Chemotherapy for Adenocarcinoma and Alveolar Cell Carcinoma
|
|
- Gwendoline Matthews
- 6 years ago
- Views:
Transcription
1 Chemotherapy for Adenocarcinoma and Alveolar Cell Carcinoma of the Lung Scott L. Faulkner, M.D., R. Benton Adkins, Jr., M.D., and Vernon H. Reynolds, M.D. ABSTRACT Ten patients with inoperable or recurrent adenocarcinoma or alveolar cell carcinoma of the lung have been treated with 5-fluorouracil (5-FU). Four of the patients treated with this drug had a marked objective and subjective response. Although 5-FU has not had a measurable effect on bronchogenic carcinoma in general, reappraisal with particular attention to adenocarcinoma and alveolar cell carcinoma seems warranted. M any factors influence the prognosis for patients with adenocarcinoma or alveolar cell carcinoma of the lung; these include the duration of symptoms, degree of cellular differentiation, extent of the primary lesion, and metastatic disease. Both neoplasms may appear as a solitary lesion, in which case there is a high resectability rate and 5-year cure rate [5, 7, 8, 121. However, many patients exhibit diffuse intrapulmonary disease, bilateral pulmonary lesions, pleural effusions, or extrathoracic metastases. Most of this latter group of patients are inoperable and die from their disease within 1 to 2 years [lo, 141. Neither radiotherapy nor chemotherapy has been beneficial in this group of patients to date [3, 71. Recently we have been impressed by the response of 4 patients with either adenocarcinoma or alveolar cell carcinoma to intravenously administered 5-fluorouracil (5-FU), although this antimetabolite has proved ineffective for treatment of bronchogenic carcinoma in general [6]. After considering the success of 5-FU in the treatment of metastatic adenocarcinoma of the breast and gastrointestinal tract [l], a more thorough evaluation of this drug in adenocarcinoma of the lung seems justified. Case Reports PATIENT 1 A 54-year-old woman was seen with bilateral lower lobe infiltrates and pleural effusions (Fig. 1). A lung biopsy demonstrated alveolar cell From the Depa.rtment of Surgery, Vanderbilt University Hospital. Nashville, Tenn. This investigation was supported in part by N.I.H. Training Grant no. GM from the National Institute of General Medical Sciences. Accepted for publication June 6, Address reprint requests to Dr. Faulkner, Department of Surgery, Vanderbilt IJniveraity School of Medicine, Nashville, Tenn THE ANNALS OF THORACIC SURGERY
2 Chemotherapy for Carcinoma of the Lung FIG. 1. (Patient I.} (A} Admission chest roentgenogram demonstrates bilateral lower lobe infiltrates and pleural effusions. (B} Four months following initiation of 5-fluorouracil (5-FU} therah the infiltrates and pleural effusions have regressed. (C) The follow-up chest roentgenogram 2 years after initiation of 5-FU therapy is essentially normal. carcinoma, and a regimen of 5-FU was begun. The pleural effusions and infiltrates disappeared in 4 months (Fig. lb, C) and did not recur until 27 months following the initiation of chemotherapy. She subsequently developed cutaneous and bone metastases and recurrence of pleural effusions. PATIENT 2 A 42-year-old man was seen initially with a right upper lobe coin lesion, malignant pleural effusion, and metastases of poorly differentiated adenocarcinoma to axillary and cervical lymph nodes as well as metastatic cutaneous nodules. The patient was severely dyspneic on admission and was started on 5-FU. Over the next 6 months the patient s dyspnea disappeared, he gained weight, and the pleural effusions and pulmonary infiltrates disappeared. Eight months after the initiation of chemotherapy, however, the patient s general condition deteriorated, with enlargement of skin lesions and lymph nodes; he died within 2 months. PATIENT 3 A 45-year-old man was first seen with a right upper lobe coin lesion, bilateral hazy infiltrates, and bilateral axillary node metastases (Fig. 2A). Axillary node biopsy demonstrated adenocarcinoma. Over the next 8 months, while he was receiving 5-FU, the axillary nodes disappeared and the coin lesion decreased 50% in size (Fig. 2B). After 8 months the coin lesion began to increase slightly in size, although the patient has remained asymptomatic to date. PATIENT 4 A 59-year-old woman underwent a left upper lobectomy for adenocarcinoma of the lung with regional lymph node involvement. Six years later the patient presented with bilateral pulmonary nodules as well as an osteolytic VOL. 18, NO. 6, DECEMBER,
3 FAULKNER, ADKINS, AND REYNOLDS FIG. 2. (Patient 3.) (A) Admission chest roentgenogram demonstrates a small right upper lobe coin lesion and bilateral infiltrates. (B) Eight months after 5-fluorouracil therah was begun, the infiltrates have cleared and the coin lesion has decreased 50% in size. metastasis to the fourth thoracic vertebra (Fig. 3A). After 5-FU was started, her chronic cough disappeared and the pulmonary nodules decreased in size by approximately 50% (Fig. 3B). One and a half years after the 5-FU therapy was started the pulmonary nodules increased in size, and the patient died 4 months later. PATIENT 5 A 60-year-old woman was first seen with dyspnea, substernal pain, and bilateral multinodular pulmonary infiltrates. Biopsy of a scalene node FZG. 3. (Patient 4.) (A) Admission chest roentgenogram demonstrates multiple bilateral metastatic pulmonary adenocarcinoma. (B) After intravenous administration of 5- fluorouracil weekly over the ensuing 6 months, the pulmonary lesions have decreased approximately 50% in size. 580 THE ANNALS OF THORACIC SURGERY
