EPIDEMIOLOGICAL REGISTRY OF NEUROENDOCRINE TUMORS IN BULGARIA--A PILOT SURVEY.

The National registry of patients with neuroendocrine tumors (NET) in Bulgaria was established in 2013 as a joint initiative of the Bulgarian Surgical Society and the Institute for Rare Diseases. The register aims to explore the epidemiology of NET in Bulgaria, as well as the different diagnostic and treatment approaches for the disease throughout the country. This the first of its kind retrospective study of NET in the country is covering the period January 2012 - January 2013. A total of 127 patients with NET were identified. At the time of the survey the average age of patients with NET was 58.61 ± 15.59 years. The data show almost equal distribution between the genders with a slight predominance of women. The largest relative part of NET is those of NET located in the gastrointestinal tract (54.10 ± 4.51%), followed by those located in the pancreas (12.30 ± 2.97%) and in the lungs (10.66 ± 2.79%). In 72.44 ± 3.96% of the patients a immunohistochemical diagnosis was performed. The study confirmed the leading role of the surgery method of the NET management. In 65.83 ± 4.33% of the patients a radical removal of the tumor was conducted, while the relative part of the undertaken partial resection was 7.50 ± 2.40%. A statistically significant association between the type of surgical treatment and during the follow-up of patients was found. An update of the information in the register will allow a more precise determining of the distribution and management of NET in Bulgaria.

[Postoperative survival in patients with inoperable lung cancer].

UNLABELLED: Despite the advances in treatment in the last two decades, the prognosis in lung cancer remains infavourable. Only 20-25% of the patients are suitable for operative treatment. Almost 75% of the patients are inoperable at the time of diagnosis. MATERIAL AND METHODS: We present 148 patients, who underwent non-radical operation for the period 01.01.1997 - 31.12.2005 - 129 men (87.16%) and 19 women (12.84%), age range - 29-65 years (53.67 +/- 0.60). RESULTS: The mean time of survival for the group submitted to radiotherapy is 13.74 months, while for the group without postoperative radiotherapy is 9.31 months. The mean time of survival for the group submitted to chemotherapy is 9.99 months, while for the group without adjuvant chemotherapy is 10.27 months. CONCLUSIONS: The radiotherapy significantly improves the survival in the patients with inoperable lung cancer, while the chemotherapy don't increase the survival.

[Stage of disease as a prognostic factor in radically operated patients with non-small cell lung cancer].

UNLABELLED: Despite the better diagnostic and therapeutic opportunities, lung cancer is still the major cause for cancer mortality. The surgical-pathological TNM-stage is known as the most reliable prognostic factor for survival in patients with lung cancer. MATERIAL AND METHODS: We present 440 patients with non-small cell lung cancer, radically operated in the Clinic of Thoracic and abdominal surgery of University Hospital "St.George" - Plovdiv for the period 01.01.1997 - 01.09.2004 - 378 men (85.91%) and 62 women (14.09%), age range 23-82 years. RESULTS: The mean time of survival according to the stage is as follows: IA - 77 months, IB - 67, IIA - 55, IIB - 42, IIIA - 33 IIIB - 14, IV - 27 months. CONCLUSIONS: The stage of the disease is an important prognostic factor for patients with lung cancer. We found the lowest survival in stage IIIB. For selected patients in stage IV, the operative treatment leads to good results.

[Extent of resection as a prognostic factor in patients with non-small cell lung cancer].

