Clinical manifestation and survival of patients with small-cell lung cancer.

OBJECTIVE: To assess the clinical manifestation, diagnostic investigation, treatment, and survival of patients with small-cell lung cancer (SCLC). DESIGN: Retrospective study. MATERIAL AND METHOD: Patients with histologically and/or cytologically proven SCLC, adequate medical record for clinical history, and survival between January 1, 1999 and December 31, 2003, were reviewed. The stage of disease at presentation was based on the Veterans' Administration Lung Cancer Study Group (VALSG) staging system of limited-stage and extensive-stage disease. RESULTS: One hundred and sixteen evaluative SCLC patients were enrolled in the present study. SCLC was common in elderly men who smoked. Major symptoms were cough 81%, weight loss 72%, and dyspnea 67%. Hoarseness and superior vena cava syndrome (SVC syndrome) were present in 18% and 17% respectively. Forty-nine patients (42%) presented with limited-stage disease and 67 (58%) with extensive-stage disease. Thirty patients (26%) received chemotherapy alone, 23 patients (20%) received radiotherapy alone, 33 patients (28%) received combined chemoradiotherapy, and 30 patients (26%) received supportive treatment. A chemotherapy regimen of cisplatin combined with etoposide was used in 61 of 63 patients (97%). The overall response to chemotherapy was complete remission in 12 cases (19%), and partial response in 20 cases (32%). The median survival of limited-stage disease was significantly better than those with extensive-stage disease (44 weeks vs. 22 weeks). Patients with chemotherapy treatment had significantly improved median survival in both limited-stage and extensive-stage disease. CONCLUSION: More than half of the SCLC patients presented in extensive-stage disease. The majority of the patients were treated with systemic chemotherapy. Patients with limited-stage disease had better response to chemotherapy and better survival than those with extensive-stage disease.

Pulmonary radiographic findings in 118 leptospirosis patients.

We retrospectively reviewed the medical records and chest radiographs of 118 patients who presented during January 1998 to October 2002 at Songklanagarin Hospital in Hat Yai, Songkhla Province, Thailand who had a high serum immunofluorescent assay titer for leptospirosis. Twenty-nine of 118 (24%) patients had abnormal chest films. Nearly all of these patients had respiratory symptoms and needed oxygen therapy (93% and 90%, respectively). Forty-eight of the 118 (40%) had respiratory symptoms, but only 27/48 (56%) had abnormal radiographs. Twenty-one of the 28 (75%) and 18/27 (67%) who had abnormal chest radiographs had coexisting impaired renal function or jaundice, respectively, whereas 21/69 (30%) of the patients who had impaired renal function and 18/55 (33%) of the patients with jaundice had abnormal radiographs. There were 6/27 (22%) patients who had abnormal chest radiographs without renal or liver impairment. The most common finding on the abnormal chest radiograph was bilateral diffuse air space disease, which resolved within 7 days. No permanent lung damage was seen. The patients who had an abnormal chest radiograph needed longer hospitalization, than those without an abnormal chest radiograph (average 12 days and 5 days, respectively).

Accuracy of the mammographic report category according to BIRADS.

OBJECTIVE: To determine the accuracy and predictive value of the mammographic report according to the BIRADS categories in Songklanagarind University Hospital. MATERIAL AND METHOD: Mammograms of 1000 women who came to Songklanagarind University Hospital from June 1998 to September 1999 were reported and placed in category 1 for negative results, category 2 for benign lesions, category 3 for probably benign lesions, category 4 for suspicious lesions and category 5 for highly suspicious lesions. Accuracy was determined by either histology or by unchanged follow-up mammography within 24 months. RESULTS: The total accuracy was 97.8%, sensitivity 62.5% and specificity 98.1%.