4 Chemotherapy for Carcinoma of the Lung demonstrated adenocarcinoma compatible with a primary adenocarcinoma of the lung. Over the first 2 months of 5-FU therapy the multinodular infiltrates became less distinct. During the third month of therapy the patient died secondary to central nervous system metastases. Five other patients have been treated with 5-FU. This group includes 2 patients with alveolar cell carcinoma and 3 with adenocarcinoma. One patient in each group had a primary diffuse neoplasm and extrathoracic metastases when first seen. The remaining 3 developed recurrence of their tumors less than 3 years following resection for solitary tumors. Each of the 5 patients received 5-FU for 3 to 6 months without measurable effect. One patient became less dyspneic subjectively, but the chest roentgenogram remained unchanged. Comment Ten patients with either adenocarcinoma or alveolar cell carcinoma of the lung who were treated with 5-FU have been presented. In order to place the experience with these patients in perspective, our total experience with these two neoplasms was reviewed. Between 1950 and 1972, 58 patients with adenocarcinoma and 54 with alveolar cell carcinoma of the lung were evaluated at the Vanderbilt University Affiliated Hospitals. Overall, patients with adenocarcinoma had a 15% 5-year survival rate, and patients with alveolar cell carcinoma had a 5-year survival rate of 12%; the majority of patients with either tumor failed to survive 2 years. In this latter group, the average survival for patients with adenocarcinoma was 7.0 months and for alveolar cell carcinoma 5.4 months. Of the 10 patients with adenocarcinoma who survived more than 2 years, only 3 died as a result of their tumor (at 2%, 7, and 8 years, respectively, following initial treatment). Of those 11 patients with alveolar cell carcinoma who survived more than 2 years, only 3 died of recurrent disease at 3%, 4, and 4% years, respectively. Four out of 10 patients (40y0) whose lesions were considered inoperable or who developed recurrent tumor had a significant objective and subjective remission while being maintained on 5-FU. The remission experienced by Patient 2 was only of short duration but was the most marked subjectively; his dyspnea, anorexia, weakness, and fatigue markedly improved for 6 months. At postmortem examination he had metastatic adenocarcinoma in both lungs, the pleura, chest wall, diaphragm, pericardium, mediastinal and mesenteric lymph nodes, liver, adrenal glands, brain, and kidney. Another patient (Patient 3) demonstrated an objective decrease in the size of both his primary tumor and axillary nodes for 8 months. The most dramatic objective remissions occurred in Patients 1 and 4: in Patient 1 bilateral infiltrates disappeared for 2 years, and in Patient 4 the pulmonary metastases markedly diminished for 1% years. Patient 5 had only a transient response. VOL. 18, NO. 6, DECEMBER,
5 FAULKNER, ADKINS, AND REYNOLDS The lesions in all these patients eventually became refractory to 5-FU. The remaining 5 patients demonstrated no response to therapy. Our treatment protocol for 5-FU has been described by VanWay and associates [13]. The patient is given a loading dose of intravenous 5-FU, 12 mg. per kilogram of body weight daily for four days, and then 12 mg./kg. once a week. All patients responded to the 5-FU with a mild leukopenia; in only 1 patient did the leukocyte count drop below 3,000 cells per cubic millimeter, but this was corrected simply by withholding 5-FU for 2 weeks. Chemotherapy for advanced or inoperable bronchogenic carcinoma has failed to demonstrate a significant increase in survival statistics [2]. When disease appears to be limited to one hemithorax, radiotherapy alone is as effective as several chemotherapeutic agents used alone or in combination with radiotherapy [2]. However, if all cases of lung cancer are evaluated with relationship to cell type, slightly different conclusions are possible. For squamous cell carcinoma, mechlorethamine causes a small increase in median survival over controls [2]. Cyclophosphamide appears to increase median survival time in patients with oat cell carcinoma [4]. Selawry [12] reports objective remission rates of 20 to 32y0 in patients with adenocarcinoma who were treated with methotrexate, mechlorethamine, mitomycin C, chloroethyl cyclohexyl nitrosourea, and hexamethylmelamine. In patients with bronchogenic carcinoma 5-FU has an objective remission rate of 6y0 [6]. This is the same as in the placebo-treated group in a controlled study of benefits of postoperative radiotherapy [9]. However, few reports on the efficacy of 5-FU specify cell type. In approximately 25y0 of patients with metastatic cancer of the breast and gastrointestinal tract, 5-FU has proved an effective palliating agent [ 11. Although this communication describes the responses of only 10 patients, the good results (objective remission in 40y0) as well as the demonstrated success of 5-FU in other adenocarcinomas suggest that continued trials in adenocarcinoma and alveolar cell carcinoma of the lung must be carried out. References 1. Ansfeld, F. J. Chemotherapy of Disseminated Solid Tumors. Springfield, Ill.: Thomas Carbone, P. P., Frost, J. K., Feinstein, A. R., Higgins, G. A., Jr., and Selawry, 0. S. Lung cancer: Perspectives and prospects. Ann. Intern. Med. 73:1003, Golbey, R. B., and Karnovsky, D. A. Types and Techniques of Chemotherapy. In W. L. Watson (Ed.), Lung Cancer: A Study of Five Thousand Memorial Hospital Cases. St. Louis: Mosby, P Greene, R., Humphrey, E., and Close, H. Alkylating agents in bronchogenic carcinoma. Am. J. Med. 46:576, Jackman, R. J., Good, C. A., Clagett, 0. T., and Woolner, L. B. Survival rates in peripheral bronchogenic carcinoma up to 4 cm. in diameter presenting as solitary pulmonary nodules. J. Thorac. Cardiovnsc. Szrrg. 57:1, Livingston, R. B., and Carter, S. K. Single Agents in Concer Chemotherapy. New York: Plenum, Pp THE ANNALS OF THORACIC SURGERY
