[Bronchiolo-alveolar cancer and its surgical treatment (a practical view)]. / Bronkhioloal'veoliarnyi rak i ego khiorurgicheskoe lechenie (vzgliad iz praktiki).

The authors have followed up 243 patients with bronchioalveolar cancer of the lung from 1979 to 1995 years. The age of the patients varied from 39-83 years. The ratio men women was as 1.1:1.9, which distinctly differ from the indices of morbidity from lung cancer of the whole, 4 forms of bronchioalveolar cancer, according to conventional methods, were singled out. 198 patients died after operation. Favourable long term results were obtained only in nodular forms of bronchioloalveolar cancer. The main diagnostic methods were roentgenological examination tramstriracic puncture and repeated studies of the phlegm.

Exposure to environmental tobacco smoke and risk of lung cancer in non-smoking women from Moscow, Russia.

The association between exposure to ETS and the risk of lung cancer in life-time non-smoking women was investigated by means of a hospital based case-control study in Moscow, Russia. The main importance of our study is that it was conducted on a population with a specific smoking pattern from which no information is available on health effects of ETS. A total of 189 incident cases of histologically confirmed lung cancer were identified in 2 principal cancer treatment hospitals in Moscow. A total of 358 female oncology patients from the same hospitals were selected as controls. The controls matched by the hospitals to the cases were similarly restricted to never-smokers. Women diagnosed with cancer of the upper respiratory organs were ineligible for selection as controls. Personal interviews of cases and controls were conducted in the hospital wards, using a closed-form structured questionnaire. An elevated risk of lung cancer was observed in women whose husbands smoked. The odds ratio (OR) adjusted by age and education for husband's smoking was 1.53 (95% CI, 1.06-2.21). Smoking by other members of the family, by colleague's, or by fathers in the women's childhood do not affect the risk of lung cancer. The risk is higher for women whose husbands smoke "papirosy" (OR 2.12; 95% CI, 1.32-3.40), a special Russian type of cigarettes with a long mouthpiece, and usually very high levels of tar (> 30 mg/cig) and nicotine (> 1.8 mg/cig). Our study suggests that the association between exposure to ETS of the spouse and risk of lung cancer in non-smoking women is somewhat stronger for squamous-cell carcinoma (OR, 1.94; 95% CI, 0.99-3.81) than for adenocarcinoma (OR, 1.52; 95% CI, 0.96-2.39).

[Role of outdoor and indoor air pollution in the etiology of lung cancer]. / Rol' zagriazneniia atmosfernogo vozdukha i vozdukha pomeshchenii v étiologii raka legkogo.

The results of a case-control study of lung cancer risk in female non-smokers in Moscow are presented in the paper. The increase in a risk of lung cancer was found to be associated with outdoor pollution, the closure of the residence to chemical industry and ferrous and non-ferrous smelters, environmental tobacco smoke from husbands and exposure to radon (Rn) at home. The relative risk of lung cancer (RR) for those living in high air polluted versus relatively pure areas was 2.6 (95% CI = 1.2-5.6). RR of lung cancer related to the closure of the residence to chemical industry and ferrous and non-ferrous smelters were 2.0 (95% CI = 1.0-3.9) and 1.75 (95% CI = 1.0-3.1). The analysis has shown that there is an increase in lung cancer risk in women whose husbands smoke, which is as high as 1.9 (95% CI = 1.3-2.9). Lung cancer risk is associated with levels of exposure to Rn in the dwellings: RR was 2.48 (95% CI = 1.4-4.3) for the Rn concentration of > 24.3 Bq/m3 versus < 13 Bq/m3.

[Surgical treatment of lung cancer in patients over 80 years of age]. / Khirurgicheskoe lechenie raka legkogo u lits starshe 80 let.

Growth of the specific fraction of individuals over 80 years of age among patients with lung carcinoma is illustrated by its incidence in Moscow. These patients account today for up to 8% of the total number of cases. Some of them may be successfully treated by operation. This was demonstrated in 11 cases. Recommendations on pre- and postoperative management of such patients are given. The authors emphasize that the patient's fate and the method of treatment should be prescribed only in an oncological medical institution.