UNLABELLED: Despite the new methods of treatment during the last two decades, prognosis in lung cancer remains unfavourable. Only 20-25% of the patients are suitable for surgery, and the surgical resection is the unique alternative with curable intent. The extent of resection is an important prognostic factor in lung cancer patients. MATERIAL AND METHODS: We present 440 patients with non-small cell lung cancer, radically operated in the Clinic of Thoracic and abdominal surgery of University Hospital "St.George" - Plovdiv for the period 01.01.1997 - 01.09.2004.191 underwent lobectomy, 12 - limited resection, 39 - bilobectomy, and 198 - pneumonectomy. RESULTS: 63 patients underwent lobectomy for stage I, and the 5-year survival was 63.49%. For the 12 patients with limited resection we found mean time of survival of 50 months, and the 5-year survival was 50%.331 of our patients were in stage II and III. 123 of them underwent lobectomy--the 5-year survival was 28.46%. 208 patients underwent bilobectomy and pneumonectomy--the 5-year survival in this group was 17.79%. CONCLUSIONS: In conclusion we found that the extent of resection is an important prognostic factor for lung cancer patients in stage I. The patients submitted to lobectomy have better survival compared with those submitted to limited resection. The survival is better for the group of patients who underwent lobectomy,compared with the one for the group with bilobectomy and pneumonectomy, which is probably due to the earlier stage of the disease.

[Prognostic value of estrogen receptors--ERalpha and ERbeta, in patients with lung cancer].

SUMMARY: There are over 150 prognostic factors in lung cancer, which allow to predict the outcome of the disease.Many molecular factors are known to have independent prognostic significance. At present these factors are not routinely used in the clinical practice, but they may play an important role in the future for precise individual prognosis. MATERIAL AND METHODS: The study included 122 patients with non-small cell lung cancer.Using immunohistochemistry we examined the expression of estrogen receptors--ERalpha and Erbeta. RESULTS: The median time of survival depending on the expression of Eralpha was 31 months, while for Erbeta was 73 months. CONCLUSIONS: Erbeta is a positive prognostic factor in patients with non-small cell lung cancer.

[Prognostic value of the molecular markers ICAM-1 and C-JUN in patients with lung cancer].

UNLABELLED: Many of the clinical and fundamental scientific studies are directed to the investigation of the prognostic factors in patients with lung cancer. Many molecular factors are known to have independent prognostic significance and although these factors are not routinely used in the clinical practice, they may play an important role in the future. MATERIAL AND METHODS: The study included 122 patients with non-small cell lung cancer. We examined the expression of ICAM-1 and C-Jun. RESULTS: The median time of survival for the group with poor expression of C-Jun was 39 months, and 26 months for the group with strong expresssion. The median time of survival for the group with poor expression of ICAM-1 was 51 months and only 9 months for the group with strong expresssion. CONCLUSION: The increased levels of ICAM-1 and C-Jun are negative prognostic factors for the patients with non-small cell lung cancer.

[The role of surgical treatment of primary non-small cell lung cancer with synchronous brain metastases].

UNLABELLED: Although several studies confirm the superiority of surgical resection of the primary lung cancer and metachronous brain metastases to other treatment modalities, the results of resection of the primary non-small cell lung cancer and synchronous brain metastases are still controversial. MATERIAL AND METHODS: In the clinic of Thoraco-abdominal surgery of the University Hospital "St.George" for the period 01.01.1997-01.09.2004 radically operated are 440 patients with non-small cell lung cancer, 6 of them had solitary brain metastases, succefully resected in clinic of neurosurgery. RESULTS: We found 5-year survival in only 1 of the patients, the mean survival for the rest of them was 16 months. CONCLUSIONS: Although the overall survival for the patients with non-small cell lung cancer and brain metastases is poor, the surgical resection may be beneficial in a select group of patients without lymph node metastases.

[Prognostic value of the molecular markers cyclin D1 and P53 in patients with lung cancer].

UNLABELLED: The discovery of new genes with important regulatory functions on cellular level, allowed the investigation of many biological and molecular changes and defining their value as potential prognostic factors. MATERIAL AND METHODS: The study included 122 patients with non-small cell lung cancer. We examined the expression of cyclin D1 and p53. RESULTS: The 5-years survival rate was 26% for the group with strong nuclear expression of cyclin D1, and 80% for the group with moderate expression of the marker. We found 5-years survival rate of 100% for the group with poor expression of p53, and 24.55% for the group with strong expression. CONCLUSIONS: The increased levels of cyclin D1 and p53 are negative prognostic factors for the patients with non-small cell lung cancer.