49 research outputs found
Clinical significance in the number of involved lymph nodes in patients that underwent surgery for pathological stage III-N2 non-small cell lung cancer
<p>Abstract</p> <p>Purpose</p> <p>This study investigated whether the number of involved lymph nodes is associated with the prognosis in patients that underwent surgery for pathological stage (p-stage) III/N2 NSCLC.</p> <p>Subjects</p> <p>This study evaluated 121 patients with p-stage III/N2 NSCLC.</p> <p>Results</p> <p>The histological types included 65 adenocarcinomas, 39 squamous cell carcinomas and 17 others. The average number of dissected lymph nodes was 23.8 (range: 6-55). The average number of involved lymph nodes was 5.9 (range: 1-23). The 5-year survival rate of the patients was 51.0% for single lymph node positive, 58.9% for 2 lymph nodes positive, 34.2% for 3 lymph nodes positive, and 30.0% for 4 lymph nodes positive, and 20.4% for more than 5 lymph nodes positive. The patients with either single or 2 lymph nodes positive had a significantly more favorable prognosis than the patients with more than 5 lymph nodes positive. A multivariate analysis revealed that the number of involved lymph nodes was a significant independent prognostic factor.</p> <p>Conclusion</p> <p>Surgery appears to be preferable as a one arm of multimodality therapy in p-stage III/N2 patients with single or 2 involved lymph nodes. The optimal incorporation of surgery into the multimodality approach therefore requires further clinical investigation.</p
The degree of oxidative stress is associated with major adverse effects after lung resection: A prospective study
Objective: This prospective randomized study was conducted in order to
define the contribution of the generated oxygen and nitrogen reactive
species on postlobectomy morbidity and mortality. Patients and methods:
Between 2001 and 2003, 132 patients with non-small cell lung cancer
(NSCLC) were prospectively studied. The patients were grouped according
to one-lung ventilation (OLV) use or not and to the duration of lung’s
atelectasis. Group A included 50 patients with confirmed non-small cell
lung cancer who were subjected to lobectomy without one-tung
ventilation. Group B included 30 patients subjected to 60 min OLV. Group
C included 30 patients subjected to 90 min OLV. Group D included 22
patients subjected to 120 min OLV. Preoperative, intraoperative and
postoperative strict blood sampling protocol was followed.
Malondiadehyde (MDA) plasma levels were measured. The groups were
statistically compared for the occurrence of postoperative
complications. OLV (groups B-D) along with other clinical parameters
were entered in multivariate analysis as risk factors for complication
development. Measurements and results: Comparison of group A with groups
B-D (OLV) documented significant increase (p < 0.001) of MDA levels
during lung reexpansion. The magnitude of oxidative stress was related
to OLV duration (group D > group C > group B, all p < 0.001). Univariate
analysis disclosed a higher incidence of acute respiratory failure,
cardiac arrhythmias and pulmonary hypertension in group D. Multivariate
analysis revealed OLV as an independent risk factor for postoperative
development of cardiac arrhythmias and pulmonary hypertension.
Conclusion: Protracted (> 1 h) OLV should be considered a potential
cause for cardiovascular complications through the generation of severe
oxidative stress due to lung reexpansion. (c) 2006 Published by Elsevier
B.V
Outpatient treatment of pulmonary embolism
Over the past decade there has been an increasing trend to manage many conditions traditionally treated during a hospital admission as outpatients. Evidence is increasing to support this approach in patients with pulmonary embolism (PE). In this article, we review the current status of outpatient management of confirmed PE and present a pragmatic approach for clinical healthcare settings. © 2020, European Respiratory Society. All rights reserved
Postresectional pulmonary oxidative stress in lung cancer patients. The role of one-lung ventilation
Objective: The authors conducted a prospective analysis in order to
investigate through lipid peroxidation metabolites the generation of
oxygen free radicals after one-lung ventilation (OLV). Methods: From
2001 to 2003, 212 patients were prospectively studied for lung
reexpansion/reperfusion injury. They were classified in six groups.
Group A, non-OLV lobectomy group; B, OLV pneumonectonny group; C-E, OLV
lobectomy of 60, 90, and 120 min duration, respectively; F, normal
subjects as baseline group. Preoperative, intraoperative and
postoperative strict blood sampling protocol was followed.
Malondialdehyde (MDA) plasma levels were measured. The recorded values
were analyzed and statistically compared between groups and within each
one. Results: Comparison of groups C-E (OLV) to A other documented
significant (P < 0.001) increase of MDA levels during lung reexpansion
and for the following 12 h. The magnitude of oxidative stress was
related to OLV duration (group E > D > C, all P < 0.001). The removal of
cancer-associated parenchyma led to MDA level decrease postoperatively
(P < 0.001) especially after pneumonectomy (A vs. B, P < 0.001).
Conclusions: (1) Lung reexpansion provoked severe oxidative stress. (2)
The degree of the amount of generated oxygen free radicals was
associated to the duration of OLV. (3) Patients with lung cancer had a
higher production of oxygen free radicals than normal population.
(4)Tumor resection removes a large oxidative burden from the organism.
(5) Mechanical ventilation and surgical trauma are weak free radical
generators. (6) Manipulated lung tissue is also a source of oxygen free
radicals, not only intraoperatively but also for several hours later.
(c) 2005 Elsevier B.V. All rights reserved