ABSTRACT
PURPOSE: To evaluate the diagnostic accuracy of transthoracic needle biopsy (TNB) in patients being treated for cancer in order to compare results from small and large pulmonary nodules and to study the efficiency of pathology versus cytology analysis. PATIENTS AND METHODS: 141 consecutive CT-guided TNBs were performed in 134 patients. Cancer had been diagnosed in all cases. From the CT images, nodules were classified as small (< or = 15 mm) (n = 63; 47%) or large (> 15 mm) (n = 71; 53%). RESULTS: There were 16 benign and 118 malignant lesions (92 metastasis, 18 primary, 8 unspecified). There was no statistically significant difference for sensitivity and for prevalence of pneumothorax between small or large nodules. For the 107 true-positive and 16 true-negative results, the cytology examination was positive alone in 41 cases (33.3%), the pathology examination in 24 cases (19.5%) and both in 58 cases (47.2%). CONCLUSION: The diagnostic efficiency of CT-guided transthoracic needle biopsy is as good for small pulmonary nodules (> or = 15 mm) as for larger lesions. This technique is particularly useful in the diagnosis of secondary lesions and does not increase the risk of complications, even in case of small nodules. Ordering both pathology and cytology examinations improves the efficacy of TNB.
Subject(s)
Biopsy, Needle/methods , Bronchoscopy , Lung Neoplasms/pathology , Radiography, Interventional , Tomography, X-Ray Computed , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy, Needle/adverse effects , Female , Fiber Optic Technology , Hemoptysis/etiology , Humans , Lung Neoplasms/secondary , Male , Middle Aged , Optical Fibers , Pneumothorax/etiology , Risk Factors , Sensitivity and Specificity , Vital Capacity/physiologyABSTRACT
Authors report results of two epidemiological studies concerning hypopharynx cancer. The first one is a part of the head and neck cancer registry of Northern France from 1984 to 1987. Hypopharynx tumors represent 18% of the 6019 registered tumors, 99% are squamous cell carcinoma; the annual european standardized incidence rate is 17.0 per 100,000 males and 0.5 per 100,000 females. The second one is a prospective study of 339 hypopharynx cancer patients: 1 out of 3 lives alone and 1 out 3 works at the moment of diagnosis. The average daily tobacco and alcohol consumption are 24 g and 128 g respectively, without any difference regarding professional exposures.
Subject(s)
Carcinoma, Squamous Cell/epidemiology , Hypopharyngeal Neoplasms/epidemiology , Pharyngeal Neoplasms/epidemiology , Adult , Aged , Aged, 80 and over , Alcohol Drinking , Environmental Exposure , Female , France/epidemiology , Humans , Male , Middle Aged , Population Surveillance , Prospective Studies , SmokingABSTRACT
The authors present the general results of a retrospective study on 2418 patients treated between 1976 and 1980. Primaries were located on buccopharynx in 51% of cases, pharyngolarynx in 45% and nasopharynx or nasal and paranasal cavities in 4%. Two out of 3 tumours were classified T3 T4 (UICC 1979) and 1 out of 2 patients presented with palpable cervical lymph nodes. Taking into account persistent diseases and recurrences, failure at primary sites occurred in 40% of patients, in the neck in 20%, distant metastases in 10%. Synchronous and/or metachronous cancers were observed in 1 out of 3 patients. Actuarial survival rates were 2/3 at 1 year, 1/3 at 3 years, 1/4 at 5 years and 1/7 at 8 years. Endolaryngeal tumours had the best prognosis while hypopharyngeal tumours had the worst prognosis.
