ABSTRACT
OBJECTIVE: To report the experience of a routine follow-up program based on medical visits and chest CT. METHODS: This was a retrospective study involving patients followed after complete surgical resection of non-small cell lung cancer between April of 2007 and December of 2015. The follow-up program consisted of clinical examination and chest CT. Each follow-up visit was classified as a routine or non-routine consultation, and patients were considered symptomatic or asymptomatic. The outcomes of the follow-up program were no evidence of cancer, recurrence, or second primary lung cancer. RESULTS: The sample comprised 148 patients. The median time of follow-up was 40.1 months, and 74.3% of the patients underwent fewer chest CTs than those recommended in our follow-up program. Recurrence and second primary lung cancer were found in 17.6% and 11.5% of the patients, respectively. Recurrence was diagnosed in a routine medical consultation in 69.2% of the cases, 57.7% of the patients being asymptomatic. Second primary lung cancer was diagnosed in a routine medical appointment in 94.1% of the cases, 88.2% of the patients being asymptomatic. Of the 53 patients who presented with abnormalities on chest CT, 41 (77.3%) were diagnosed with cancer. CONCLUSION: Most of the cases of recurrence, especially those of second primary lung cancer, were confirmed by chest CT in asymptomatic patients, indicating the importance of a strict follow-up program that includes chest CTs after surgical resection of lung cancer.
Subject(s)
Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Follow-Up Studies , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Neoplasm Recurrence, Local/diagnostic imaging , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
ABSTRACT Objective: To report the experience of a routine follow-up program based on medical visits and chest CT. Methods: This was a retrospective study involving patients followed after complete surgical resection of non-small cell lung cancer between April of 2007 and December of 2015. The follow-up program consisted of clinical examination and chest CT. Each follow-up visit was classified as a routine or non-routine consultation, and patients were considered symptomatic or asymptomatic. The outcomes of the follow-up program were no evidence of cancer, recurrence, or second primary lung cancer. Results: The sample comprised 148 patients. The median time of follow-up was 40.1 months, and 74.3% of the patients underwent fewer chest CTs than those recommended in our follow-up program. Recurrence and second primary lung cancer were found in 17.6% and 11.5% of the patients, respectively. Recurrence was diagnosed in a routine medical consultation in 69.2% of the cases, 57.7% of the patients being asymptomatic. Second primary lung cancer was diagnosed in a routine medical appointment in 94.1% of the cases, 88.2% of the patients being asymptomatic. Of the 53 patients who presented with abnormalities on chest CT, 41 (77.3%) were diagnosed with cancer. Conclusion: Most of the cases of recurrence, especially those of second primary lung cancer, were confirmed by chest CT in asymptomatic patients, indicating the importance of a strict follow-up program that includes chest CTs after surgical resection of lung cancer.
RESUMO Objetivo: Relatar a experiência de um programa de acompanhamento de rotina baseado em consultas médicas e TC de tórax. Métodos: Estudo retrospectivo envolvendo pacientes acompanhados após ressecção cirúrgica completa de câncer de pulmão de células não pequenas entre abril de 2007 e dezembro de 2015. O programa de acompanhamento consistiu em exame clínico e TC de tórax. Cada visita de acompanhamento foi classificada como uma consulta de rotina ou fora da rotina, e os pacientes foram considerados sintomáticos ou assintomáticos. Os desfechos do programa de acompanhamento foram ausência de evidência de câncer, recidiva ou segundo câncer de pulmão primário. Resultados: A amostra foi composta por 148 pacientes. A mediana do tempo de acompanhamento foi de 40,1 meses, e 74,3% dos pacientes realizaram menos TCs do que as recomendadas em nosso programa de acompanhamento. Recidiva e segundo câncer de pulmão primário foram encontrados em 17,6% e 11,5% dos pacientes, respectivamente. A recidiva foi diagnosticada em uma consulta médica de rotina em 69,2% dos casos, sendo 57,7% dos pacientes assintomáticos. O segundo câncer de pulmão primário foi diagnosticado em consulta médica de rotina em 94,1% dos casos, sendo 88,2% dos pacientes assintomáticos. Dos 53 pacientes que apresentaram anormalidades na TC de tórax, 41 (77,3%) foram diagnosticados com câncer. Conclusões: A maioria dos casos de recidiva, principalmente os de segundo câncer de pulmão primário, foi confirmada por TC de tórax em pacientes assintomáticos, indicando a importância de um programa de acompanhamento rigoroso que inclua TC de tórax após ressecção cirúrgica de câncer de pulmão.
Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms/surgery , Lung Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Retrospective Studies , Follow-Up Studies , Neoplasm Recurrence, Local/diagnostic imagingABSTRACT
Intraoperative localization of ground-glass opacities is difficult because they are not easy to palpate and may be invisible at radioscopy. Therefore, various techniques have been developed to improve intraoperative localization of these lesions, allowing an adequate surgical resection. The aim of this study is to report two cases of preoperative localization of ground-glass opacities through computed tomography-guided placement of a metallic clip inside the lesion and to discuss this new technique in comparison with those previously described.
Subject(s)
Adenocarcinoma/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Solitary Pulmonary Nodule/diagnostic imaging , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Diagnosis, Differential , Female , Humans , Image-Guided Biopsy , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Middle Aged , Pneumonectomy/methods , Preoperative Care/methods , Risk Assessment , Sampling Studies , Solitary Pulmonary Nodule/pathology , Solitary Pulmonary Nodule/surgery , Surgical Instruments , Thoracic Surgery, Video-Assisted/methods , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
Os autores apresentam um caso de síndrome ictérica obstrutiva. O paciente apresentou com quadro clínico fraquezas nos membros inferiores, hipotensäo postural, icterícia e episódios de desfalecimento. relatava na sua história colúria, alternância do hábito intestinal com fezes pretas e aumento do número de evacuaçöes. Nos exames laboratoriais se constatou 3,7 g/dl de hemoglobina, hematócrito de 12,2 (por cento) bilirrubina total de 5,16 mg/dl, bilirrubina direta 5 mg/dl, gama - GT 439 U/I, fosfatase alcalina 1214 U/I. O diagnóstico foi realizado pela colangiopancreatografia retrógrada endoscópica. Como tratamento, indicou-se o transplante hepático. Foi realizado também uma revisäo bibliográfica sobre o tema.(au)
