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1.
《Archivos de bronconeumologia》2020,56(5):277-281
IntroductionLung cancer mortality is increasing in women. In Spain, estimates suggest that lung cancer mortality may soon surpass breast cancer mortality, the main cause of cancer mortality among women. The aim of this study was to estimate the proportion of women at high risk of developing lung cancer in a group of participants in a population-based breast cancer screening program.MethodsCross-sectional study in a sample of women who participated in a population-based breast cancer screening program in 2016 in Hospitalet de Llobregat n = 1,601. High risk of lung cancer was defined according to the inclusion criteria of the National Lung Screening Trial (NLST) and the Dutch-Belgian randomized lung cancer screening trial (NELSON).ResultsAround 20% of smokers according to NLST and 40% of smokers according to NELSON criteria, and around 20% of former smokers according to both criteria, are at high risk of developing lung cancer. A positive and statistically significant trend is observed between the proportion of women at high risk and nicotine dependence measured with the brief Fagerström Test.ConclusionsA high proportion of participants in this breast cancer screening program have a high risk of developing lung cancer and would be eligible to participate in a lung cancer screening program. Population-based breast cancer screening programs may be useful to implement lung cancer primary prevention activities. 相似文献
2.
Ryoichi Kondo Kazuo Yoshida Takashi Eguchi Nobutaka Kobayashi Gaku Saito Kazutoshi Hamanaka Takayuki Shiina Makoto Kurai 《European journal of cardio-thoracic surgery》2011,40(6):1439-1443
Objectives: We estimated the influence of chronic obstructive pulmonary disease (COPD) upon the clinicopathological characteristics of lung cancer (LC) in Japanese surgical cases by comparing LC cases in non-COPD smokers. Method: A consecutive cohort comprising 157 COPD patients (78 in Global Initiative for Obstructive Lung Disease-1 (GOLD-1) and 79 in GOLD-2) and 374 non-COPD smoker-LC patients were enrolled in this study. Comparative analyses of the clinicopathological features of these two groups, including clinical outcomes, were performed. Results: By analyzing all cases, we found that LC patients with COPD were older on average, more likely to be male, and heavier smokers than LC patients without COPD. In sub-analysis involving matched patient backgrounds, histological differentiation grade of LC in smokers with COPD was lower than in LC smokers without COPD, although distribution of clinical stages and histological types of LCs did not differ between smokers with and without COPD. The 5-year-survival rate in COPD patients was poorer than in non-COPD smokers in terms of both overall (38% vs 54%) and cancer-related mortality (45% vs 63%). By single-variant risk analysis, COPD became a prognostic factor. Conclusion: We concluded from our analysis that COPD-related LC may have a higher malignant potential than LC in non-COPD smokers, as the histological differentiation grade and clinical outcomes were poorer. 相似文献
3.
Manabu Yasuda Akira Nagashima Akira Haro Genkichi Saitoh 《International journal of surgery case reports》2013,4(8):690-692
INTRODUCTIONPulmonary aspergillosis occurs in the parenchymal cavities or ectatic airways. It rarely affects healthy people with an intact immune response. There have been few reports describing an aspergilloma mimicking a lung cancer.PRESENTATION OF CASEWe experienced the case of an asymptomatic healthy 71-year-old female who was admitted with an abnormal lung shadow. Chest CT revealed an irregularly shaped solid lung nodule in the left upper lobe, which increased in size during the follow-up at a regional hospital. The pathology of the bronchial biopsy was negative for malignant cells, and the cultures were negative. Because a lung cancer was strongly suspected, video-assisted thoracic surgery was performed. Aspergillus was detected by a pathological study of the excised specimen, with no evidence of lung cancer.DISCUSSIONIt is difficult to make an accurate diagnosis of aspergilloma by imaging findings in healthy people with an intact immune response, and therefore a surgical resection allows both the pathological diagnosis and treatment to be performed concurrently.CONCLUSIONAn aspergilloma presenting a mass shadow on imaging may mimic a lung cancer in healthy people with intact immune response. 相似文献
4.
