naviko nekrozės ir storo fibrino sluoksnio. Trys (4,4 %) ligoniai po intervencijos mirė. 65 (95,6 %) ligoniams atlikus intervenciją pagerėjo gyvenimo kokybė, išnyko dusulys ir švokštimas alsuojant. Ankstyvuoju pooperaciniu laikotarpiu 25 (37 %) ligoniams atsirado nepageidaujamų reiškinių, dėl kurių reikėjo papildomų intervencijų: 2 – koreguoti protezą, 23 – siurbti sekretą iš kvėpavimo takų. Išvada: Endobronchinė intervencija dėl susiaurėjusio apatinių kvėpavimo takų spindžio yra saugus ir patikimas paliatyviojo gydymo būdas, kai radikalusis gydymas negalimas dėl sunkios bendrosios būklės, gretutinių ligų ar senyvo amžiaus. Reikšminiai žodžiai: endobronchinė intervencija, kvėpavimo takų protezavimas, kvėpavimo takų naviko rezekcija. Treatment of stenosis of trachea and large bronchi Renatas Aškinis1, Saulius Cicėnas1,2, Valdas Puodžiūnas1, Arnoldas Krasauskas1, Sigitas Zaremba11 Vilnius University, Institute of Oncology, Department of Thoracic sSurgery and Oncology, Santariškių str. 1,LT-08660 Vilnius, Lithuania E-mail: [email protected] Vilnius University, Faculty of Medicine, Institute of Rehabilitation, Sport Medicine and nursing Objective: To evaluate the role and possibilities of endobronchial procedures during the treatment of stenosis of trachea and large bronchi. Patients and methods: At the Department of Thoracic Surgery and Oncology, Institute of Vilnius university, from 2005 to 2009 there were performed 68 endobronchial procedures of trachea and large bronchi for patients suffering from airway stenosis: 28 (41 %) airway stenting, 3 (4.4 %) airway tamponade because of sudden bleeding and life threatening risk, 35 (51 %) endobronchial tumour resection and recanalisation of lumen, 2 (3.6 %) foreign body removed from the airway. The mean of age patients was 63 years. There were 50 (73.5 %) males and 18 (26.5 %) females. 33 (48.5 %) patients had lung cancer. Results: Stenosis of large bronchi and trachea lumen was due to several reasons: in 33 (48.5 %) patients it was lung cancer, in 23 (33.8 %) patients – metastases from other malignant diseases or penetration from adjacent organs (testicular cancer, thyroid cancer, lymphoma, renal cancer, tracheal cancer, laryngeal cancer, esophageal cancer, breast cancer), in 12 (17.7 %) patients – for non- malignant reasons (benign tracheal disease, tuberculosis, benign lung disease, benign mediastinal disease, foreign body). For 35 patients, airway recanalisation was achieved by endobronchial tumour resection: 3 (8.6 %) patients – trachea, 32 (91.4 %) patients – large bronchi. For 28 patients, endobronchial turmour resection and airway stenting were performed: for 8 (28.5 %) patients a stent was placed in large bronchi, 8 (28.5 %) patients in the trachea, and 12 (43 %) patients were treated by placing “Y” stent at the tracheobronchial junction. For 33 (48.5 %) patients, endobronchial interventions were performed due to lung cancer. After tumour resection, in 12 (37 %) patients squamous cell carcinoma, in 2 (6 %) patients non-small cell lung cancer, in 5 (15 %) patients adenocarcinoma, in 4 (12 %) patients small cell carcinoma, in 4 (12 %) patients atypic carcinoid were diagnosed, in 6 (18%) patients the morphologic diagnosis was not confirmed because of tumour necrosis and a large fibrin layer. 3 (4.4 %) patients died after the intervention. After interventions, 65 (95.6 %) patients felt improvement of the quality of life, shortness of breath and stridor disappeared. 25 (37 %) patients during the early postoperative period needed additional interventions: for 2 patients correction of the stent position was perfomed, 23 patients required further bronchoscopies to evacuate secretion. Conclusion: Endobronchial intervention due to inferior airway stenosis is a safe and reliable method of palliative treatment when radical treatment is not possible because of poor condition, comorbidity or advanced age. Keywords: endobronchial intervention, airway stenting, airway tumour resection and recanalisation.