6 Chemotherapy for Curcinomu of the Lung 7. McNamara, J. J., Kingsley, W. B., Paulson, D. L., Arndt, J. H., Salinas- Izaquiree, S. F., and Urschel, H. C., Jr. Alveolar cell (bronchiolar) carcinoma of the lung. J. Thorac. Cardiovasc. Surg. 57:648, Munnell, E. R., Lawson, R. C., and Keller, D. F. Solitary bronchiolar carcinoma of the lung. J. Thorac. Cardiovasc. Surg , Roswit, B., Patno, M. E., Rapp, R., Veinberg, A., Feder, B., Stahlberg, J., and Reid, C. B. The survival of patients with inoperable lung cancer: A large scale randomized study of radiation therapy versus placebo. Radiology 90:688, Sasser, W. F., Bennett, D. E., Ferguson, T. B., and Burford, T. H. Primary adenocarcinoma of the lung in men. Ann. Thorac. Surg. 5:508, Selawry, 0. S. Monochemotherapy of bronchogenic carcinoma with special reference to cell type: 111. Cancer Chemother. Rep. 4: 177, Steele, J. D., and Buell, P. Survival in bronchogenic carcinomas resected as solitary pulmonary nodules. Proc. Natl. Cancer Conf. (sixth), P VanWay, C. W., 111, and Reynolds, V. H. A new method for treatment of carcinoma of the breast and colon with 5-fluorouracil. Am. Surg. 36:210, Viragh, Z., and Woods, J. R. Alveolar carcinoma of the lung. Med. Thorac. (Basel) 19: 129, VOL. 18, NO. 6, DECEMBER,
Carcinoma of the Lung
THE ANNALS OF THORACIC SURGERY Journal of The Society of Thoracic Surgeons and the Southern Thoracic Surgical Association VOLUME 1 I - NUMBER 3 0 MARCH 1971 Carcinoma of the Lung M. L. Dillon, M.D., and
More informationBronchogenic Carcinoma
A 55-year-old construction worker has smoked 2 packs of ciggarettes daily for the past 25 years. He notes swelling in his upper extremity & face, along with dilated veins in this region. What is the most
More informationTreatment of Inoperable Lung Carcinoma: A Combined Modality Approach
Treatment of Inoperable ung Carcinoma: A Combined Modality Approach Hiroshi Takita, M.D., Ariel C. Hollinshead, h.d., Donna J. Rizzo, R.N., Christine M. Kramer, M.S., Tah Y. Chen, M.D., Joginder N. Bhayana,
More informationTumour size as a prognostic factor after resection of lung carcinoma
Tumour size as a prognostic factor after resection of lung carcinoma A. S. SOORAE AND R. ABBEY SMITH Thorax, 1977, 32, 19-25 From the Cardio-Thoracic Unit, Walsgrave Hospital, Clifford Bridge Road, Coventry
More informationCauses of Treatment Failure and Death in Carcinoma of the Lung
THE YALE JOURNAL OF BIOLOGY AND MEDICINE 54 (1981), 201-207 Causes of Treatment Failure and Death in Carcinoma of the Lung JAMES D. COX, M.D.,a AND RAYMOND A. YESNER, M.D.b The Medical College of Wisconsin,
More informationFifteen-year follow-up of all patients in a study of
Br. J. Cancer (1985), 52, 867-873 Fifteen-year follow-up of all patients in a study of post-operative chemotherapy for bronchial carcinoma D.J. Girling, H. Stott, R.J. Stephens & W. Fox Medical Research
More informationSite of Recurrence in Patients. of the Lung Resected for Cure. with Stages I and I1 Carcinoma
Site of Recurrence in Patients with Stages I and I1 Carcinoma of the Lung Resected for Cure Steven C. Immerman, M.D., Robert M. Vanecko, M.D., Willard A. Fry, M.D., Louis R. Head, M.D., and Thomas W. Shields,
More informationPreferred Surgical Treatment for Alveolar Cell Caranoma
Preferred Surgical Treatment for Alveolar Cell Caranoma Edwin C. James, LTC, George F. Schuchmann, LTC, Roger V. Hall, MAJ, James R. Patterson, MAJ, James T. Gillespie, COL, and Alphonse C. Gomez, COL,
More informationRespiratory Interactive Session. Elaine Borg
Respiratory Interactive Session Elaine Borg Case 1 Respiratory Cytology 55 year old gentleman Anterior mediastinal mass EBUS FNA Case 1 Respiratory Cytology 55 year old gentleman with anterior mediastinal
More informationLung Cancer Imaging. Terence Z. Wong, MD,PhD. Department of Radiology Duke University Medical Center Durham, NC 9/9/09
Lung Cancer Imaging Terence Z. Wong, MD,PhD Department of Radiology Duke University Medical Center Durham, NC 9/9/09 Acknowledgements Edward F. Patz, Jr., MD Jenny Hoang, MD Ellen L. Jones, MD, PhD Lung
More informationChirurgie beim oligo-metastatischen NSCLC
24. Ärzte-Fortbildungskurs in Klinischer Onkologie 20.-22. Februar 2014, Kantonsspital St. Gallen Chirurgie beim oligo-metastatischen NSCLC Prof. Dr. med. Walter Weder Klinikdirektor Thoraxchirurgie, UniversitätsSpital
More informationTHORACIC MALIGNANCIES
THORACIC MALIGNANCIES Summary for Malignant Malignancies. Lung Ca 1 Lung Cancer Non-Small Cell Lung Cancer Diagnostic Evaluation for Non-Small Lung Cancer 1. History and Physical examination. 2. CBCDE,
More informationRadiology Pathology Conference
Radiology Pathology Conference Sharlin Johnykutty,, MD, Cytopathology Fellow Sara Majewski, MD, Radiology Resident Friday, August 28, 2009 Presentation material is for education purposes only. All rights
