A randomized clinical trial on adjuvant interferon-alpha for completely resected stage I-II non-small cell lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>To investigate the role of interferon-alpha (IFN-α) in completely resected stage I and II non-small cell lung cancer (NSCLC) patients.</p><p><b>METHODS</b>Forty-four stageIand II NSCLC patients were randomized to two groups. Study group (surgery+IFN-α) received IFN-α injection, 3 million unit, every two days, with a period of treatment of 90 days. Control group (surgery only) received no adjuvant therapy until relapse or metastasis were detected. pTNM stage, histological types, relapse or metastasis, survival time were observed and evaluated.</p><p><b>RESULTS</b>Median follow-up was 49.9 months. The 1-, 2-, 3-, 4-year survival rates were 90.5%, 80.9%, 52.4%, 52.4% in the study group and 95.2%, 80.9%, 66.0%, 50.8% in the control group respectively. No significant statistic difference was found between the two groups ( P = 0.663 9 ). Kaplan-Meier and Cox Model analysis showed pTNM stage ( P =0.010 2), N status ( P =0.015) and weight loss ( P =0.030) were prognostic factors in completely resected stage I and II NSCLC.</p><p><b>CONCLUSIONS</b>Postoperative low-dose IFN-α short-term therapy cannot significantly improve 3- and 4-year survival rates of patients with stage I and II completely resected NSCLC.</p>

Surgical treatment for stage III N2 non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the survival and prognostic factors of stage III N2 non-small cell lung cancer (NSCLC) after surgical treatment.</p><p><b>METHODS</b>266 patients with stage III N2 NSCLC underwent operation from 1982 to 1996, with the 5-year survival rate compared with those of stage N0 and N1 patients who received operation in the same period. Histological classification, number of positive nodes, location and extent of mediastinal lymph node involvement, T primary tumor status, complete or incomplete operation, the procedure of operation were univariately and multivariately analyzed to determine their impact on the 5-year survival.</p><p><b>RESULTS</b>The 5-year survival rate of patients with stage III N2 non-small lung cancer after surgical treatment was 17.3%, which was significant lower than those with N0 (51.4%) and N1 (30.4%). Four prognostic factors significantly influenced the outcome: number of positive nodes, location and extent of mediastinal lymph node involvement, T primary tumor status and complete resection of the tumor.</p><p><b>CONCLUSION</b>Patients with stage III N2 NSCLC are candidates for surgical treatment if they have evidence of limited mediastinal lymph node metastasis and prospects of complete resection.</p>

Prognostic factor analysis of pneumonectomy for non-small cell lung cancer / 中华外科杂志

<p><b>OBJECTIVES</b>To identify predictors of survival following pneumonectomy for non-small cell lung cancer (NSCLC) and provide evidence for the revision of patient selection criteria.</p><p><b>METHODS</b>81 cases of pneumonectomy for NSCLC from January 1990 to May 1996 at our hospital were reviewed retrospectively. There were 65 men (80.2%) and 16 women (19.8%), with a mean age 53.4 +/- 9.4 years (range 20 - 68 years). Predominant histological types included squamous cell carcinoma (54.3%), adenocarcinoma (24.7%), and squamoadenocarcinoma (17.3%). After follow-up for more than 5 years, data were examined using the chi-square test, Kaplan-Meier method, and Cox-mantel test. The possible factors affecting survival were tested with univariate and multivariate analysis.</p><p><b>RESULTS</b>The 5-year survival of N(0), N(1) and N(2) disease of NSCLC following pneumonectomy was (20.8 +/- 9.9)%, (15.4 +/- 10.0)% and (4.0 +/- 2.8)%, respectively. There was no perioperative death. The operative complications morbidity was 22.2%. Factors adversely affecting survival with univariate analysis included age over 60 years for right pneumonectomy, cardiopulmonary complications, adenocarcinoma, peripheral location, tumor greatest dimension more than 10 cm, chest wall involvement and N(2) disease. Factors adversely affecting survival with multivariate analysis included cardiopulmonary complications, greatest tumor dimension more than 10 cm, chest wall involvement and N(2) disease.</p><p><b>CONCLUSIONS</b>Pneumonectomy provides survival benefit with a high operative complications morbidity. Old age (>/= 60 years) for right pneumonectomy, cardiopulmonary complications, adenocarcinoma, and N(2) disease may be negative prognostic factors of long-term survival. Patient selection should be based on cardiopulmonary evaluation and the stage of disease.</p>

The diagnostic value of mediastinoscopy and its application in staging for lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the value of mediastinoscopy in diagnosing unknown mediastinal disease and staging of lung cancers.</p><p><b>METHODS</b>From October 2000 to August 2001, 41 patients were examined by cervical mediastinoscopy with or without anterior mediastinotomy for diagnostic and staging purposes. Of these 41 patients, 12 were for diagnosis of unknown mediastinal disease, 3 for diagnosis and staging of pulmonary nodule or mass clinically suspected to be malignancy and 26 for the staging of lung cancer.</p><p><b>RESULTS</b>Ten of 12 patients with unknown mediastinal disease were diagnosed pathologically as thymoma in 1, metastatic lesion from lung cancer in 1, metastatic thyroid carcinoma in 1, lymph node hyperplasia in 1, teratoma in 1, sarcoidosis in 1, inflammatory pseudotumor in 1 and tuberculosis in 3, giving a diagnostic rate of 83.3%. Of three patients with suspected malignancy, one was diagnosed as tuberculosis by cervical mediastinoscopy and the other two as lymphoma and pulmonary inflammatory pseudotumor by thoracoscopy and thoracotomy. The sensitivity and specificity of mediastinoscopy for the staging of mediastinal nodes in 26 lung cancers were 87.5% and 100%. Only one wound infection but no other major complication was found.</p><p><b>CONCLUSION</b>Mediastinoscopy is a safe procedure which can accurately provide information on diagnosis and staging.</p>

Determination of phellodenrine in Cortex Phellodendri by HPLC / 中成药

Objective: To determine phellodendrine in Cortex Phellodendri by HPLC. Methods : HPLC condition consists of C 18 column (Phenomenex, 150mm, 5?), actonitrile:250mL of 0.05mol?L -1 phosphoric acid +0.4mL of diethylamine (9∶91, v/v) as mobile phase, detection wavelength at 284nm. Results : The averagy recovery of phellofendrine was 101.43% ( RSD =1.56%, n =5) and the linear range of phellodrine was 0.4368～2.1840?g??L -1 , r =0.9998. Conclusion : The method is simple, accurate and reproducible, and can be used for the determination of phellodendrine in Cordex Phellodendri.