A re-evaluation of squamous cell carcinoma antigen (SCC) as a serum marker for non-small cell lung cancer

2007 ◽  
Vol 25 (2) ◽  
pp. 187-189 ◽  
Author(s):  
Katsunori Kagohashi ◽  
Hiroaki Satoh ◽  
Hiroichi Ishikawa ◽  
Morio Ohtsuka ◽  
Kiyohisa Sekizawa
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Small Cell Lung Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cell Lung Cancer ◽  
Serum Marker ◽  
Small Cell ◽  
Squamous Cell Carcinoma Antigen ◽  
Small Cell Lung

scholarly journals Epidemiologic trends in lung cancer over two decades in Northern Greece: an analysis of bronchoscopic data

2016 ◽  
Vol 71 (4) ◽  
Author(s):  
T. Kontakiotis ◽  
N. Manolakoglou ◽  
F. Zoglopitis ◽  
D. Iakovidis ◽  
L. Sacas ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Small Cell Lung Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Northern Greece ◽  
Female Ratio

Background and Aim. The relative frequency of histological subtypes of lung cancer in Europe has changed dramatically during the 20th century. The aim of this study was to explore the changing epidemiology of lung cancer in Northern Greece over the last two decades. Methods. From the extensive database of the Bronchoscopy Unit of the G. Papanicolaou General Hospital, Thessaloniki, Greece, we identified all patients with a histologic and/or cytologic report positive for lung cancer over two consecutive decades. Results. Between 1/1/1986 and 31/12/2005 we identified 9981 patients with specimens positive for lung cancer. A significant increase in mean patient age was observed during the second decade (64.8±9.4 vs. 62.1±8.9, p=0.001). Men developed lung cancer ten times more often than women. The predominant histological type was squamous cell cancer in males (4203 cases, 45.7%) and adenocarcinoma (418 cases, 52.6%) in females. The number of lung cancer cases was significantly higher during the second decade compared to the first decade (5766 cases [57.8%] vs. 4215 cases [42.2%], respectively, p<0.001). There was a significant decrease in the percentage of squamous cell carcinoma in males in the second decade (2317 cases [44.1%] vs. 1886 cases [48.0%], p<0.001), and an increase in adenocarcinoma (1021 cases [19.4%] vs. 609 [11.6%], p<0.001). In females, the relative incidence of adenocarcinoma was decreased and that of squamous cell carcinoma was increased, but not significantly. There was no obvious change in the incidence of small cell lung cancer. Neoplastic lesions were most often located in the upper lobes. Conclusion. The number of lung cancer cases has increased in the last decade. Squamous lung cancer appears to be decreasing in men and increasing in women. Adenocarcinoma appears to be increasing in men and decreasing in women. There appears to be no change in small cell lung cancer. During the second decade there has been a significant decrease in the male: female ratio.

scholarly journals Predictors of immunotherapy-induced immune-related adverse events

2018 ◽  
Vol 25 (5) ◽  
Author(s):  
A. Kartolo ◽  
J. Sattar ◽  
V. Sahai ◽  
T. Baetz ◽  
J. M. Lakoff
Keyword(s):  
Lung Cancer ◽  
Renal Cell Carcinoma ◽  
Adverse Events ◽  
Small Cell Lung Cancer ◽  
Cell Carcinoma ◽  
Cell Lung Cancer ◽  
Renal Cell ◽  
Small Cell ◽  
Small Cell Lung ◽  
Goodness Of Fit Test

Purpose We aimed to elucidate predictive factors for the development of immune-related adverse events (iraes) in patients receiving immunotherapies for the management of advanced solid cancers.Methods This retrospective study involved all patients with histologically confirmed metastatic or inoperable melanoma, non-small-cell lung cancer, or renal cell carcinoma receiving immunotherapy at the Cancer Centre of Southeastern Ontario. The type and severity of iraes, as well as potential protective and exacerbating factors, were collected from patient charts.ResultsThe study included 78 patients receiving ipilimumab (32%), nivolumab (33%), or pembrolizumab (35%). Melanoma, non-small-cell lung cancer, and renal cell carcinoma accounted for 70%, 22%, and 8% of the cancers in the study population. In 41 patients (53%) iraes developed, with multiple iraes developing in 12 patients (15%). In most patients (70%), the iraes were of severity grade 1 or 2. Female sex [adjusted odds ratio (oradj): 0.094; 95% confidence interval (ci): 0.021 to 0.415; p = 0.002] and corticosteroid use before immunotherapy (oradj: 0.143; 95% ci: 0.036 to 0.562; p = 0.005) were found to be associated with a protective effect against iraes. In contrast, a history of autoimmune disease (oradj: 9.55; 95% ci: 1.34 to 68.22; p = 0.025), use of ctla-4 inhibitors (oradj: 6.25; 95% ci: 1.61 to 24.25; p = 0.008), and poor kidney function of grade 3 or greater (oradj: 10.66; 95% ci: 2.41 to 47.12; p = 0.025) were associated with a higher risk of developing iraes. A Hosmer–Lemeshow goodness-of-fit test demonstrated that the logistic regression model was effective at predicting the development of iraes (chi-square: 1.596; df = 7; p = 0.979).Conclusions Our study highlights several factors that affect the development of iraes in patients receiving immunotherapy. Although future studies are needed to validate the resulting model, findings from the study can help to guide risk stratification, monitoring, and management of iraes in patients given immunotherapy for advanced cancer.

