ABSTRACT
Cavity in lung cancer patients is usually attributed to worse prognosis, which could be caused by diagnostic difficulties and late surgery. The aim of this study is to identify cavity as clinical subentity in squamous cell lung cancer (SqCLC) patients. 1094 patients with I0 - III0 of SqCLC underwent surgery with the purpose of radical lobectomy or pneumonectomy. The patients were divided into two groups: 100 patients with cavity (cSqCLC) and 994 with solid tumor (sSqCLC). The clinical, histological and prognostic features were compared for the both groups. The Cox multivariate analysis of the prognostic factors was performed. The survival curves for both groups were compared. cSqCLC patients showed lower body mass and more frequent hemoptoe. They had larger tumors, located peripherically, rarer nodal involvement and atelectasis. Despite the similar cancer stage and the exploratory thoracotomies ratio, cSqCLC patients lived shorter. The survival curves for both groups were different: in all population, for patients after radical surgery and even after exploratory thoracotomy. We conclude that the cavitation in SqCLC patients can be regarded as a separate subentity related to worse prognosis.
Subject(s)
Carcinoma, Squamous Cell/diagnosis , Lung Neoplasms/diagnosis , Adolescent , Adult , Aged , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/pathology , Female , Humans , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Male , Middle Aged , Prognosis , Survival AnalysisABSTRACT
Ninety-three patients with pulmonary metastases (PM) were operated on between 1983 and 1997. Surgical complications occurred in 8 (9%) of patients. Two (3%) of patients died in hospital, 7 were operated on again due to further PM. An average survival after lung metastasis surgery was 40 months, median 22 months. 44% and 35% of patients survived respectively 3 and 5 years. Thanks to lung metastasis surgery the overall survival was longer; an average overall survival was 87 months (median 58 months). 58% and 38% of patients survived respectively 5 and 10 years. Time between treatment of primary tumour (PT) and lung metastasis surgery (disease free interval DFI) was on average 4 years, median 41 months. The patients who showed DFI-longer than 2 years had tendency to live longer (p = 0.086). Patients with PM are recommended to be operated on, even if further PM occur.
Subject(s)
Lung Neoplasms/secondary , Lung Neoplasms/surgery , Adenocarcinoma/secondary , Adolescent , Adult , Aged , Carcinoma, Squamous Cell/secondary , Female , Germinoma/secondary , Humans , Lung Neoplasms/mortality , Male , Melanoma/secondary , Middle Aged , Sarcoma/secondary , Survival RateABSTRACT
AIMS: To evaluate the efficacy of pulmonary metastasectomy in 93 patients with lung metastases (LM) operated on from 1983 to 1997. METHODS: We assessed: location and histological diagnosis of the primary tumour (PT); the extent of pulmonary resection; and disease-free interval (DFI). Survival analysis was undertaken using the Kaplan-Meier method. RESULTS: Surgical complications occurred in eight (9%) patients; two (3%) died in hospital; seven (8%) were operated again because of further LM. In the whole patient group the average survival after metastasectomy was 40 months (median 22 months). The actuarial survival was 44% at 3 years and 35% at 5 years. With metastasectomy we achieved an overall survival after treatment of PT of 87 months (median 58 months). The actuarial survival was 58% at 5 years and 38% at 10 years. The average time between the treatment of PT and metastasectomy DFI was 4 years (median 41 months). Patients with a DFI of more than 2 years tended to live longer (P=0.086). There were 23 patients with non-epithelial and 70 patients with epithelial tumours. Their DFIs were similar (mean 47, median 34 months for non-epithelial and mean 51, median 29 months for epithelial tumours). Of patients with non-epithelial tumours, 38% survived for 5 years and their survival curves were similar. In the group of tumours with the most frequent location, the results of metastasectomy did not differ considerably: 5 year survival rates of 20% for patients with kidney tumours, 28% for colorectal cancer, 30% for soft-tissue sarcoma, 28% for skin melanoma and 18% for breast cancer. CONCLUSIONS: Lung metastasectomy seems to be a safe and efficient method of treatment even for patients who show further metastases. According to our study it seems that, except for LM of breast carcinoma (which has a slightly worse prognosis), the results of surgical resection are not dependent on either the location or the histological pattern of the PT. For this reason patients indicated for operation can be selected according to similar criteria.
Subject(s)
Lung Neoplasms/secondary , Lung Neoplasms/surgery , Actuarial Analysis , Adult , Disease-Free Survival , Female , Humans , Male , Middle Aged , Patient Selection , Prognosis , Retrospective Studies , Survival Analysis , Treatment OutcomeABSTRACT
The results of radical and partial surgical treatment of 146 patients with mediastinal tumors have been assessed. All patients were operated at the Specialistic Hospital in Zakopane from the 1st January, 1967 to the 31st December, 1989. Hundred twenty one patients (82.9%) suffered from malignancy and 25 (17.1%) from non-malignant mediastinal tumors. Mortality rate was 2.0%. Late results have been expressed in terms of survival period, and they have been as follows: 44.4% of patients survived 20 years after surgery, 36.5% of patients survived 15 years, 42.9% of patients--10 years, and 56.1% of patients survived 5 years. More than 50% of operated patients resumed their previous work.
