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414 Treatment of multiple primary squamous cell carcinoma of the lung
Therapy - Combined Modal@ Results: pathological
The table shows the survival at 2 years 1997 stage grouping classification.
Pathologtcal stages (n)
Survival at 2 years
IA (68) If3 (199) IIB (119) IIIA (98) IIIB (103)
PS 0.89 0.73 0.60 0.48 0.33
(SE) (0.04) (0.04) (0.05) (0.05) (0.06)
n = number of patients; pS = probability of sur~al; confidence Interval at 95%.
according
to the
(Cl 95%)
Log-rank
(0.81-0.97) (0.65-0.81) (0.50-0.69) (0.38-0.57) (0.21-0.44)
0 0001
There were 8 patients in stage IIA ant 16 patients in stage IV. Due to the small number of patients, these stages were not included in this survival analysis. Conclusions: This preliminary survival analysis shows that there is a progressive degradation of the probability of survival confirming that more advanced stages have poorer prognosis. The 1997 stage grouping classification further defines more prognostic groups with significant survival differences in postoperative stages.
14131
Lung
cancer
in young
patients
N. Ishikawa, M. Oda, Y. Ohta, Y. Hayashi, S. Murakami, Dept. of Surgery Kanazawa Univ., Kanazawa, Japan
Y. Watanabe.
From 1960 to 1996, 1982 primary lung cancer patients were treated at our department. Thirty eight patients (1.9%) under 40 years of age were clinically evaluated. The patients ranged in age from 1340 tears (13-30 in 7 pts, 31-35 in 8, 36-40 in 23). There were 25 males and 13 females and the male to female ratio of the young patients was 1.9: 1, although that of the whole patients was 2.7: 1. Thirty cases were discovered with symptoms (cough, hemosputum, etc). Histologically there were 20 adenocarcinomas, IO squamous cell carcinomas, 2 carcinoids, 2 small cell carcinomas, 1 adenosqumous cell carcinoma, 1 large cell carcinoma, and 1 mucoepidermoid carcinoma. Clinical stages were stage I in 7 pts, stage II in 1, stage Ill A in 14, stage IIIB in 10, and stage IV in 6. Twenty nine patients (76%) underwent pulmonary resection wtth 7 curative and 22 nonculative operation. The over all 5-year survival rate after operation was 16.9% which tended to be worse than that of the whole patients (40.6%). Postoperative stages were stage I in 7 pts, stage II in 1, stage IIIA in 14, stage IIIB in 7 and stage IV in 2. The 5-year survival rates were 51.9%, 16.7%, O%, and 0% for stage I, stage IIIA, stage 1118, and stage IV respectively, whereas the 5-year survival rates of whole patients were 67.4%, 21.6%, 12.4% and 7.2% for stage I, stage IIIA, stage IIIB and stage IV respectively. Most of the young patients was discovered with symptoms and characterized by advanced stage. Prognosis of young patients with early stage was favorable and early detection of lung cancer is advocated even for young patients.
414 n
Treatment carcinoma
of multiple primary of the lung
squamous
107
lymph node metastasis, 1 patient underwent sleeve lobectomy with long survival, and the other 2 patients without operation died of bleeding or had recurrence. One patient with IIIA (T2 N2) secondary cancer who underwent lobectomy died 14 months after the second operation. The surgical treatment of multiple squamous cell carcinoma is justified and limited operation using bronchoplastic techniques provides superior results.
I
415
SE = standard error; Cl 95% =
Therapy
Platelet - Activating factor BN52021’s lung preservation clamped
(PAF) after
acether inhibitor the hilus was
Wu Xi, Gu Yongping. Department of Cardiothoracic Surgery, Affiliated Hospital of Nanjing Railway Medical College, Nanjing 210009, PR China Platelet-activating factor, identified as 1 -o-alkyl-2-o-acetyl-sn-glycero-3-phosphorylcholine. The PAF activities increased progressively after clamping hilum during pulmonary transplantatio#]. BNsscsr, a PAF inhibrtor, was isolated from the Ginkgo biloba tree. It inhibits most of the effects of PAF-acether, including leukocyte and platelet activation hypotension and bronchoconstriction and increased vassopermeation. Sixteen adult dogs were divided into four groups. The control groups: I. II. The BNszszt GROUPS: Ill. IV. In group I: The hilus of the left lung was clamped for 210 min without ischemia of the right lung. Lung ischemia was created in the group II by clamped the left hilum for 150 min, Subsequently reperfusion of the left lung was maintained for 120 min, while the right hilus was kept occlude. In group III the conditions were the same as in group I,
but the BNssss, (5 mgikg iv) was administered camped. In group I and Ill. The experimental result is as follows:
5 min before
the hilus was
Group
MDA (nmolimg) Phospholipase A2
PLAz (U)
Gap area vs whole area
I Ill
0.45 i 0.05 0 29 * 0.05
45.27f2.15 38.62 i 1 92
0.28 i 0.05 0.18 f 0.04
P < 0.01 I “S Ill Group
Oxygen content (ml/l00 ml blood) tn the left artial blood
Extravascular lung water vs ho blood dried luno (ml/o)
II IV
17.12+ 1 53 1897+1 26
6.36 + 0.28 4 46 * 0.47
In this study we used scanning electron microscopy to observe the endothelial cell in pulmonary arterial wall (x300). In Group I (control group) we found that the gap of cells have significant increase. In Group Ill (BNs2021 group) the gap of cells increase insignificantly and the arterial wall was invade by a few leukocytes the platelet-induced thrombi haven’t been found. BNssssr inhibits the PAF bioactivity, decreases the PAF content. Restrains PLAp activation indirectly. BN 52021 inhibits the generation of oxy gen-free radicals. The MDA content decrease. From our study we therefore conclude that PAF-acether inhibitor reduce pulmonary injury it is a safe preservation methods to prolong the ischemic tolerance of donor organs during pulmonary transplantation.
cell
S. Murakami, J. