[Diagnosis and treatment of lung cancer in polyneoplasia].

Recently there has been an increase in the incidence of polyneoplasias (PNP) of various organs. This is associated with certain advances in the treatment of malignancies with prolonged survival on the one hand and with better diagnosis and the emergence of new instrumental studies. The diagnosis and treatment of lung cancer as a component of PNP) currently remains a great challenge. In 1985 to 2004, the Acad. B. V. Petrovsky Russian Research Center of Surgery, Russian Academy of Medical Sciences, and Moscow Cancer Dispensary One treated 403 patients for lung cancer detected in combination with an extrapulmonary malignant tumor or second lung cancer, which amounted to 8.9% of the patients operated on for lung cancer. Primary malignancy of the lung and secondary neoplasm were synchronously and metachronously diagnosed in 165 (40.9%) and 238 (59.1%) patients, respectively. Lobectomy was performed in 207 (51.4%) patients while 79 (19.6%) patients underwent sublobar resection. Three- and 5-year overall survival was 43.4 and 30.6%, respectively. After radical operations, better 5-year survival rates were observed in patients with metachronous lung cancer in PNP (32.5% than in those with synchronously detected one (27.9%) (p < 0.05). The results depended on the stage of the disease--all patients with Stage IIIB died within the first year postoperatively. Thus, lung cancer as a component of PNP should be treated by the principles of bronchopulmonary cancer. Moreover, the similar long-term results that mainly depend on the stage of the disease are achieved. New instrumental studies establish the preoperative diagnosis in 88.4% of cases.

[Results of surgical treatment of lung cancer in patients over 70 years old]. / Rezul'taty khirurgicheskogo lecheniia raka legkogo u bol'nykh v vozraste starshe 70 let.

Results of surgical treatment of 345 patients (210 men--61%; 135 women--39%) over 70 years with non-small-cell lung cancer were analyzed. Central lung cancer was diagnosed in 141 (40.9%), peripheral--in 204 (59.1%) patients. Squamous cell cancer was seen in 233 (67.3%), glandular--in 67 (19.4%), dimorphic--in 22 (6.5%), large-cell--in 23 (6.8%) patients. Stage I of the disease was diagnosed in 121 (35.1%); stage II--in 49 (14.1%); stage III--in 175 (50.8%) patients. Rate of postoperative complications in the study group was 27.8%, lethality--6.4%. The highest lethality was after combined pneumonectomy. The most frequent postoperative complications were pneumonia (7.5%), arrhythmia (10.1%), pulmonary-heart insufficiency (4.9%). Five-year survival after radical surgery in patients over 70 years with lung cancer was 49%, in patients with stage I of the disease this parameter was the highest--71.4%.