Non-Small Cell Lung Cancer with Ipsilateral Intrapulmonary Metastasis

2000 ◽  
Vol 8 (2) ◽  
pp. 141-145
Author(s):  
Mitsuhiro Kamiyoshihara ◽  
Osamu Kawashima ◽  
Shuji Sakata ◽  
Susumu Ishikawa ◽  
Yasuo Morishita
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Blood Vessel ◽  
Small Cell Lung Cancer ◽  
Cell Carcinoma ◽  
Pulmonary Metastasis ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Blood Vessel Invasion ◽  
Small Cell Lung

From 1981 through 1997, lobectomy or pneumonectomy with mediastinal lymph node dissection was performed in 604 patients with non-small cell lung cancer, of whom 42 (7%) were diagnosed as having ipsilateral pulmonary metastasis. There were 23 males and 19 females, the mean age was 66 years. Lobectomy was carried out in 37 cases and pneumonectomy in 5. Postoperative histology identified 29 adenocarcinomas, 11 squamous cell carcinomas, 1 large cell carcinoma, and 1 adenosquamous cell carcinoma. Two cases were classified as pathologic stage I, 1 as stage II, 26 as IIIA, and 13 as IIIB. Blood vessel invasion was present in 33 cases and absent in 2 cases. Five and 10-year survival rates were 34.3% and 17.1%, respectively. Patients with pulmonary metastasis had a poorer prognosis than those without metastasis; there were local recurrences in 6 patients, distant metastases in 9, and 15 deaths. There were no significant differences in recurrence sites between patients with and without pulmonary metastasis. Multivariate analysis showed that lymph node involvement and blood vessel invasion were useful prognostic factors. Ipsilateral pulmonary metastasis in the same lobe was regarded as local invasion for which surgical resection is the optimal treatment.

scholarly journals Type and mode of diagnosis of carcinoma lung in a tertiary care centre: one year experience

2017 ◽  
Vol 5 (11) ◽  
pp. 4891
Author(s):  
Jayaprakash Balakrishnan ◽  
Sindhu Nair Prasannakumari ◽  
Ajith Achuthan ◽  
John Mathew
Keyword(s):  
Lung Cancer ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Tertiary Care ◽  
Small Cell ◽  
Common Type ◽  
Ultra Sound ◽  
Tertiary Care Centre ◽  
Easy Method ◽  
One Year

Background: Lung cancer is one of the commonest cancers and cause of cancer related deaths all over the world. The reported incidence of adenocarcinoma is increasing globally and now reported to be the most common type of lung cancer. A panel of investigations are used for the diagnosis of lung cancer. Hence a study was planned to find out the pattern of malignancy and the most appropriate investigation for diagnosis. Objective of present study was to find out the type of carcinoma lung and to find out the best and easy method for diagnosis of carcinoma lung in a tertiary care centre.Methods: A hospital based cross sectional study was conducted in one unit of the Department of Pulmonary Medicine, Government Medical college, Thiruvananthapuram for a period of one year.148 diagnosed cases of carcinoma lung were enrolled. The type and the methods used for diagnosis were analysed.Results: Adenocarcinoma was the commonest malignancy 57 (38.5%), followed by squamous cell carcinoma 44 (29.7%) and small cell carcinoma 10 (6.75%). Rest of the cases 37 (25%) include non small cell carcinoma, poorly differentiated carcinoma and lymphoma. Diagnosis was established by FNA Lung in 46 (31.1%) patients and bronchoscopy and biopsy in 41 (27.7%). Other methods include TBNA 12 (8.1%), lymph node FNA/biopsy 11 (7.4%), pleural fluid cytology 24 (16.2%), sputum cytology and tru cut biopsy 14 (9.5%).Conclusions: The most common type of lung malignancy in present study was adenocarcinoma. Ultra sound guided FNAC lung and bronchoscopy biopsy were the best methods in present study to confirm the diagnosis.