Juan P. de-Torres Juan P. Wisnivesky Gorka Bastarrika David O. Wilson Bartolome R. Celli Javier J. Zulueta 《Archivos de bronconeumologia》2021,57(1):36-41
BackgroundLung Cancer (LC) screening with low dose chest computed tomography (LDCT) in smokers reduces LC mortality. Patients with Obstructive Lung Disease (OLD) are at high risk for LC. The potential effect of LC screening in this population is unknown.ObjectiveTo determine if screening with LDCT reduces LC mortality in smokers with spirometrically defined OLD.MethodsThe National Lung Screening Trial-American College of Radiology Imaging Network (NLST-ACRIN) study included 13,831 subjects (55–74 years of age with ≥30 pack-year history of smoking) that had a baseline spirometry. Randomly assigned to LDCT or Chest X-ray, all had 3 annual rounds of screening. LC mortality was compared between the LDCT and chest X-ray arms during the 1st year and at 6 years of follow up. Landmark analysis explored LC mortality differences between arms after the first year.ResultsFrom the 4584 subjects with OLD (FEV1/FVC <0.7), 152 (3.3%) died from LC. Multivariable analysis showed that screening trended to decrease LC mortality at 6 years (HR, 95%CI: 0.75, 0.55–1.04, p = 0.09). During the 1st year no differences were found between arms (p = 0.65). However, after this year, LDCT significantly decreased LC mortality (HR, 95%CI: 0.63, 0.44–0.91, p = 0.01). The number needed to screen to avoid one LC death in these subjects was 108 while in those without OLD was 218.ConclusionsLC screening with LDCT in smokers with spirometrically diagnosed OLD, showed a trend to reduce lung cancer mortality but a study with a larger number of patients and with a more robust design would be needed to confirm these findings. 相似文献
5.
Helen Ho Christina Williamson Shawn M. Regis Cameron T. Stock Syed M. Quadri Brady J. McKee Andrea B. McKee Elliot L. Servais 《The Journal of thoracic and cardiovascular surgery》2021,161(3):790-802.e2
ObjectiveLung cancer screening with low-dose chest computed tomography improves survival. However, concerns about overdiagnosis and unnecessary interventions persist. We reviewed our lung cancer screening program to determine the rate of surgery and invasive procedures for nonmalignant disease.MethodsWe reviewed all patients undergoing lung cancer screening from January 2012 to June 2017 with follow-up through January 2019. Patients with suspicious findings (Lung CT Screening Reporting and Data System 4) were referred for further evaluation.ResultsOf 3280 patients screened, 345 (10.5%) had Lung CT Screening Reporting and Data System 4 findings. A total of 311 patients had complete follow-up, of whom 93 (29.9%) were diagnosed with lung cancer. Eighty-three patients underwent lung surgery (2.5% of screened patients). Forty patients underwent lobectomy (48.2%), 3 patients (3.6%) underwent bilobectomy, and 40 patients (48.2%) underwent sublobar resection. Fourteen patients underwent surgery for benign disease (0.43% of screened patients). Fifty-four patients, 5 with benign disease, had at least 1 invasive diagnostic procedure but never underwent surgery. The incidence of any invasive intervention for nonmalignant disease was 0.95% (31/3280 patients). There were no postprocedural deaths within 60 days. Twenty-five patients (0.76%) underwent stereotactic body radiation therapy; 19 patients (76%) had presumed lung cancer without pretreatment pathologic confirmation.ConclusionsSurgical resection for benign disease occurred in 0.43% of patients undergoing lung cancer screening. The combined incidence of any invasive diagnostic or therapeutic intervention, including surgical resection, for benign disease was only 0.95%. Periprocedural complications were rare. These results indicate that concern over unnecessary interventions is overstated and should not hinder adoption of lung cancer screening. A multidisciplinary team approach, including thoracic surgeons, is critical to maintain an appropriate rate of interventions in lung cancer screening. 相似文献
6.
