Progression-Free Survival: An Important Prognostic Marker for Long-Term Survival of Small Cell Lung Cancer / 결핵및호흡기질환

BACKGROUND: Small cell lung cancer (SCLC) is an extremely aggressive tumor with a poor clinical course. Although many efforts have been made to improve patients' survival rates, patients who survive longer than 2 years after chemotherapy are still very rare. We examined the baseline characteristics of patients with long-term survival rates in order to identify the prognostic factors for overall survivals. METHODS: A total of 242 patients with cytologically or histologically diagnosed SCLC were enrolled into this study. The patients were categorized into long- and short-term survival groups by using a survival cut-off of 2 years after diagnosis. Cox's analyses were performed to identify the independent factors. RESULTS: The mean patient age was 65.66 years, and 85.5% were males; among the patients, 61 of them (25.2%) survived longer than 2 years. In the multivariate analyses, CRP (hazard ratio [HR], 2.75; 95% confidence interval [CI], 1.25-6.06; p=0.012), TNM staging (HR, 3.29; 95% CI, 1.59-6.80; p=0.001), and progression-free survival (PFS) (HR, 11.14; 95% CI, 2.98-41.73; p<0.001) were independent prognostic markers for poor survival rates. CONCLUSION: In addition to other well-known prognostic factors, this study discovered relationships between the long-term survival rates and serum CRP levels, TNM staging, and PFS. In situations with unfavorable conditions, the PFS would be particularly helpful for managing SCLC patients.

A Case of Atypical Adenomatous Hyperplasia of Larger Than 2 cm / 결핵및호흡기질환

Atypical adenomatous hyperplasia (AAH) has been considered to be a precursor lesion of bronchioloalveolar carcinoma (BAC) and pulmonary adenocarcinoma. It usually coexists with BAC and/or an adenocarcinoma. Chest computed tomography reveals multiple well-defined nodules with ground-glass opacity. Usually, AAH does not exceed 10 mm in size. AAH with extensive involvement on one side of the lung field or one that is larger than 2 cm has not been previously reported. We herein report a case of a 71-year-old nonsmoking female with lung AAH of larger than 2 cm.

Second Complete Remission of Relapsed Stage IV Non-Small Cell Lung Cancer Following Retreatment / 결핵및호흡기질환

Non-small cell lung cancer (NSCLC) is the leading cause of cancer related deaths. Most patients were presented with advanced disease at the time of diagnosis. In advanced NSCLC, it is almost impossible to anticipate complete remission by using only cytotoxic chemotherapy or molecularly targeted agents. In our case, two patients were diagnosed as advanced NSCLC and received chemotherapy. They achieved complete response (CR). After finishing treatment, disease recurred. They were retreated with the same regimens and achieved second CR. Until now, they have received each regimen, continuously, and the CR state has been maintained.

Clinical Characteristics of Patients Older than 76 with Lung Cancer / 대한내과학회지

BACKGROUND/AIMS: A significant proportion of elderly patients who have lung cancer do not receive treatment even though they may benefit from it. The aims of this study were to analyze the clinical characteristics of elderly patients with lung cancer, especially those aged 76 years and older. METHODS: In this retrospective study, we analyzed clinical data from 341 patients with lung cancer who were diagnosed at Chungnam National University Hospital from January 2003 to September 2010. RESULTS: The median age of patients was 79 years (76-91), and 39.6% (n = 135) of the total sample were older than 80. Squamous cell carcinoma was the most common type of lung cancer, and the performance status (Eastern Cooperative Oncology Group [ECOG] 0-1) of 40.6% (n = 116) of the sample was good. Of the 293 non small cell lung cancer (NSCLC) patients, 53.6% were untreated. About 68% of all patients knew about their disease (n = 232). CONCLUSIONS: Our data indicated that many elderly patients with lung cancer were undertreated. Elderly patients with lung cancer should receive education to help them understand their disease and to encourage them to receive appropriate treatment.

A Case of Pneumonia and Parapneumonic Effusion Caused by Streptococcus parasanguinis / 결핵및호흡기질환

Streptococcus parasanguinis is a Viridans group bacteria that is most often discovered in the oral cavity and causes dental plaque and endocarditis in a rat model. It has low virulence but an unknown relationship to human respiratory infections. We report on a 61-year-old woman who developed hemoptysis followed by pleuritic chest pain after conscious sedation during a gastroscopic polypectomy and was diagnosed with pneumonia and parapneumonic effusion from Streptococcus parasanguinis isolated in pleural fluid. Microaspiration during the procedure was presumed to play a role in the pathogenesis.