scholarly journals Overall survival of patients with non-small cell lung cancer after surgery treatment

2018 ◽  
Vol 75 (12) ◽  
pp. 1157-1164
Author(s):  
Olivera Loncarevic ◽  
Slobodan Acimovic ◽  
Jelena Vukovic ◽  
Marko Stojisavljevic ◽  
Nebojsa Maric ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Small Cell ◽  
The Other ◽  
Small Cell Lung ◽  
Cumulative Survival ◽  
Recurrence Group

Background/Aim. Lung cancer is one of the most common malignant tumors. About 80% of all lung cancers are non-small cell lung cancer (NSCLC). According to histopathological characteristics, the most common types of NSCLC are squamous cell carcinoma and adenocarcinoma. The aim of this study was to evaluate the overall survival rate in the NSCLC patients initially received surgery according to its histopathological type and T ? primary tumor, N ?regional lymph nodes, M ? distant metastasis (TNM) stages which were treated with surgical treatment, and after that, according to the TNM stage, chemotherapy protocols and/or radiation therapy. Methods. This retrospective case series study included all patients with NSCLC admitted to the Military Medical Academy in Belgrade in the period 2010?2015. A total number of selected patients was 85 (27 females and 58 males). Results. Out of 41 patients with squamous cell carcinoma, 19.5% deceased. On the other hand, in the group of patients with adenocarcinoma, 43.2% out of 44 patients deceased. The average cumulative survival was statistically significantly lower in the adenocarcinoma patients in comparison to the patients with squamous cell carcinoma (1,605.2 vs.1,304.8 days; p = 0.005). On the other hand, the average cumulative survival was statistically significantly lower in our patients in the recurrence group with adenocarcinoma in comparison to the recurrence group with squamous cell carcinoma (1,212.8 vs. 1,835.5 days; p = 0.032). Conclusion. Adenocarcinoma is more aggressive cancer in comparing to squamous cell carcinoma with lower overall survival in comparing to squamous cell carcinoma. Additional studies are needed to identify risk factors for recurrence after surgery, and to additionally explain role of tumor markers and molecular biological techniques in the progression of this kind of cancer.

scholarly journals Mutation profile of non-small cell lung cancer revealed by next generation sequencing

2020 ◽  
Author(s):  
Ya-Sian Chang ◽  
Siang-Jyun Tu ◽  
Yu-Chia Chen ◽  
Ting-Yuan Liu ◽  
Ya-Ting Lee ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
Small Cell Lung Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cell Lung Cancer ◽  
Targeted Therapies ◽  
Small Cell ◽  
Small Cell Lung ◽  
Whole Exome

Abstract Background: Precision therapy for lung cancer requires comprehensive genomic analyses. Specific effects of targeted therapies have been reported in Asia populations, including Taiwanese, but genomic studies have rarely been performed in these populations. Method: We enrolled 72 patients with non-small cell lung cancer, of whom 61 had adenocarcinoma, 10 had squamous cell carcinoma, and 1 had combined adenocarcinoma and squamous cell carcinoma. Whole-exome or targeted gene sequencing was performed. To identify trunk mutations, we performed whole-exome sequencing in two tumor regions in four patients. Results: Nineteen known driver mutations in EGFR, PIK3CA, KRAS, CTNNB1, and MET were identified in 34 of the 72 tumors evaluated (47.22%). A comparison with the Cancer Genome Atlas dataset showed that EGFR was mutated at a much higher frequency in our cohort than in Caucasians, whereas KRAS and TP53 mutations were found in only 5.56% and 25% of our Taiwanese patients, respectively. We also identified new mutations in ARID1A, ARID2, CDK12, CHEK2, GNAS, H3F3A, KDM6A, KMT2C, NOTCH1, RB1, RBM10, RUNX1, SETD2, SF3B1, SMARCA4, THRAP3, TP53, and ZMYM2. Moreover, all ClinVar pathogenic variants were trunk mutations present in two regions of a tumor. RNA sequencing revealed that the trunk or branch genes were expressed at similar levels among different tumor regions.Conclusions: We identified novel variants potentially associated with lung cancer tumorigenesis. The specific mutation pattern in Taiwanese patients with non-small cell lung cancer may influence targeted therapies.

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