Non small cell lung cancer: surgical treatment in the elderly.

Lung cancer resection in elderly patients is justified and has decreasing morbidity and mortality rates. Careful patient selection and operative planning are necessary, however. It is wise to have a diagnosis and staging done before the patient arrives in the operating theater. The surgeon should avoid extended resections when possible. In addition, elderly patients should be ambulated as soon as possible and adequate pain control should be ensured. Finally, the stage of the disease and occurrence of cardiopulmonary complications are the main determinants of outcome.

Non-small cell lung cancer: pulmonary parenchyma resection in lung-compromised patients.

Surgery remains the primary curative treatment for patients who have early-stage non-small cell lung cancer (NSCLC). The proper use of surgical resection depends on a careful assessment of the extent of disease and the cardiopulmonary function. Because lung cancer is more common in patients who have chronic obstructive pulmonary disease (COPD), it is important to select carefully those patients who can safely undergo potentially curative therapy, thereby minimizing postoperative morbidity and mortality. This article discusses the preoperative pulmonary assessment for patient selection, the preparation of high-risk patients, special surgical considerations, and patient management in the immediate postoperative period.

Quality of life survey and palliative care in lung cancer patients.

Aim. In patients with advanced and/or inoperable bronchial tumors, methods of palliative care such as radiotherapy, chemotherapy, brachytherapy and cryotherapy, singly and/or in combination, aiming at extending the survival time and improving the quality of life, were examined. Methods. One hundred and sixty three (163) patients, with mean age 67.9 yrs (range 22-25) and a male/female ratio at 1.34/1, treated between 2000-2004 were studied. Eighty one (81) patients receiving only cryotherapy presented a two-year survival rate at 19.3%, whilst eighty three (83) patients treated with radiotherapy or brachytherapy and/or chemotherapy showed a two-year survival rate at 25%. Sixty-five percent (65%) of patients only cryotreated had improvement in at least one or more Karnofsky and WHO indices. Results. Eighty percent (80%) of patients who received cryotherapy accompanied with supplementary palliative treatment showed amelioration of their clinical status. Conclusion. It seems that for patients with advanced or inoperable lung tumors, cryotherapy associated with additional palliative care may influence the survival time and improve their quality of life.

Left atrial myxoma prolapsing into the left ventricle. Case report and review of the literature.

Cardiac myxomas are rare tumors which may present differently. Left atrial myxoma is an entity from anatomopathological and clinical aspects. To the best of our knowledge, only 2 cases of infected left atrial myxomas treated surgically have been reported in the last 6 years. Herein, we present a patient with a left atrial myxoma prolapsing into the left ventricle in the diastolic phase, which was infected with Streptococcus viridans. Combined therapy, consisting of surgical management and antimicrobial therapy, was used. Clinical presentation, diagnosis and treatment are reviewed.

Primary lung cancer: treatment with radio-frequency thermal ablation.

Primary lung cancer is the most frequently diagnosed malignancy in the world and the leading cause of death from cancer [1]. When the initial diagnosis is made, most cases are inoperable or the patients' condition does not permit surgical interventions [2]. For patients with inoperable lung cancer, percutaneous radio-frequency thermal ablation (RFA) under CT guidance represents an alternative and minimally invasive treatment. It can also be applied in combination with radiation therapy and chemotherapy. We report three cases treated by percutaneous CT-guided RF ablation, from which two had post-operative recurrent tumor and one was inoperable.

Serum estimation of carcinoembryonic antigen, beta(2)-microglobulin and calcitonin as tumor markers in primary lung cancer.

PURPOSE: The aim of this study was to estimate the diagnostic significance of carcinoembryonic antigen (CEA), beta(2)-microglobulin (beta(2)-MG), and calcitonin (CAL) as tumor markers in patients with lung cancer. PATIENTS AND METHODS: Sixty patients were included and CEA, beta(2)-MG, and CAL serum levels were measured before treatment, and one and 6 months after treatment. RESULTS: The results taken showed that CEA mean baseline level was 23.4 ng/ml (normal range 0-5 ng/ml and up to 8 ng/ml in smokers), elevated in 80% of small-cell lung cancer (SCLC) cases, in 93% of adenocarcinomas, in 84% of squamous-cell carcinomas, and in 84% of large-cell carcinomas. The mean beta(2)-MG level was 3.6 mg/l (normal range 0.7-3.4 mg/l), elevated in 70% of SCLC, in 40% of adenocarcinomas, in 66% of large-cell and in 50% of squamouscell carcinomas. The mean CAL level was 170 pg/ml (normal < 26 pg/ml), elevated in 60% of SCLC, in 33% of adenocarcinomas, in 16% of large-cell and in 16% of squamouscell carcinomas. CONCLUSION: CEA, beta(2)-MG, and CAL can be used as tumor markers with diagnostic value in primary lung cancer.

[Night work: a choice of society?]. / Le travail de nuit: un choix de société?

The methodology and first results of a research on night-work management, carried out by the PNR 15, are presented. We show that the effects of night-work and the way it is experienced by the workers, varies from one person to another, and mainly depend on the type of activity concerned and on work conditions. With the aim of prevention, we try to define risk-populations.