Significance of Smoking as a Postoperative Prognostic Factor in Patients with Non-small Cell Lung Cancer

IntroductionIn this study, we investigated the influence of smoking on the postoperative prognosis in patients with non-small cell lung cancer.MethodsThe subjects consisted of 770 patients who underwent a resection of lung cancer in our department between 1994 and 2005. We compared the clinico-pathological findings between the smoking and never-smoking groups. The pack-year index (PYI) was used as a smoking index.ResultsThe smoking group consisted of 569 patients (74%), and the never-smoking group consisted of 201 patients (26%). The smokers were composed of 492 men and 77 women. Among the adenocarcinoma patients, there were 293 (61%) smokers and 185 (39%) never-smokers. The patients with squamous cell carcinoma included 204 (95%) smokers and 10 (5%) never-smokers. The proportion of patients with stage IA disease was significantly higher in the never-smokers than that of the smokers. The 5-year survival rate after surgery was 66% in the never-smoking group; however, the rates were 56% in patients with a PYI more than or equal to 20, and 55% in those with PYI more than 20. Seventy-nine (13.9%) patients in the smoking group and seven (3.5%) patients in the never-smoking group died of other diseases, with a significant difference (p < 0.01). Of these patients, 44 (56%) and 13 (16%) in the smoking group died of respiratory and cardiovascular disorders, respectively. In our series, excluding those who died of other diseases, there were no significant differences in the postoperative prognosis.ConclusionsIn the smoking group, the prognosis was poorer than that in the never-smoking group. The higher proportion of early stage disease (stage IA) and female gender were major causes of the better prognosis of the never-smokers. Nevertheless, the high pulmonary/cardiovascular complication-related mortality was another cause of the poor prognosis of the smokers with lung cancer

Carcinoid tumors of the lung: A report of 11 cases

Carcinoid tumors of the lung are rare, and account for 1% of all primary tumors of the lung. This study was undertaken to investigate the histological characteristics and clinical behavior of carcinoid tumors of the lung. We have retrospectively reviewed the hospital records of 11 consecutive patients undergoing surgical treatment for carcinoid tumors of the lung between 1992 and 2007. Patients with carcinoid tumors accounted for 0.8% (11 of 1319) of the patients undergoing surgical treatment for nonsmall cell lung cancer. The group comprised six males and five females with a mean age at presentation of 58.6 years (range 27–78 years). All of the operations were lobectomies, including two sleeve lobectomies. Six patients had typical and five had atypical carcinoid tumors. Seven patients had stage IA disease, two had stage IB, one had stage IIA, and one had stage IIIA. Recurrent tumors developed in two of the five patients affected by atypical carcinoid tumors, but none of the six patients with typical carcinoid tumors. Overall, the 5-year survival rate of patients with both typical and atypical carcinoid tumors was 90.9%. Survival of carcinoid tumors was favorable. In this analysis, two patients with atypical carcinoid had postoperative recurrences. Recurrence was more common among patients with atypical carcinoid tumors

Surgical treatment of catamenial pneumothorax: Report of three cases

Catamenial pneumothorax (CP) is a rare entity of spontaneous, recurring pneumothorax in females. Although it has been known to be associated with thoracic endometriosis, varying clinical course and the lack of consistent intraoperative findings have led to conflicting etiological theories. We herein discuss the etiology, clinical course, and surgical treatment of three patients with CP. Three females (aged 40 years, 28 years, and 34 years) had recurrent right-sided spontaneous pneumothoraces that coincided with their menses. They had undergone video-assisted thoracoscopic surgery (VATS) previously. Blueberry spots in the right diaphragm were detected in all three cases. Two patients had recurrence, postoperatively. The other patient, who received luteinizing hormone-releasing hormone analog therapy for an abdominal endometriosis in the perioperative period and postoperative chemical pleurodesis to prevent recurrence, has been free of recurrence for 15 months, postoperatively. However, pelvic endometriosis was detected in this patient only. Therefore, CP should be suspected in ovulating females with spontaneous pneumothorax, even in the absence of any symptoms associated with pelvic endometriosis. In addition, while performing VATS, careful inspection of the diaphragmatic surface is important. In complicated cases, hormonal suppression therapy and chemical pleurodesis might also be helpful adjunct modalities

