Operative approach for multiple primary lung carcinomas

AbstractOf 908 patients who underwent operation for primary lung cancer between January 1985 and June 1996, we considered 57 (6.3%) to have a second primary lung cancer, which was synchronous in 28 cases (3.1%) and metachronous in 29 cases (3.2%). Five-year survival for patients with synchronous and metachronous disease from initial treatment of cancer was 70.3% and 66.0%, respectively. Survival after the development of a metachronous lesion was 32.9% at 5 years. Sixteen of the synchronous second tumors (57%) were detected on preoperative radiography or bronchoscopy and 11 (39%) at the time of operation. Survival of patients at stage I or II from treatment of a synchronous lesion (p = 0.002) and of a metachronous second lesion (p = 0.028) was significantly better compared with those at stage III or IV. Therefore it is important to carefully examine a synchronous lesion before and during the operation of a primary lung cancer and to perform close follow-up surveillance for early detection of a metachronous lesion. In treating multiple lung carcinomas consideration should always be given to performing precise staging, aggressive operative approach for early stage, and oncologically sound parenchymal sparing procedures. (J Thorac Cardiovasc Surg 1998;115:836-40

Measurement of multi-red blood cells interactions in blood flow by confocal micro-PTV

In microcirculation the flow behavior of red blood cells (RBCs) plays a crucial role in many physiological and pathological phenomena. For instance, the interaction of RBCs in shear flow is believed to play an important role to the thrombogenesis process. Despite the relevance of this phenomenon on the blood mass transport, very little studies have been performed during the years, partly due to the absence of adequate visualization techniques able to obtain both direct and quantitative measurements on multi-RBCs motions in concentrated suspensions. Past studies on both individual and concentrated RBCs used conventional microscopes and/or ghost cells to obtain visible trace RBCs at high concentration suspension of blood cells [1, 2]. Recently, advances of confocal microscopy and consequent advantages over conventional microscopes have led to an emerging technique known as confocal micro-PIV [3, 4]. This paper presents the application of a confocal micro- PTV system to measure RBC-RBC hydrodynamic interactions in flowing blood

MUTYH Gln324His gene polymorphism and genetic susceptibility for lung cancer in a Japanese population

<p>Abstract</p> <p>Background</p> <p>Genetic polymorphisms of DNA repair enzymes in the base excision repair (BER) pathway, may lead to genetic instability and lung cancer carcinogenesis. We investigated the interactions among the gene polymorphisms in DNA repair genes and lung cancer.</p> <p>Methods</p> <p>We analyzed associations among <it>OGG1 </it>Ser326Cys and <it>MUTYH </it>Gln324His gene polymorphisms in relation to lung cancer risk using PCR-RFLP. The study involved 108 lung cancer patients and 121 non-cancer controls divided into non-smokers, smokers according to pack-years smoked in Japanese.</p> <p>Results</p> <p>The results showed that the <it>MUTYH His/His </it>genotype compared with <it>Gln/Gln </it>genotype showed an increased risk for lung cancer (adjusted odds ratio [OR] 3.03, confidence interval [95%CI], 1.31–7.00, p = 0.010), whereas there was no significant increase for the <it>Gln/His </it>genotype (adjusted OR 1.35, 95%CI 0.70–2.61, p = 0.376). The <it>MUTYH His/His </it>genotype was at a borderline increased risk for both adenocarcinoma and squamous cell carcinoma (adjusted OR 2.50, 95%CI 0.95–6.62, p = 0.065 for adenocarcinoma; adjusted OR 3.20, 95%CI 0.89–11.49, p = 0.075 for squamous cell carcinoma, respectively). However, the <it>OGG1 Ser/Cys </it>or <it>Cys/Cys </it>genotypes compared with the <it>Ser/Ser </it>genotype did not have significantly increased risk for lung cancer, containing either adenocarcinoma or squamous cell carcinoma. The joint effect of tobacco exposure and the <it>MUTYH His/His </it>genotype compared with the <it>Gln/Gln </it>genotype showed a significant association with lung cancer risk in smokers, and there was not significantly increased in non-smokers (adjusted OR 3.82, 95%CI 1.22–12.00, p = 0.022 for smokers; adjusted OR 2.60, 95%CI 0.60–11.25, p = 0.200 for non-smokers, respectively). The effect of tobacco exposure and the <it>OGG1 </it>Ser326Cys showed also no significant risk for lung cancer.</p> <p>Conclusion</p> <p>Our findings suggest that the <it>MUTYH </it>Gln324His polymorphism appear to play an important role in modifying the risk for lung cancer in the Japanese population.</p

Survival related to lymph node involvement in lung cancer after sleeve lobectomy compared with pneumonectomy

AbstractObjective: The purpose of this study was to compare the outcomes after sleeve lobectomy and pneumonectomy for patients with non–small cell lung cancer distributed according to their nodal involvement status. Methods: Of 1172 patients in whom primary non–small cell lung carcinoma, including mediastinal lymph nodes, was completely excised, 151 patients underwent sleeve lobectomy and 60 underwent pneumonectomy. For bias reduction in comparison with a nonrandomized control group, we paired 60 patients undergoing sleeve lobectomy with 60 patients undergoing pneumonectomy by using the nearest available matching method. Results: The 30-day postoperative mortality was 2% (1/60) in the pneumonectomy group and 0% in the sleeve lobectomy group. Postoperative complications occurred in 13% of patients in the sleeve lobectomy group and in 22% of those in the pneumonectomy group. Local recurrences occurred in 8% of patients in the sleeve lobectomy group and in 10% of those in the pneumonectomy group. The overall 5- and 10-year survivals for the sleeve lobectomy group were 48% and 36%, respectively, whereas those for the pneumonectomy group were 28% and 19%, respectively (P = .005). Multivariable analysis showed that the operative procedure, T factor, and N factor were significant independent prognostic factors and revealed that survival after sleeve lobectomy was significantly longer than that after pneumonectomy (P = .03). Conclusions: These data suggest that sleeve lobectomy should be performed instead of pneumonectomy in patients with non–small cell lung cancer regardless of their nodal status whenever complete resection can be achieved because this is a lung-saving procedure with lower postoperative risks and is as curative as pneumonectomy. (J Thorac Cardiovasc Surg 2000;119:814-9