Bram Balduyck Peyman Sardari Nia Anouschka Cogen Yanina Dockx Patrick Lauwers Jeroen Hendriks Paul Van Schil 《European journal of cardio-thoracic surgery》2011,40(6):1432-1438
Objective: This study aimed to evaluate the effect of smoking status on quality of life (QoL) after non-small-cell lung cancer surgery with the European Organisation for Research and Treatment of Cancer (EORTC) QoL Questionnaire-C30 and LC13. Methods: QoL was prospectively recorded in 70 consecutive patients undergoing lobectomy or pneumonectomy. Questionnaires were administered preoperatively and 1, 3, 6 and 12 months postoperatively (MPO). Results: Of all patients analysed, nine (13%) were non-smokers, 20 (29%) former smokers, six (8%) recent quitters and 35 (50%) current smokers. All four groups had comparable patients’ characteristics and preoperative QoL scores, with exception of non-smokers who had significantly lower physical functioning, role functioning, cognitive functioning and a higher thoracic pain burden. In non-smokers, all QoL scores returned to baseline 3 months after surgery. Former smokers complained of a significant 3-month decrease in physical functioning (3 MPO, p = 0.01) and a 12-month decrease in role functioning (12 MPO, p = 0.01). Former smokers complained of a significant increase in dyspnoea (6 MPO, p = 0.001) during the first 6 months after surgery. Recent quitters had a longer impairment in physical functioning (6 MPO, p = 0.01) and a 3-month burden of dyspnoea (3 MPO, p = 0.02). In current smokers, no return to baseline in physical (12 MPO, p = 0.01), role (12 MPO, p = 0.01) and social functioning (12 MPO, p = 0.02) and a persistent increase in dyspnoea (12 MPO, p = 0.04) were reported. Current smokers also complained of increased thoracic pain (12 MPO, p = 0.02). Except non-smokers, all patients complained of fatigue the first 3 months after surgery. Conclusions: Smoking cessation is beneficial at any time point to lung cancer surgery and current smoking at the time of surgery is associated with a poor postoperative QoL. 相似文献
7.
INTRODUCTIONThe prognosis of patients with lung cancer metastasis to the spine is not very promising and a palliative approach is often suggested by scales such as the Tomita score. The choice of surgery for these patients is questionable based on the aggressiveness of the disease. However, certain patient characteristics can be sought out to determine if surgery is indicated.PRESENTATION OF CASEHere, we present a case of a 59 year old male which consulted for back pain, numbness of the upper left thigh, and weakness corresponding to an L2 lesion. It was later discovered that he was suffering from non small cell lung cancer (adenocarcinoma) with a single metastasis to the spine at the level of L2. The patient also presented an EGFR mutation. Thus, the patient presented two good prognosis characteristics: adenocarcinoma and an EGFR mutation.DISCUSSIONAn aggressive treatment was chosen. This included an EGFR inhibitor, surgical treatment, and radiotherapy thereafter. The patient had no complications due to surgery and to date, the patient has survived over 12 months and is free of any symptoms. This case demonstrates that surgical intervention can be considered for certain patients with lung cancer metastasized to the spine.CONCLUSIONThis case demonstrates that surgical intervention can be considered for certain patients with lung cancer metastasized to the spine. We hope spine surgeons in general will start verifying the EGFR mutation status of adenocarcinoma lung cancer patients to determine if surgery is indicated. 相似文献
8.