More informationNew lung lesion in a 55 year-old male treated with chemoradiation for non-small cell lung carcinoma
July 2016 New lung lesion in a 55 year-old male treated with chemoradiation for non-small cell lung carcinoma Contributed by: Laurel Rose, MD, Resident Physician, Indiana University School of Medicine,
More informationThe Spectrum of Management of Pulmonary Ground Glass Nodules
The Spectrum of Management of Pulmonary Ground Glass Nodules Stanley S Siegelman CT Society 10/26/2011 No financial disclosures. Noguchi M et al. Cancer 75: 2844-2852, 1995. 236 surgically resected peripheral
More informationcame from a carcinoma and in 12 from a sarcoma. Ninety lesions were intrapulmonary and the as the chest wall and pleura. Details of the primary
Thorax 1982;37:366-370 Thoracic metastases MARY P SHEPHERD From the Thoracic Surgical Unit, Harefield Hospital, Harefield ABSTRACI One hundred and four patients are reviewed who were found to have thoracic
More informationCASE REPORT. Introduction. Case series reports. J Thorac Dis 2012;4(S1): DOI: /j.issn s003
CASE REPORT Lost in time pulmonary metastases of renal cell carcinoma: complete surgical resection of metachronous metastases, 18 and 15 years after nephrectomy Kosmas Tsakiridis 1, Aikaterini N Visouli
More informationPrimary Tumors of Ribs
Primary Tumors of Ribs Frank E. Schmidt, M.D., and Max J. Trummer, Capt, MC, USN ABSTRACT An analysis of 50 consecutive patients with primary rib tumors operated on at the U.S. Naval Hospital, San Diego,
More informationThe Value of Adjuvant Radiotherapy in Pulmonary and Chest Wall Resection for Bronchogenic Carcinoma
The Value of Adjuvant Radiotherapy in Pulmonary and Chest Wall Resection for Bronchogenic Carcinoma G. A. Patterson, M.D., R. Ilves, M.D., R. J. Ginsberg, M.D., J. D. Cooper, M.D., T. R. J. Todd, M.D.,
More informationClinical Staging and the Tendency of Malignant Pleural Mesotheliomas to Remain Localized
Clinical Staging and the Tendency of Malignant Pleural Mesotheliomas to Remain Localized Russell J. Nauta, M.D., Robert T. Osteen, M.D., Karen H. Antman, M.D., and J. Kenneth Koster, M.D. ABSTRACT Thirty-two
More informationPET CT for Staging Lung Cancer
PET CT for Staging Lung Cancer Rohit Kochhar Consultant Radiologist Disclosures Neither I nor my immediate family members have financial relationships with commercial organizations that may have a direct
More informationMolly Boyd, MD Glenn Mills, MD Syed Jafri, MD 1/1/2010
LSU HEALTH SCIENCES CENTER NSCLC Guidelines Feist-Weiller Cancer Center Molly Boyd, MD Glenn Mills, MD Syed Jafri, MD 1/1/2010 Initial Evaluation/Intervention: 1. Pathology Review 2. History and Physical
More informationThe Role of Radiation Therapy
The Role of Radiation Therapy and Surgery in the Treatment of Bronchogenic Carcinoma R Adams Cowley, M.D., Morris J. Wizenberg, M.D., and Eugene J. Linberg, M.D. A study of the combined use of preoperative
More informationAmerican College of Radiology ACR Appropriateness Criteria
American College of Radiology ACR Criteria Radiologic Management of Thoracic Nodules and Masses Variant 1: Middle-aged patient (35 60 years old) with an incidental 1.5-cm lung nodule. The lesion was smooth.
More informationAggressive Slurgical Management of Testicular Carcinoma Metastatic to Lungs and Mediastinurn
Aggressive Slurgical Management of Testicular Carcinoma Metastatic to Lungs and Mediastinurn Isadore Mandelbaum, M.D., Stephen D. Williams, M.D., and Lawrence H. Einhorn, M.D. ABSTRACT During the past
More informationBoot Camp Case Scenarios
Boot Camp Case Scenarios Case Scenario 1 Patient is a 69-year-old white female. She presents with dyspnea on exertion, cough, and right rib pain. Patient is a smoker. 9/21/12 CT Chest FINDINGS: There is
More informationRapidly Progressive Skin Metastasis in EGFR Wild and ALK Fusion Negative Adenocarcinoma Lung: An Unusual Presentation
Human Journals Research Article April 2017 Vol.:6, Issue:2 All rights are reserved by Dr Venkata Pradeep Babu Koyyala et al. Rapidly Progressive Skin Metastasis in EGFR Wild and ALK Fusion Negative Adenocarcinoma
More informationBronchiolar Carcinoma (Alveolar Cell), Another Great Imitator; A Review of 41 Cases*
Bronchiolar Carcinoma (Alveolar Cell), Another Great Imitator; A Review of Cases* Louis G. Ludington, M.D., F.C.C.P.;oo Joseph J. Verska, M.D., F.C.C.P.;t Thora Howard, M.D.;:!: George Kypridakis, M.D.;
More informationGUIDELINES FOR CANCER IMAGING Lung Cancer
GUIDELINES FOR CANCER IMAGING Lung Cancer Greater Manchester and Cheshire Cancer Network Cancer Imaging Cross-Cutting Group April 2010 1 INTRODUCTION This document is intended as a ready reference for
More informationAbstracting Upper GI Cancer Incidence and Treatment Data Quiz 1 Multiple Primary and Histologies Case 1 Final Pathology:
Abstracting Upper GI Cancer Incidence and Treatment Data Quiz 1 Multiple Primary and Histologies Case 1 A 74 year old male with a history of GERD presents complaining of dysphagia. An esophagogastroduodenoscopy
More informationMEDIASTINAL LYMPH NODE METASTASIS IN PATIENTS WITH CLINICAL STAGE I PERIPHERAL NON-SMALL-CELL LUNG CANCER
MEDIASTINAL LYMPH NODE METASTASIS IN PATIENTS WITH CLINICAL STAGE I PERIPHERAL NON-SMALL-CELL LUNG CANCER Tsuneyo Takizawa, MD a Masanori Terashima, MD a Teruaki Koike, MD a Hideki Akamatsu, MD a Yuzo
More informationCase Scenario 1. The patient agreed to a CT guided biopsy of the left upper lobe mass. This was performed and confirmed non-small cell carcinoma.
