Combined modality treatment for non-small cell lung cancer. Lung Cancer Study Group

A total of 265 patients with non-small cell lung cancer at stages 1 and 2 by preoperative clinical staging were divided into 4 stages after exploratory thoracotomy. Patients at each stage were further divided into subgroups to receive different adjuvant therapies. The cumulative 5-year survival rate showed to be 44.4% for stage 1, 35.5% for stage 2, 7.4% for stage 3 and 0% for stage 4. Histologically, the rate was 28.8% for squamous cell carcinoma, 23.4% for adenocarcinoma, and 29.8% for large cell carcinoma and carcinoma poorly differentiated. For patients at stage 1, it made no significant difference whether they underwent surgical resection only or combined with postoperative intrapleural BCG injection. For patients at stage 2, there was no significant difference between surgical resection only and resection combined with postoperative radiotherapy. For patients at stage 3, who underwent surgical resection combined with chemotherapy and/or radiotherapy, it seemed that combined chemotherapy and radiotherapy presented better results than radiotherapy or chemotherapy alone.     

Neurocutaneous melanosis: electron microscopic comparison of the pigmented melanocytic nevi of skin and meningeal melanosis

This is a report of a 28-day-old male infant who had concommitant pigmented melanocytic nevi and meningeal melanosis. Pigment cells of the two lesions were observed by electron microscopy and compared with previous reports of nevus cell nevus, meningeal melanosis, meningeal melanocytoma and leptomeningeal malignant melanoma. Based on our findings, we have reached the following three conclusions: (1) Pigment cells in the nevus and meningeal melanosis in our case were similar in their cellular structures and their relationship to blood vessels and consistent with a neural crest origin for pigment cells; (2) Ultrastructural characteristics of the meningeal melanosis in our case were similar to those of the meningeal melanocytoma; (3) Pigment cells in meningeal melanosis have tumorous potential and may tend to cause malignant changes.     

Superior Vena Cava Syndrome Revisited

A clinical review with analysis of prognostic factors, includingthe impact of the initial management modality, was conductedon 137 patients with superior vena cava syndrome (SVCS) seenat the Veterans General Hospital-Taipei between 1989 and 1993.Malignant diseases account for most of the SVCS in our Chinesepatients. Patients received diagnostic intervention for theirunderlying diseases without obvious complications. Whether ornot there is a development of SVCS in lung cancer patients,showed prognostic significance in non-small cell lung cancer(NSCLQ 'and no significance in small cell lung cancer (SCLQ.Those with SVCS as the initial manifestation of malignant diseasehad a poor prognosis compared to those who developed SVCS later.Survival is best in lymphoma/leukemia patients, followed bymalignant thymoma and SCLC, and worst in NSCLC and metastaticcancer. The rapid onset of symptoms from SVCS had a short mediansurvival in lung cancer and significantly compromised survivalin SCLC. The overall survival of SCLC with SVCS was not affected,regardless of whether the initial therapy had been radiotherapyor chemotherapy