[Morbidity and surgical treatment of lung cancer in middle-aged and aged patients in Moscow]. / Zabolevaemost' i khirurgicheskoe lechenie raka legkogo u bol'nykh starshego i pozhilogo vozrasta v Moskve.

Analysis of lung cancer incidence in Moscow residents shows that of late the rise in the incidence has occurred only in absolute number. Intensive rates remain stable. The number of cases in the age groups 1-59, 60-69 and 70 years and older is approximately the same. Of all the patients who need treatment annually, it is provided to one-third of them and surgical treatment to 16-18%. The percentage of operable cancer patients drops with age. Basing on his own 10-year surgical experience, the author thinks it proper to rise surgical activity in the elderly patients.

[Lung cancer in women in Moscow (epidemiology, etiology and surgical treatment)]. / Rak legkogo u zhenshchin v Moskve (nekotorye voprosy épidemiologii, étiologii i khirurgicheskogo lecheniia).

In the studied period (1973-1987) the lung carcinoma morbidity rate among females of Moscow, in general intensive indices (per 100,000 females), showed a tendency to reduce (18.4 in 1973 and 15.1 in 1987). A reverse tendency is mostly encountered in other countries. More than half of patients with lung carcinoma were over 70 years of age. The ratio of males with lung carcinoma to that of females grew from 3.0:1.0 in 1973-1977 to 3.6:1.0 in 1983-1987. In the period from 1979 to 1988, 380 females suffering from carcinoma of the lung were hospitalized to the thoracic department of the clinic. Operations were performed on 215 of them, 174 of the operations were radical. The ratio of operated on males to females was 7.4:1.0. The frequency of central carcinoma among females was 28.8%, which was half that among males (56%). The number of operations according to volume was as follows: pulmonectomy 37, lob- and bilobectomy 119, wedge resection 18. More than half of the female patients had the glandular form of lung carcinoma and its incidence was 3-5 times that among males who were operated on (10-15%). According to the authors, the principal etiological factors are smoking, a history of another malignant tumor, and the exogenous effect of the consequences of urbanization.

[Malignant nonepithelial tumors of the lung]. / Zlokachestvennye neépitelial'nye opukholi legkikh.

The main peculiarities of the clinical course of lung sarcoma were determined from representative material of 134 patients. The main features differentiating malignant nonepithelial tumors from carcinoma of the lung are: younger age (average age 45.5 years), predominantly peripheral clinico-anatomical form (82.8%), and prevalent hematogenic metastasis. Five-year survival in the whole group of patients after surgical treatment was 54%. The size and histological form of the tumor are the main factors of prognosis. The degree of differentiation acquires prognostic significance in tumors measuring more than 3 cm in diameter.

[The immediate results of the surgical treatment of lung cancer in patients over 70 years of age]. / Neposredstvennye rezul'taty khirurgicheskogo lecheniia raka legkogo u bol'nykh starshe 70 let.

The study was concerned with analysis of the data on 342 patients with lung cancer aged more than 70 years, 170 of whom had undergone surgery (peripheral cancer--117, central--53). Considering the poor functional status of the patients and their low compensatory potential, mostly organ-saving procedures (80.4%) (lobe-, bilobectomy, segmentectomy or wedge pneumonectomy) were used. Postoperative, largely bronchopulmonary and cardiovascular, complications developed in 37.6%. Postoperative lethality rate was 14.7%: after partial resection of the lung--13.5%, pneumonectomy--29.6%.

[Lung cancer in the elderly and middle-aged in Moscow and its surgical treatment]. / Rak legkogo u lits starshego i pozhilogo vozrasta v Moskve i ego khirurgicheskoe lechenie.

Lung cancer morbidity in Moscow in recent years is discussed. Two-thirds of the patients were 60 years of age or older. Lung cancer operability in Moscow has remained relatively stable accounting for 10-15%. The age distribution of the said parameter was as follows: patients under 60 years--30-32%; 60-69 years--12-14% and those over 70--4-5%. Results can be better if more middle-aged and elderly patients are operated on. The authors' clinical data on 842 surgical cases of lung cancer (males and females of varying age) are analysed.