Case Scenario 1 An 89 year old male patient presented with a progressive cough for approximately six weeks for which he received approximately three rounds of antibiotic therapy without response. A chest
More informationR. F. Falkenstern-Ge, 1 S. Bode-Erdmann, 2 G. Ott, 2 M. Wohlleber, 1 and M. Kohlhäufl Introduction. 2. Histology
Case Reports in Oncological Medicine Volume 2013, Article ID 167585, 4 pages http://dx.doi.org/10.1155/2013/167585 Case Report Late Lung Metastasis of a Primary Eccrine Sweat Gland Carcinoma 10 Years after
More informationUpdate on Small Cell Lung Cancer
Welcome to Master Class for Oncologists Session 4: 10:00 AM - 10:45 AM San Francisco, CA October 23, 2009 Speaker: Bruce E. Johnson, MD Professor of Medicine, Dana-Farber Cancer Institute and Harvard Medical
More informationPET/CT in lung cancer
PET/CT in lung cancer Andrei Šamarin North Estonia Medical Centre 3 rd Baltic Congress of Radiology 08.10.2010 Imaging in lung cancer Why do we need PET/CT? CT is routine imaging modality for staging of
More informationLung. 10/24/13 Chest X-ray: 2.9 cm mass like density in the inferior lingular segment worrisome for neoplasm. Malignancy cannot be excluded.
Lung Case Scenario 1 A 54 year white male presents with a recent abnormal CT of the chest. The patient has a history of melanoma, kidney, and prostate cancers. 10/24/13 Chest X-ray: 2.9 cm mass like density
More informationCURRENT REVIEW. Tumors
CURRENT REVIEW Primary Malignant of the Mediastinum Tumors David M. Conkle, M.D., and R. Benton Adkins, Jr., M.D. ABSTRACT Forty-three patients with primary malignant tumors of the rnediastinum are reviewed.
More informationAfter primary tumor treatment, 30% of patients with malignant
ESTS METASTASECTOMY SUPPLEMENT Alberto Oliaro, MD, Pier L. Filosso, MD, Maria C. Bruna, MD, Claudio Mossetti, MD, and Enrico Ruffini, MD Abstract: After primary tumor treatment, 30% of patients with malignant
More informationperformed to help sway the clinician in what the appropriate diagnosis is, which can substantially alter the treatment of management.
Hello, I am Maura Polansky at the University of Texas MD Anderson Cancer Center. I am a Physician Assistant in the Department of Gastrointestinal Medical Oncology and the Program Director for Physician
More informationHodgkin s Disease of the Mediastinum
THE ANNALS OF THORACIC SURGERY Journal of The Society of Thoracic Surgeons and the Southern Thoracic Surgical Association VOLUME 3 NUMBER 4 APRIL 1967 Hodgkin s Disease of the Mediastinum William A. Burke,
More informationSlide 1. Slide 2. Slide 3. Investigation and management of lung cancer Robert Rintoul. Epidemiology. Risk factors/aetiology
Slide 1 Investigation and management of lung cancer Robert Rintoul Department of Thoracic Oncology Papworth Hospital Slide 2 Epidemiology Second most common cancer in the UK (after breast). 38 000 new
More informationLung Cancer-a primer. Sai Yendamuri, MD Professor and Chair, Dept of Thoracic Surgery,RPCI,Buffalo
Lung Cancer-a primer Sai Yendamuri, MD Professor and Chair, Dept of Thoracic Surgery,RPCI,Buffalo CLINICAL CATEGORIES THE SOLITARY PULMONARY NODULE MULTIPLE PULMONARY NODULES Differential Diagnosis Malignant
More informationTake Home Quiz 1 Please complete the quiz below prior to the session. Use the Multiple Primary and Histology Rules
Take Home Quiz 1 Please complete the quiz below prior to the session. Use the Multiple Primary and Histology Rules Case 1 72 year old white female presents with a nodular thyroid. This was biopsied in
More informationCarcinoma of the Lung: A Clinical Review
Carcinoma of the Lung: A Clinical Review R. Samuel Cromartie, 111, M.D., Edward F. Parker, M.D., James E. May, M.D., John S. Metcalf, M.D., and David M. Bartles, M.S. ABSTRACT Records of 702 patients with
More informationLYMPH NODE METASTASIS IN SMALL PERIPHERAL ADENOCARCINOMA OF THE LUNG
LYMPH NODE METASTASIS IN SMALL PERIPHERAL ADENOCARCINOMA OF THE LUNG Tsuneyo Takizawa, MD a Masanori Terashima, MD a Teruaki Koike, MD a Takehiro Watanabe, MD a Yuzo Kurita, MD b Akira Yokoyama, MD b Keiichi
More informationLung Cytology: Lessons Learned from Errors in Practice
Lung Cytology: Lessons Learned from Errors in Practice Stephen S. Raab, M.D. Department of Laboratory Medicine Eastern Health and Memorial University of Newfoundland, St. John s, NL and University of Washington,
More informationThe 8th Edition Lung Cancer Stage Classification
The 8th Edition Lung Cancer Stage Classification Elwyn Cabebe, M.D. Medical Oncology, Hematology, and Hospice and Palliative Care Valley Medical Oncology Consultants Director of Quality, Medical Oncology
More informationVOLUME 19 NUMBER 2 * FEBRUARY 1975
THE ANNALS OF THORACIC SURGERY Journal of The Society of Thoracic Surgeons and the Southern Thoracic Surgical Association VOLUME 9 NUMBER 2 * FEBRUARY 975 Medias tinoscopy Its Application in Central Versus
More informationAdam J. Hansen, MD UHC Thoracic Surgery
Adam J. Hansen, MD UHC Thoracic Surgery Sometimes seen on Chest X-ray (CXR) Common incidental findings on computed tomography (CT) chest and abdomen done for other reasons Most lung cancers discovered
More informationMediastinal Staging. Samer Kanaan, M.D.