Weigel TL Yousem S Dacic S Kosco PJ Siegfried J Luketich JD 《Annals of surgical oncology》2000,7(3):176-180
Background
Second lung primaries occur at a rate of up to 3% per patient-year after curative resection for non-small-cell lung carcinoma. Postresection patients are often poor candidates for further curative surgery because of their diminished pulmonary reserve. The aim of this study was to evaluate the role of fluorescence bronchoscopy by using the Xillix® LIFE-Lung Fluorescence Endoscopy SystemTM to identify second lung primaries in patients who have had a previous curative resection of a non-small-cell lung cancer.Methods
Patients who had no evidence of disease status after resection of a non-small-cell lung cancer were identified from a prospectively collected data base and entered onto a fluorescence bronchoscopy surveillance protocol. All suspicious areas, as well as several areas of apparently normal mucosa, were sampled for biopsy. A single pathologist reviewed all biopsy specimens, with 10% of biopsies re-reviewed, for quality control, by a second pulmonary pathologist.Results
A total of 31 surveillance fluorescence bronchoscopies were performed on 25 patients after conventional bronchoscopy. Four intraepithelial neoplasias or invasive carcinomas were identified in 3 (12%) of 25 patients screened. The addition of the LIFE examination to conventional bronchoscopy increased the sensitivity of screening from 25.0% to 75.0%, which yielded a relative sensitivity of 300% with a negative predictive value of .97.Conclusions
Use of postresection surveillance with fluorescence bronchoscopy identified intraepithelial or invasive lesions in 12% of non-small-cell lung cancer patients, and the system was three times more sensitive than conventional bronchoscopy to identify these early mucosal lesions. Fluorescence bronchoscopic surveillance of this high-risk, postresection population will help better define the true rate of occurrence and the natural history of second primaries and may assist in monitoring their response to newer, noninvasive treatment methods, such as photodynamic therapy or chemopreventive agents, in future trials. 相似文献9.
Loss of blood group antigen a in non-small cell lung cancer 总被引:1,自引:0,他引:1
Dr. John L. Gwin MD Andres J. P. Klein-Szanto MD Shi-Yu Zhang MD Pasha Agarwal MD Andre Rogatko PhD Steven M. Keller MD 《Annals of surgical oncology》1994,1(5):423-427
Background: Many human tumor cells display alterations in blood group antigen expression, and the loss of antigen A expression by non-small
cell lung cancer (NSCLC) in blood group A patients has recently been associated with decreased survival.
Methods: To confirm this finding, we performed a retrospective study of 62 NSCLC patients undergoing potentially curative resection
between August 1987 and December 1991 who were blood group A and had paraffin-embedded primary lung cancer tissue suitable
for immunohistological analysis of antigen A expression. Twenty-seven patients expressed antigen A in their tumors, whereas
35 had loss of antigen expression. Disease-free survival (DFS) curves were calculated for stage I (n=26) and IIIA (n=25) patients.
Results: The two groups of patients with or without antigen A expression did not have significantly different DFS. A proportional
hazards regression analysis identified no significant difference in the DFS of stage I patients with or without antigen A,
but stage IIIA patients who had preservation of antigen A had significantly shorter DFS than did those who lost antigen A
(p=0.0002).
Conclusions: The loss of expression of antigen A by primary tumor cells was not a significant adverse prognostic factor in DFS in our
series, and we would recommend further studies to define clearly the clinical importance of antigen A expression in pulmonary
carcinoma.
Presented at the 46th Annual Cancer Symposium of The Society of Surgical Oncology, Los Angeles, California, March 18–21, 1993. 相似文献
10.
Dong Gon Yoo Yong-Hee Kim Dong Kwan Kim Hyeong Ryul Kim Seung-il Park 《European journal of cardio-thoracic surgery》2011,40(6):1483-1486
Objective: This study was performed to assess the clinical feasibility and surgical outcomes of video-assisted mediastinoscopic lymphadenectomy in the treatment of resectable lung cancer. Methods: Between July 2004 and December 2009, we retrospectively analyzed 108 consecutive video-assisted mediastinoscopic lymphadenectomies in lung cancer patients from a prospectively collected database. Ninety-seven (89.8%) patients underwent combined operation during the same anesthesia and six (5.3%) patients underwent a staged operation for the resection of lung cancer and systematic lymphadenectomy. We reviewed the indication and duration of video-assisted mediastinoscopic lymphadenectomy, its complication, combined or staged operation type, the number of dissected lymph nodes and nodal stations, and pathologic staging of the mediastinal node. Results: Mean operative time of video-assisted mediastinoscopic lymphadenectomy was 39.8 ± 12.3 min (range of 14–85 min). Mean number of resected lymph nodes was 16.0 ± 7.7 (range of 3–37). In video-assisted mediastinoscopic lymphadenectomy, the rates of lymph node dissection of stations 4R, 4L, and 7 were 71.3%, 88.0%, and 100%, respectively, whereas the rates of dissection of lymph nodes in station 2R and 2L were only 22.2% and 17.6%, respectively. There was no operative mortality. We identified five complications of recurrent nerve palsy. Conclusions: Video-assisted mediastinoscopic lymphadenectomy is a clinically feasible procedure with acceptable complication rate and provides more accurate staging of mediastinal node in lung cancer patients. It may be also an excellent supplementary technique used for complete mediastinal node dissection at minimal invasive surgery for cancer resection, especially with left-sided video-assisted thoracoscopic lobectomy. 相似文献
11.