Carcinoid tumors of the lung: A report of 11 cases

Objective: Carcinoid tumors of the lung are rare, and account for 1% of all primary tumors of the lung. This study was undertaken to investigate the histological characteristics and clinical behavior of carcinoid tumors of the lung. Methods: We have retrospectively reviewed the hospital records of 11 consecutive patients undergoing surgical treatment for carcinoid tumors of the lung between 1992 and 2007. Results: Patients with carcinoid tumors accounted for 0.8% (11 of 1319) of the patients undergoing surgical treatment for nonsmall cell lung cancer. The group comprised six males and five females with a mean age at presentation of 58.6 years (range 27–78 years). All of the operations were lobectomies, including two sleeve lobectomies. Six patients had typical and five had atypical carcinoid tumors. Seven patients had stage IA disease, two had stage IB, one had stage IIA, and one had stage IIIA. Recurrent tumors developed in two of the five patients affected by atypical carcinoid tumors, but none of the six patients with typical carcinoid tumors. Overall, the 5-year survival rate of patients with both typical and atypical carcinoid tumors was 90.9%. Conclusion: Survival of carcinoid tumors was favorable. In this analysis, two patients with atypical carcinoid had postoperative recurrences. Recurrence was more common among patients with atypical carcinoid tumors

Surgical treatment of catamenial pneumothorax: Report of three cases

Catamenial pneumothorax (CP) is a rare entity of spontaneous, recurring pneumothorax in females. Although it has been known to be associated with thoracic endometriosis, varying clinical course and the lack of consistent intraoperative findings have led to conflicting etiological theories. We herein discuss the etiology, clinical course, and surgical treatment of three patients with CP. Three females (aged 40 years, 28 years, and 34 years) had recurrent right-sided spontaneous pneumothoraces that coincided with their menses. They had undergone video-assisted thoracoscopic surgery (VATS) previously. Blueberry spots in the right diaphragm were detected in all three cases. Two patients had recurrence, postoperatively. The other patient, who received luteinizing hormone-releasing hormone analog therapy for an abdominal endometriosis in the perioperative period and postoperative chemical pleurodesis to prevent recurrence, has been free of recurrence for 15 months, postoperatively. However, pelvic endometriosis was detected in this patient only. Therefore, CP should be suspected in ovulating females with spontaneous pneumothorax, even in the absence of any symptoms associated with pelvic endometriosis. In addition, while performing VATS, careful inspection of the diaphragmatic surface is important. In complicated cases, hormonal suppression therapy and chemical pleurodesis might also be helpful adjunct modalities

Surgical Treatment of Patients With Stenosis of the Central Airway due to Tracheal Tumours

This study retrospectively evaluated bronchoscopic and surgical treatments for patients with central airway stenosis due to tracheal tumours. Seven patients treated by resection and reconstruction of the trachea for tracheal tumours between 1994 and 2008 were retrospectively reviewed. The most common histological finding was thyroid carcinoma (n = 3), followed by adenoid cystic carcinoma (n = 2), a metastatic thyroid tumour (n = 1), and a benign granular cell tumour (n = 1). Three of the patients required preoperative laser treatment (Nd:YAG) for recanalization. Five patients underwent end-to-end anastomosis for reconstruction. There was no postoperative mortality or morbidity such as anastomotic insufficiency of the reconstructed trachea. Three patients with a microscopic residual tumour required postoperative external radiotherapy. Surgical resection of malignant tracheal tumours is recommended not only for curative purposes, but also for reduction of the risk of smothering

SUMMARY

Marked clinical and immunological response of MAGE-A3 peptides vaccination in a patient with adenocarcinoma of the lung case report: A case repor