Surgical outcomes of second primary lung cancer after the extrapulmonary malignancy.

OBJECTIVE: To study the surgical outcomes of patients with a second primary lung cancer after the extrapulmonary malignancy. MATERIALS AND METHODS: Patients who underwent surgical resection for lung cancers between January 2005 and December 2014 were reviewed. Clinical data, imaging characteristics of tumors, surgical approaches, and outcomes were analyzed with a mean follow-up of 97 months. RESULTS: Of 1075 patients, 166 (15.4%) had a second primary lung cancer after extrapulmonary malignancy. There were no differences in overall 5-year survival rates (81.8% for the group of lung cancer vs. 72.9% for the second primary lung cancer group, p = 0.069) and 5-year disease-free survival (70.1% for the lung cancer group vs. 70.3% for the second primary lung cancer group, p = 0.863) between the two groups. Gender, performance status, tumor size, and maximum standard uptake value (SUVmax) were significantly different between the two groups. After propensity-score matching analysis, patients in the group with lung cancers had better 5-year overall survival (88.1% vs. 72.1% for the group with second primary lung cancers, p = 0.016) and 5-year disease-free survival (80.6% vs. 70.3% for the group with second primary lung cancers; p = 0.054). In the second primary lung cancer group, the patients with preceding breast or thyroid cancers had better prognoses than did those with other extrapulmonary malignancy. CONCLUSIONS: Second primary lung cancers following extrapulmonary malignancies were not uncommon. Surgical resection is considered for early stage secondary primary lung cancer after meticulous work up and result in fair outcome.

The role of the ground-glass opacity ratio in resected lung adenocarcinoma.

OBJECTIVES: The goal of this study was to investigate the role of the ground-glass opacity (GGO) ratio in lung adenocarcinoma in predicting surgical outcomes. METHODS: Patients who underwent surgical resection for pulmonary adenocarcinoma between January 2004 and December 2013 were reviewed. The clinical data, imaging characteristics of nodules, surgical approaches and outcomes were analysed with a mean follow-up of 87 months. RESULTS: Of 789 enrolled patients, 267 cases were categorized as having a GGO ratio ≥0.75; 522 cases were categorized as having a GGO ratio <0.75. The gender, tumour differentiation, epidermal growth factor receptor mutation, smoking habits, lymphovascular space invasion, tumour size, maximum standard uptake value and carcinoembryonic antigen levels were significantly different in the 2 groups. In the group with a GGO ratio ≥0.75, 63.3% of the patients underwent sublobar resection (18.8% with a GGO ratio < 0.75, P <0.001). These patients had fewer relapses (2.2% for GGO ratio ≥0.75, 26.8% for GGO ratio <0.75, P < 0.001) and a better 5-year survival rate (95.5% for GGO ratio ≥0.75, 77.4% for GGO ratio <0.75, P < 0.001). None of the patients with a GGO ratio ≥0.75 had lymph node involvement. The multivariable Cox regression analysis revealed that a GGO ratio <0.75 was an independent factor for postoperative relapse with a hazard ratio of 3.96. CONCLUSIONS: A GGO ratio ≥0.75 provided a favourable prognostic prediction in patients with resected lung adenocarcinoma. Sublobar resection and lymph node sampling revealed a fair outcome regardless of tumour size. However, anatomical resection is still the standard approach for patients with tumours with a GGO ratio <0.75, size >2 cm.

Determination of dichlorvos by on-line microwave-assisted extraction coupled to headspace solid-phase microextraction and gas chromatography-electron-capture detection.

The pretreatment technique of microwave-assisted extraction on-line headspace solid-phase microextraction (MAE-HS-SPME) was designed and studied for one-step in-situ sample preparation prior to the chromatographic analysis of a pesticide on vegetables. The pesticide on chopped vegetables was extracted into an aqueous solution with the aid of microwave irradiation and then directly onto the SPME fiber in headspace. After being collected on to the SPME fiber and desorbed in the GC injection port, the pesticide (dichlorvos) was analyzed with a GC-electron-capture detection system. The optimum conditions for obtaining extraction efficiency, such as the pH, the polarity modifier, and the salt added in sample solution, the microwave irradiation, as well as the desorption parameters were investigated. Experimental results indicated that the proposed MAE-HS-SPME technique attained the best extraction efficiency of 106% recovery under the optimized conditions, i.e. irradiation of extraction solution (10% aqueous ethylene glycol) at pH 5.0 with medium microwave power for 10 min. Desorption at 220 degrees C for 3 min offered the best detection result. The detection was linear at 5-75 microg/l with correlation coefficient of 0.9985. Detection limit was obtained at approximately 1.0 microg/l level based on S/N=3. The proposed method provided a very simple, fast, and solvent-less procedure to collect pesticides directly from vegetables for GC determination. Its application was illustrated by the analysis of trace dichlorvos in vegetables.