《Urologic oncology》2015,33(2):65.e19-65.e25
PurposeBladder cancer (BC) screening is not accepted in part owing to low overall incidence. We used the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) and National Lung Cancer Screening Trial (NLST) to identify optimal high-risk populations most likely to benefit from screening.Materials and methodsData were extracted from PLCO and NLST to stratify risk of BC by overall population, sex, race, age at inclusion, and smoking status. Incidence rates between groups were compared using chi-square test.ResultsBC was identified in 1,430/154,898 patients in PLCO and 439/53,173 patients in NLST. BCs were grade III/IV in 36.8% and 41.3%. Incidence rates were significantly higher in men than in women (PLCO: 1.4 vs. 0.31/1,000 person-years and NLST: 1.84 vs. 0.6/1,000 person-years, both P<0.0001). In proportional hazards models, male sex, higher age, and duration and intensity of smoking were associated with higher risk of BC (all P<0.0001). In men older than 70 years with smoking exposure of 30 pack-years (PY) and more, incidence rates were as high as 11.92 (PLCO) and 5.23 (NLST) (per 1,000 person-years). In current high-intensity smokers (≥50 PY), the sex disparity in incidence persists in both trials (0.78 vs. 2.99 per 1,000 person-years in PLCO and 1.12 vs. 2.65 per 1,000 person-years in NLST).ConclusionsMen older than 60 years with a smoking history of>30 PY had incidence rates of more than 2/1,000 person-years, which could serve as an excellent population for screening trials. Sex differences in the incidence of BC cannot be readily explained by the differences in exposure to tobacco, as sex disparity persisted regardless of smoking intensity. 相似文献
12.
The interim and final results of randomized controlled trials on the efficacy of lung cancer computed tomography (CT) screening have been reported recently from Western countries. The outcome of the National Lung Screening Trial (NLST) demonstrated the efficacy of low-dose thoracic CT screening for heavy smokers; however, other studies have found no apparent reduction in the mortality rate, and the outcome of the NELSON study is awaited. To date, a few studies have reported on the efficacy of lung cancer CT screening for non-/light smokers. A report from the Hitachi district, which is an ecological/time series study where non-/light smokers account for approximately half of the CT screening examinees, was published in 2012, with an outcome suggesting efficacy. Currently, a randomized controlled trial (JECS Study) is underway in Japan with non-/light smokers as the subjects, and this trial is very important in terms of cancer prevention. 相似文献
13.
