Factors Influencing the Progression Trend of Early Lung Cancer and CT Findings / 中国肺癌杂志

BACKGROUND@#It has been known that the volume doubling time (VDT) of different lung nodule types is different. At present, there is still a lack of studies about the volume doubling time of lung cancer with different pathological types. The purpose of the study is to explore the factors influencing the progression of the early-stage adenocarcinoma, and provide some reference for the follow-up strategy of lung nodules by retrospective analysis of the image data of 143 early-stage adenocarcinoma.@*METHODS@#143 cases of the early adenocarcinoma were classified according to the 2015 World Health Organization Classification of Lung Tumors and the Eighth edition of the tumor-node-metastasis (TNM) classification of lung cancer. The volume doubling time was calculated with reference to the revised Schwartz formula.@*RESULTS@#Among the 143 cases of the early adenocarcinoma, 50 cases (34.97%) were in progression. By multivarIate analysis, there were several factors associated with the progression of the early adenocarcinoma: the follow-up time, the dimension of nodule, the pathological type, the nodule type and the pathological stage. The VDT of lepidic predominant adenocarcinoma (LPA) is (594±272) d. The VDT of the invasive adenocarcinoma with lepidic part, but not predominant, is (520±285) d. The VDT of the invasive adenocarcinoma without lepidic part is (371±183) d.@*CONCLUSIONS@#About 35% of the early adenocarcinoma is in progress. Whether with the lepidic component is a positive factor to the speed of tumor progression.

Study on the prognosis of the T1a non-small cell lung cancer / 中国肺癌杂志

<p><b>BACKGROUND AND OBJECTIVE</b>The new edition of the TNM staging for lung and pleural tumours has been finished, which put weight on the extent of primary tumor as one of the important prognosises. But little study has performed on the primary tumor extent < or = 2 cm. The aim of this study is to explore the prognosis of patients with tumor extent < or = 2 cm in stage I of non-small cell lung cancer, which helps us to choose the best treatment for these patients.</p><p><b>METHODS</b>Retrospective study on the clinical response and survival time of whom underwent complete surgical resection and diagnosed as T1a of stage I NSCLC from 1998 to 2004 was analyzed. Data was analyzed by SPSS 17.0 software.</p><p><b>RESULTS</b>Overall survival rate was 80.8%. By the study, age (P = 0.241), gender (P = 0.175), history of smoking (P = 0.845), pathologic type ( P =0.265), and systematic mediastinal lymphadenectomy (SML )(P = 0.918) or not, postoperative adjuvant chemotherapy or not ( P = 0.616) and visceral pleural invasion (P = 0.827) were not the prognosises of these patients. Only the tumor differentiation such as poorly differentiated was the important prognosis ( P = 0.01).</p><p><b>CONCLUSION</b>In the tumor extent < or = 2 cm of stage I non-small cell lung cancer, the visceral pleural invasion maybe not influence the patients survival. The tumor differentiation is one of the important prognostic factors.</p>

The clinical value of routine preoperative surgical staging to mediastinal lymph nodes on lung cancer / 中国肺癌杂志

<p><b>BACKGROUND AND OBJECTIVE</b>The aim of this study is the clinical value of preoperative routine surgical staging to mediastinal lymph nodes on lung cancer.</p><p><b>METHODS</b>Seventy-six cases underwent lymph nodes biopsy with mediastinoscopy. The diagnostic efficacy of thoracic CT scan and mediastinoscopy on mediastinal lymph nodes metastasis were compared.</p><p><b>RESULTS</b>The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of thoracic CT scan and mediastinoscopy on diagnosing mediastinal lymph nodes metastasis were 68.5%, 66.7%, 68.4%, 84.6%, 16.7% and 87.5%, 100%, 84.2%, 100%, 60%, respectively.</p><p><b>CONCLUSION</b>Routine preoperative mediastinoscopy had obvious advantage compared with thoracic CT scan on mediastinal lymph nodes staging. The routine preoperative surgical staging of mediastinal lymph nodes on lung cancer had high clinical value.</p>

Trachea-bronchoplasty in the surgical treatment of locally advanced non-small cell lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>Some of the locally advanced non-small cell lung cancer (NSCLC) need different trachea-bronchoplasty operative styles in order to make the widest possible to resect the tumor and remain normal pulmonary function. The aim of this study is to explore the surgical problem during trachea-bronchoplasty operation.</p><p><b>METHODS</b>There were 2206 patients with NSCLC underwent surgical treatment from January 2003 to June 2005 in this hospital. Of the 2206 cases, 100 patients accepted the trachea-bronchoplasty, whose clinic data were analyzed. There were 42 cases of squamous cell carcinoma, 23 adenosquamous carcinoma, 11 adenocarcinoma, 5 mucoepidermoid carcinoma, 4 adeoid cystic carcinoma, 3 carcinoid and 12 undetermined. Thirty-four cases were in stage IB, 23 in stage IIB, 23 in stage IIIA and 20 in stage IIIB. There were 42 cases of right upper sleeve lobectomy, 1 right lower sleeve lobectomy, 24 left upper sleeve lobectomy, 4 left lower sleeve lobectomy, 8 sleeve bilobectomy, 17 carinal reconstruction, 4 sleeve lobectomy plus pulmonary artery angioplasty.</p><p><b>RESULTS</b>Complete resection (R0) of the cancer was performed in 97 patients and uncomplete resection (margin positive, R1) was performed in 3 patients. Postoperative complication happened in 5 cases (the occurrence rate was 5%): Pneumonia in 2 cases, pleura cavity infection in 1 case, broncho-pleura fistula in 1 case, alveoli-pleura fistula in 1 case. One patient died of pulmonary infection, the operative mortality was 1%. The postoperative inpatient time was from 4 days to 27 days, with median of 11 days.</p><p><b>CONCLUSIONS</b>Trachea-bronchoplasty is suitable for some patients of the locally advanced NSCLC and consistent to the tumor surgical treatment principle. A satisfactory cure effect can be obtained for undergoing such operative style. The key point of successful operation is the operating skill to manage trachea, bronchi and pulmonary vessels.</p>