Mediastinal Staging Samer Kanaan, M.D. Overview Importance of accurate nodal staging Accuracy of radiographic staging Mediastinoscopy EUS EBUS Staging TNM Definitions T Stage Size of the Primary Tumor
More informationRadiation-induced Brachial Plexopathy: MR Imaging
Radiation-induced Brachial Plexopathy 85 Chapter 5 Radiation-induced Brachial Plexopathy: MR Imaging Neurological symptoms and signs of brachial plexopathy may develop in patients who have had radiation
More informationCase Scenario 1. The patient has now completed his neoadjuvant chemoradiation and has been cleared for surgery.
Case Scenario 1 July 10, 2010 A 67-year-old male with squamous cell carcinoma of the mid thoracic esophagus presents for surgical resection. The patient has completed preoperative chemoradiation. This
More informationAJCC-NCRA Education Needs Assessment Results
AJCC-NCRA Education Needs Assessment Results Donna M. Gress, RHIT, CTR Survey Tool 1 Survey Development, Delivery, Analysis THANKS to NCRA for the following work Developed survey with input from partners
More informationApproach to Pulmonary Nodules
Approach to Pulmonary Nodules Edwin Jackson, Jr., DO Assistant Professor-Clinical Director, James Early Detection Clinic Department of Internal Medicine Division of Pulmonary, Allergy, Critical Care and
More informationof Surgery for Control of Lung Cancer
Assessment of the Role of Surgery for Control of Lung Cancer Clifton F. Mountain, M.D. ABSTRACT When morphologically stratified, the classification of patients according to surgical stage provides an objective
More informationLung cancer pleural invasion was recognized as a poor prognostic
Visceral pleural invasion classification in non small cell lung cancer: A proposal on the basis of outcome assessment Kimihiro Shimizu, MD a Junji Yoshida, MD a Kanji Nagai, MD a Mitsuyo Nishimura, MD
More informationNon-Small Cell Lung Cancer: Disease Spectrum and Management in a Tertiary Care Hospital
Non-Small Cell Lung Cancer: Disease Spectrum and Management in a Tertiary Care Hospital Muhammad Rizwan Khan,Sulaiman B. Hasan,Shahid A. Sami ( Department of Surgery, The Aga Khan University Hospital,
More informationRadiologic assessment of response of tumors to treatment. Copyright 2008 TIMC, Matthew A. Barish M.D. All rights reserved. 1
Radiologic assessment of response of tumors to treatment Copyright 2008 TIMC, Matthew A. Barish M.D. All rights reserved. 1 Objective response assessment is important to describe the treatment effect of
More informationWell-differentiated Papillary Mesothelioma of the Pleura Diagnosed by Video-Assisted Thoracic Surgical Pleural Biopsy : A Case Report
Showa Univ J Med Sci 25 1, 67 72, March 2013 Case Report Well-differentiated Papillary Mesothelioma of the Pleura Diagnosed by Video-Assisted Thoracic Surgical Pleural Biopsy : A Case Report Yuri TOMITA
More informationAfternoon Session Cases
Afternoon Session Cases Case 1 19 year old woman Presented with abdominal pain to community hospital Mild incr WBC a14, 000, Hg normal, lipase 100 (normal to 75) US 5.2 x 3.7 x 4 cm mass in porta hepatis
More informationLymph node dissection for lung cancer is both an old
LOBE-SPECIFIC EXTENT OF SYSTEMATIC LYMPH NODE DISSECTION FOR NON SMALL CELL LUNG CARCINOMAS ACCORDING TO A RETROSPECTIVE STUDY OF METASTASIS AND PROGNOSIS Hisao Asamura, MD Haruhiko Nakayama, MD Haruhiko
More informationDo you want to be an excellent Radiologist? - Focus on the thoracic aorta on lateral chest image!!!