目的探讨鲁西冀南地区低剂量螺旋CT(LDCT)在不同性别和年龄人群中肺癌检出率的差异,为制定更适宜的筛查方案提供依据。
方法回顾性分析2015年在聊城市第二人民医院进行LDCT肺癌筛查的2 056例受检者的资料。根据性别、国内肺癌高危人群年龄段,以及实际检出高危人群年龄段三种方法进行分组,比较各组间肺癌检出率的差异。
结果2 056例受检者中,确诊肺癌22例,其中腺癌20例,鳞癌2例。45~75岁共检出肺癌21例,占总检出人数的95.5%(21/22)。男性组肺癌检出率为0.8%(10/1 217),女性组为1.4%(12/839),两组比较差异无统计学意义(χ2=1.738,P=0.187)。根据国内肺癌高危人群定义中的年龄段分组,高危组(50~75岁)肺癌检出率为1.3%(15/1 158),低危组(<50岁或>75岁)为0.8%(7/898),两组比较差异无统计学意义(χ2=1.271,P=0.26)。根据实际检出高危人群的年龄段分组,新高危组(45~75岁)肺癌检出率为1.4%(21/1 502),新低危组(<45岁或>75岁)为0.2%(1/554),新高危组检出率显著高于新低危组(χ2=5.668,P=0.017)。
结论鲁西冀南地区人群在LDCT肺癌筛查中,不仅要关注男性,也要关注女性;且将肺癌筛查高危人群年龄调整为45~75岁更为合适。 相似文献
14.
Igor Saftic Andrea Bille Nicole Asemota Loreto Berjon de la Vega Tom Routledge Juliet King Karen Harrison Phipps John Pilling 《Interactive Cardiovascular and Thoracic Surgery》2021,33(6):905
Open in a separate windowOBJECTIVESSurgeons will face an increasing number of octogenarians with lung cancer potentially curable by surgery. The goal of this study was to evaluate short- and long-term outcomes after lung resection.METHODSWe performed a single-centre study of consecutive patients ≥80 years old, surgically treated for suspected lung cancer between 2009 and 2016. Age, sex, performance status, lung function, surgical approach, type of lung resection, complications, in-hospital and 30- and 90-day deaths and long-term survival were analysed.RESULTSTwo hundred and fifty-seven patients were enrolled. The median age was 82 years (range 80–97). One hundred and thirty-four patients were treated by thoracotomy and 123 by video-assisted thoracic surgery [10 (8.1%) converted]. Two hundred and thirty-two underwent lobar resection and 25 underwent sublobar resection. There were no intraoperative deaths and 9 admissions to the intensive therapy unit; 112 (43.6%) patients suffered complications: More complications occurred after lobar versus after sublobar resections [45.7% vs 24% (P = 0.037)] and in those with chronic obstructive pulmonary disease (COPD) [57.4% vs 40% (P = 0.02)]. The 30-day mortality was 3.9% (n = 10) and the 90-day mortality was 6.22% (n = 16). One hundred and sixty-seven patients died during the study period; patients with non-small-cell lung cancer (n = 233) had a median survival of 46.5 months with 67.2% alive at 2 years and 40.8% at 5 years. Pathological stage and R status were independent prognostic factors for survival.CONCLUSIONSSurgery for malignancies in octogenarians is feasible and safe with good long-term outcomes. The risk of postoperative complications, especially in those with COPD, is high but can be minimized with sublobar resection. Postoperative mortality is acceptable, and long-term survival is primarily governed by lung cancer stage. Age is no reason to deny patients surgery for early-stage disease. 相似文献
15.
Screening for lung cancer 总被引:1,自引:0,他引:1
Dominioni L Strauss GM Imperatori A Rovera F Dionigi G 《Chest surgery clinics of North America》2000,10(4):729-736
The large clinical studies of lung cancer screening carried out more than 20 years ago were interpreted as evidence against screening. Those studies have been recently reassessed in the light of methodologic flaws in the randomization of subjects at risk for lung cancer. There is no evidence to support the former conclusion that screening is ineffective and the consequent official recommendation not to screen for lung cancer. The hypothesis of overdiagnosis of lung cancers diagnosed by screening is false. Clinical evidence supports the concept that the current dogma against screening for lung cancer is untrue. Indeed, the 5-year survival rate of patients with NSCLC detected in stage I and radically resected ranges from 60% to 80%. This rate is in sharp contrast to the 10% survival rate of stage I NSCLC not resected. About 90% of lung cancer cases are detected among smokers and former smokers; these well-known at-risk subjects should be offered a screening test with the goal of detecting the disease when it is in stage I. It is expected that the techniques for early detection of lung cancer will be refined and become more sensitive in the near future, so that it will be possible to detect an increasingly large proportion of lung cancers when they are truly in stage I (i.e., nonmetastatic) and curable by radical surgical resection. Low-dose helical CT scan is currently believed to represent a very useful technique for screening for lung cancer, with a higher sensitivity than chest radiograph screening. Chest radiography for lung cancer screening, however, is cheaper and ubiquitously available, and it should still be recommended if CT scan is locally unavailable. As underscored in a recent commentary in The Lancet, the existing public health policy discouraging the screening for lung cancer is in urgent need of reconsideration. 相似文献
16.
