Detection and prognostic significance of micrometastasis in peripheral blood of patients with non-small cell lung cancer treated by chemo-radiation therapy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the prognostic significance of micrometastasis (MM) in peripheral blood of patients with non-small cell lung cancer (NSCLC) treated by chemo-radiation therapy.</p><p><b>METHODS</b>Peripheral blood was taken from 67 NSCLC patients before and after definitive chemo-radiation therapy. CK19 mRNA of the peripheral blood was measured by nested RT-PCR and both their relationship with clinicopathological features and prognostic significance were further investigated.</p><p><b>RESULTS</b>The micrometastasis-positive rates were 65.7% (44/67) and 32.8% (22/67), respectively, before and after the treatment. The micrometastasis-positive rate before treatment was closely in correlation with N-stage (P = 0.014). In contrast, it turned out to be more closely related with histological types (P = 0.019), weight loss (P = 0.01), KPS status (P = 0.027) as well as N-stage (P = 0.032) after chemo-radiation therapy. 4-yr distant metastasis rates (DMR) for micrometastasis-positive and -negative patients were 78.3% and 70.4%, respectively, before the treatment (P = 0.544) while they were 100% and 62.9%, respectively, after the chemoradiation (P < 0.001). The median survival time (MST) and 4-yr overall survival rate (OSR) for pretreatment micrometastasis-positive and -negative patients were 13.8 months and 17.6 months, and 18.2% and 17.4%, respectively (P = 0.619), while for post-treatment micrometastasis-positive and -negative patients they were 7.8 months and 27.6 months and 0 and 26.4%, respectively (P < 0.001). Multivariate analysis showed that the post-treatment positive micrometastasis was an independent unfavorable prognostic factor (P = 0.000).</p><p><b>CONCLUSION</b>Detection of micrometastasis in peripheral blood may possess a prognostic significance after definitive chemo-radiation therapy. Micrometastasis-negative patients have better prognosis compared to those with positive micrometastasis.</p>

Treatment of 40 patients with primary tracheal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the efficacy of treatment in 40 patients with primary tracheal carcinoma.</p><p><b>METHODS</b>From 1970 to 2001, 40 patients with primary tracheal carcinoma treated in our hospital were retrospectively reviewed. Twenty-eight were male and 12 were female with median age of 47 years. The median interval from onset of symptoms to diagnosis was 10 months (1 - 60 months). Fifteen patients had adenoid cystic carcinoma, 14 squamous cell carcinoma, 8 adenocarcinoma, 2 small-cell carcinoma and 1 mucoepidermoid carcinoma. Thirty-two patients received operation plus adjuvant radiotherapy, 6 received radiotherapy alone and 2 received operation alone.</p><p><b>RESULTS</b>The median survival time for all patients was 40 months. The 1-, 5-, and 10-year survival rate was 86%, 59% and 29%, respectively. The 1-, 5-, and 10-year local control rate was 84%, 60% and 50%, respectively. Distant metastasis rate in 1, 5, and 10 years was 17%, 51% and 84%, respectively.</p><p><b>CONCLUSION</b>Surgical resection plus adjuvant radiotherapy is a reasonable mode of treatment. Despite late local recurrence after initial treatment, its intrinsic feature, excellent long-term palliation can be achieved after treatment.</p>