The lateral chest radiograph: Challenging area around the thoracic aorta!!! Do you want to be an excellent Radiologist? - Focus on the thoracic aorta on lateral chest image!!! Dong Yoon Han 1, So Youn
More informationCase Report Solitary Osteolytic Skull Metastasis in a Case of Unknown Primary Being latter Diagnosed as Carcinoma of Gall Bladder
Cronicon OPEN ACCESS CANCER Case Report Solitary Osteolytic Skull Metastasis in a Case of Unknown Primary Being latter Diagnosed as Carcinoma of Gall Kartik Mittal 1, Rajaram Sharma 1, Amit Dey 1, Meet
More informationTreatment Strategy for Patients With Surgically Discovered N2 Stage IIIA Non-Small Cell Lung Cancer
Treatment Strategy for Patients With Surgically Discovered N2 Stage IIIA Non-Small Cell Lung Cancer Ryoichi Nakanishi, MD, Toshihiro Osaki, MD, Kozo Nakanishi, MD, Ichiro Yoshino, MD, Takashi Yoshimatsu,
More informationUtility of 18 F-FDG PET/CT in metabolic response assessment after CyberKnife radiosurgery for early stage non-small cell lung cancer
Utility of F-FDG PET/CT in metabolic response assessment after CyberKnife radiosurgery for early stage non-small cell lung cancer Ngoc Ha Le 1*, Hong Son Mai 1, Van Nguyen Le 2, Quang Bieu Bui 2 1 Department
More informationRole of CT imaging to evaluate solitary pulmonary nodule with extrapulmonary neoplasms
Original Research Article Role of CT imaging to evaluate solitary pulmonary nodule with extrapulmonary neoplasms Anand Vachhani 1, Shashvat Modia 1*, Varun Garasia 1, Deepak Bhimani 1, C. Raychaudhuri
More informationRadiological staging of lung cancer. Shukri Loutfi,MD,FRCR Consultant Thoracic Radiologist KAMC-Riyadh
Radiological staging of lung cancer Shukri Loutfi,MD,FRCR Consultant Thoracic Radiologist KAMC-Riyadh Bronchogenic Carcinoma Accounts for 14% of new cancer diagnoses in 2012. Estimated to kill ~150,000
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,800 116,000 120M Open access books available International authors and editors Downloads Our
More informationINTERACTIVE SESSION 2
INTERACTIVE SESSION 2 2 patients with lung metastases, with complete response after oncologic treatment - Clinical Case Presentation: Dr. Esther Casado Dr. Sergi Call - Expert Opinion: Dr. Raúl Embún Dr.
More informationA case of giant benign localized fibrous tumor of the pleura
Turkish Journal of Cancer Vol.30 / No. 4/2000 A case of giant benign localized fibrous tumor of the pleura ALİ KEMAL UZUNLAR 1, MEHMET YALDIZ 1, İBRAHİM H. ÖZERCAN 2, FAHRİ YILMAZ 1, AKIN E. BALCI 3 1
More informationFDG PET/CT in Lung Cancer Read with the experts. Homer A. Macapinlac, M.D.
FDG PET/CT in Lung Cancer Read with the experts Homer A. Macapinlac, M.D. Patient with suspected lung cancer presents with left sided chest pain T3 What is the T stage of this patient? A) T2a B) T2b C)
More informationAn Unexpected Cause of Hypoglycemia
An Unexpected Cause of Hypoglycemia Stacey A. Milan, MD FACS Surgical Oncology Nothing to disclose Disclosures Objectives Identify indications for workup of hypoglycemia Define work up for hypoglycemic
More informationLung Cancer in Women: A Different Disease? James J. Stark, MD, FACP
Lung Cancer in Women: A Different Disease? James J. Stark, MD, FACP Medical Director, Cancer Program and Director of Palliative Care Maryview Medical Center Professor of Medicine Eastern Virginia Medical
More informationBronchial Carcinoma and the Lymphatic Sump: The Importance of Bronchoscopic Findings
Bronchial Carcinoma and the Lymphatic Sump: The Importance of Bronchoscopic Findings Gordon F. Murray, M.D., Ormond C. Mendes, M.D., and Benson R. Wilcox, M.D. ABSTRACT The lymphatic sump of Borrie is
More informationPLACE LABEL HERE. Radiation Therapy Oncology Group Phase II - SBRT - Medically Inoperable I /II NSCLC Follow-up Form. RTOG Study No.
Radiation Therapy Oncology Group Phase II - SBRT - Medically Inoperable I /II NSCLC Follow-up Form RTOG Study No. 0813 Case # Name RTOG Patient ID INSTRUCTIONS: Submit this form at the appropriate followup
More informationCollaborative Stage. Site-Specific Instructions - LUNG
Slide 1 Collaborative Stage Site-Specific Instructions - LUNG In this presentation, we are going to review the AJCC Cancer Staging criteria for the lung primary site. Slide 2 Reading Assignments As each
More informationLymphoma (Lymphosarcoma) by Pamela A. Davol
Lymphoma (Lymphosarcoma) by Pamela A. Davol Cells derived from the bone marrow that mature and take part in cellular immune reactions are called lymphocytes. When lymphocytes undergo transformation and
More informationMulti-Organ Distant Metastases in Follicular Thyroid Cancer- Rare Case Report
Multi-Organ Distant Metastases in Follicular Thyroid Cancer- Rare Case Report Dr. Mohammed Raza 1, Dr. Sindhuri K 2, Dr. Dinesh Reddy Y 3 1 Professor, Department of Surgery, JSS University, Mysore, India
More informationRole of Surgery in Management of Non Small Cell Lung Cancer. Dr. Ahmed Bamousa Consultant thoracic surgery Prince Sultan Military Medical City
Role of Surgery in Management of Non Small Cell Lung Cancer Dr. Ahmed Bamousa Consultant thoracic surgery Prince Sultan Military Medical City Introduction Surgical approach Principle and type of surgery
More informationPredicting Postoperative Pulmonary Function in Patients Undergoing Lung Resection*
Predicting Postoperative Pulmonary Function in Patients Undergoing Lung Resection* Bernhardt G. Zeiher, MD; Thomas ]. Gross, MD; Jeffery A. Kern, MD, FCCP; Louis A. Lanza, MD, FCCP; and Michael W. Peterson,
More informationMEDIASTINAL STAGING surgical pro