BACKGROUND: There has been resurgence of interest in lung cancer screening using low-dose computed tomography. The implications of directing a screening programme at smokers has been little explored. METHODS: A nationwide telephone survey was conducted. Demographics, certain clinical characteristics and attitudes about screening for lung cancer were ascertained. Responses of current, former and never smokers were compared. RESULTS: 2001 people from the US were interviewed. Smokers were significantly (p < 0.05) more likely than never smokers to be male, non-white, less educated, and to report poor health status or having had cancer, and less likely to be able to identify a usual source of healthcare. Compared with never smokers, current smokers were less likely to believe that early detection would result in a good chance of survival (p < 0.05). Smokers were less likely to be willing to consider computed tomography screening for lung cancer (71.2% (current smokers) v 87.6% (never smokers) odds ratio (OR) 0.48; 95% confidence interval (CI) 0.32 to 0.71). More never smokers as opposed to current smokers believed that the risk of disease (88% v 56%) and the accuracy of the test (92% v 71%) were important determinants in deciding whether to be screened (p < 0.05). Only half of the current smokers would opt for surgery for a screen-diagnosed cancer. CONCLUSION: The findings suggest that there may be substantial obstacles to the successful implementation of a mass-screening programme for lung cancer that will target cigarette smokers. 相似文献
17.
Hueto Pérez De Heredia J Cebollero Rivas P Cascante Rodrigo JA Andrade Vela I Pascal Martínez I Boldú Mitjans J Eguía Astibia VM 《Archivos de bronconeumologia》2012,48(8):267-273
ObjectiveTo analyze the results obtained in a lung cancer (LC) screening program since its inception five years ago regarding correct referrals, diagnostic and therapeutic delay times and days of hospitalization. To compare the diagnostic–therapeutic delays and hospital stays with those obtained in patients evaluated with the standard system.Patients and methodsIncluded for study were all those patients evaluated in our lung cancer screening program (LCSP) in the last five years. For the cases with LC, we recorded the dates the patients were referred to a specialist, the first consultation, diagnostic tests, stage, start of treatment, and days of hospitalization. We compared these same data with LC patients who did not partake in the LCSP and were diagnosed between October 2008 and October 2010.ResultsWe evaluated 179 patients remitted to the LCSP, which represented 26.7% of the consultations; 166 (92.7%) of the referrals were correct, out of which 44.5% were LC. In 75.6% of these, the entire study was completed in the outpatient setting, and more than 85% of the cases met the current recommendations related with diagnostic–therapeutic delays. When these results were compared with the non-LCSP group (n=151), differences were found in the data for hospitalizations: there was a lower percentage of hospitalizations (P<.0001) and shorter hospital stays (P<.0001) in the LCSP group. There were no differences between the two groups for diagnostic or therapeutic delays.ConclusionIn our setting, LC screening programs allow for cancer studies to be carried out in the outpatient consultations in a large percentage of cases, and within the time periods recommended by current guidelines. In spite of this fact, we have detected that these programs are underused. 相似文献
18.
Background The most critical parameter in the evaluation of the feasibility of video-assisted thoracoscopic surgery (VATS) lobectomy for lung cancer is long-term outcome. In this study, patients in whom more than 5 years had elapsed since
they had undergone VATS lobectomy for lung cancer were identified, and the 5-year survival rate and frequency of recurrence
were evaluated as the long-term outcomes; in addition, the frequency of perioperative complications were also evaluated as
the short-term outcomes.