MEDIASTINAL STAGING surgical pro Paul E. Van Schil, MD, PhD Department of Thoracic and Vascular Surgery University of Antwerp, Belgium Mediastinal staging Invasive techniques lymph node mapping cervical
More informationLung Cancer: A review of 589 Malaysian patients
Med. J. Malaysia Vol. 43 No. 4 December 1988 Lung Cancer: A review of 589 Malaysian patients Prathap Gopal, MBBS(Mal), FRCP(Lond), AM(Mal), FCCP(USA) Kuppusamy Iyawoo, MBBS(Mal), MRCP(I) Hooi Lai Ngoh,
More informationPre-operative assessment of patients for cytoreduction and HIPEC
Pre-operative assessment of patients for cytoreduction and HIPEC Washington Hospital Center Washington, DC, USA Ovarian Cancer Surgery New Strategies Bergamo, Italy May 5, 2011 Background Cytoreductive
More informationNorth of Scotland Cancer Network Clinical Management Guideline for Non Small Cell Lung Cancer
THIS DOCUMENT IS North of Scotland Cancer Network Clinical Management Guideline for Non Small Cell Lung Cancer [Based on WOSCAN NSCLC CMG with further extensive consultation within NOSCAN] UNCONTROLLED
More informationFour Cases of Malignant Pleural Effusion in Patients with Papillary Thyroid Carcinoma
Endocrinol Metab 26(4):330-334, December 2011 CASE REPORT Four Cases of Malignant Pleural Effusion in Patients with Papillary Thyroid Carcinoma Min Ji Jeon, Ji Hye Yim, Eui Young Kim, Won Gu Kim, Tae Yong
More informationIt is a malignancy originating from breast tissue
59 Breast cancer 1 It is a malignancy originating from breast tissue including both early stages which are potentially curable, and metastatic breast cancer (MBC) which is usually incurable. Most breast
More informationCarcinoma of the Lung in Women
Carcinoma of the Lung in Marvin M. Kirsh, M.D., Jeanne Tashian, M.A., and Herbert Sloan, M.D. ABSTRACT The 5-year survival of 293 men and of 78 women undergoing pulmonary resection and mediastinal lymph
More informationTreatment of oligometastatic NSCLC
Treatment of oligometastatic NSCLC Jarosław Kużdżał Department of Thoracic Surgery Jagiellonian University Collegium Medicum, John Paul II Hospital, Cracow New idea? 14 NSCLC patients with solitary extrathoracic
More informationGastric Metastasis of Lung Cancer Mimicking an Adrenal Tumor
Published online: March 13, 2014 1662 0631/14/0081 0077$39.50/0 This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC)
More informationSurgical Approaches to Pulmonary Metastases
Surgical Approaches to Pulmonary Metastases Raja M Flores MD Professor and Chief Thoracic Surgery Mount Sinai School of Medicine New York, New York History of Lung Metastasectomy 1882 Weinlechner +CW 1926
More informationQuality of Life (QOL) versus Curability for Lung Cancer Surgery
Quality of Life (QOL) versus Curability for Lung Cancer Surgery Hirokuni Yoshimura, MD Standard operations for lung cancer patients are generally accepted as performing lobectomy or pneumonectomy on the
More informationSurgical Treatment for Pulmonary Me. Tsunehisa; Kugimiya, Toshiyasu. Citation Acta medica Nagasakiensia. 1983, 28
NAOSITE: Nagasaki University's Ac Title Author(s) Surgical Treatment for Pulmonary Me Ayabe, Hiroyoshi; Tomita, Masao; Na Katsunobu; Nakao, Susumu; Eguchi, M Tsunehisa; Kugimiya, Toshiyasu Citation Acta
More informationCOLORECTAL CANCER CASES
COLORECTAL CANCER CASES Case #1 Case #2 Colorectal Cancer Case 1 A 52 year-old female attends her family physician for her yearly complete physical examination. Her past medical history is significant
More informationRevisit of Primary Malignant Neoplasms of the Trachea: Clinical Characteristics and Survival Analysis
Jpn J Clin Oncol 1997;27(5)305 309 Revisit of Primary Malignant Neoplasms of the Trachea: Clinical Characteristics and Survival Analysis -, -, - - 1 Chest Department and 2 Section of Thoracic Surgery,
More informationCancer Cases Treated and Results
Cancer Cases Treated and Results Below are some of the cases, from more than 30 cases we have treated so far with good results. When reading the PET/CT scans, the picture on the left is before treatment,
More informationFDG PET/CT STAGING OF LUNG CANCER. Dr Shakher Ramdave
FDG PET/CT STAGING OF LUNG CANCER Dr Shakher Ramdave FDG PET/CT STAGING OF LUNG CANCER FDG PET/CT is used in all patients with lung cancer who are considered for curative treatment to exclude occult disease.
More informationP sumed to have early lung disease with a favorable
Survival After Resection of Stage I1 Non-Small Cell Lung Cancer Nael Martini, MD, Michael E. Burt, MD, PhD, Manjit S. Bains, MD, Patricia M. McCormack, MD, Valerie W. Rusch, MD, and Robert J. Ginsberg,
More informationBronchioloalveolar Cell Carcinoma of the Lung: A Clinicopathological Study
Bronchioloalveolar Cell Carcinoma of the Lung: A Clinicopathological Study Daniel Dunn, M.D., Bruce Hertel, M.D., William Norwood, M.D., and Demetre M. Nicoloff, M.D. ABSTRACT Thirty-nine patients with
More informationDivision of Diagnostic Imaging, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
89 Lymphology 28 (1995) 89-94 Division of Diagnostic Imaging, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA ABSTRACT The anatomy of the posterior intercostal lymphatics and lymph
More informationSeptember 2014 Imaging Case of the Month. Michael B. Gotway, MD. Department of Radiology Mayo Clinic Arizona Scottsdale, AZ
September 2014 Imaging Case of the Month Michael B. Gotway, MD Department of Radiology Mayo Clinic Arizona Scottsdale, AZ Clinical History: A 57-year-old non-smoking woman presented to her physician as
More information