Methods The stage, histology, perioperative complications, recurrence, and survival data were carefully reviewed in 198 patients who
underwent VATS lobectomy for lung cancer between 1998 and 2002.
Results Median postoperative follow-up period was 72.1 months. Of the 198 patients, 138 and 30 were diagnosed as having p-stage IA and IB disease, respectively, while the remaining 30 patients had more advanced disease. Perioperative complications
were observed in 20 patients (10.1%), however, there were no perioperative mortalities. Recurrence was observed in 26 patients
(13.1%): of these, 11 patients showed local recurrence, including malignant pleural effusion and mediastinal lymph node recurrence,
and 16 patients showed distant metastasis, the lung being the commonest site of metastasis; six patients had both local recurrence
and distant metastasis. During the study period, there were 26 deaths (13.1%), of which 17 were due to lung cancer and 9 were
due to other causes. The 5-year overall survival rates of the patients with p-stage IA and IB disease were 93.5% and 81.6%, respectively.
Conclusion VATS lobectomy for the treatment of lung cancer is as feasible and safe as open lobectomy in terms of both very long- and
short-term outcomes. 相似文献
19.
A. End 《European Surgery》2006,38(1):45-53
Summary BACKGROUND: The prognosis of lung tumors is determined by histology and staging (nodal status). The most common tumor is non-small
cell lung carcinoma (NSCLC) with a 5-year survival rate of 67 % (stage IA) to <5 % (stage IV). METHODS: By reviewing the literature
guidelines for diagnosis and treatment of non-small cell lung cancer and neurendocrine tumors are presented. RESULTS: Functional
operability provided, (bi)lobectomy or pneumonectomy with mediastinal lymph node dissection are the standard procedures. In
case of positive mediastinal lymph nodes (stage IIIA/IIIB) induction chemo(radio)therapy is indicated. Cervical mediastinoscopy
is performed in patients with enlarged mediastinal nodes (CT >1 cm), especially in PET-positive cases. Adjuvant chemotherapy
is used in clinical trials. Small-cell lung cancer (SCLC, neuroendocrine tumor grade III) has a poor prognosis, and is treated
with chemotherapy; resection may be performed in early stages. Neuroendocrine tumors grade I (typical carcinoid) are resected
by segmentectomy, lobectomy, or bronchoplastic resection. Neuroendocrine tumors grade II (atypical carcinoids) are treated
like NSCLC. CONCLUSIONS: The incidence of lung cancer is decreased by tobacco control, and the chances of survival are improved
by early detection and multimodality regimens.
相似文献
20.
《Asian journal of surgery / Asian Surgical Association》2022,45(8):1553-1558
ObjectiveThere is limited literature on patients with a history of COVID-19 pneumonia who underwent anatomical lung resection for non-small cell lung cancer (NSCLC). This study was aimed to share the early postoperative outcomes in patients who underwent lung resection after COVID-19 pneumonia.Materials and methodsWe retrospectively evaluated 30 patients who underwent lobectomy with thoracotomy and systematic mediastinal lymph node dissection due to NSCLC in a single center between November 2018 and September 2021. The patients were divided into two groups regarding COVID-19 pneumonia history; the COVID-19 group consisted of 14 patients (46.7%) and the non-COVID-19 group 16 (53.3%) patients. The patients’ age, gender, comorbidity, Charlson Comorbidity Index (CCI) score, forced expiratory volume in 1 s (FEV1) value, tumor type and size, resection type, postoperative air leak duration, total drainage volume, drain removal time, postoperative complications, and length of stay (LOS) were recorded.Results9 (30%) patients were female, and 21 (70%) were male. The mean age was 62.1 ± 8.91 years. Our comparison of postoperative air leak duration, total drainage volume, time to drain removal, postoperative complications, and LOS between the COVID-19 and non-COVID-19 groups revealed no statistically significant difference.ConclusionAnatomical lung resection can be performed safely in NSCLC patients with a history of COVID-19 pneumonia without significant difference in early postoperative morbidity and mortality. 相似文献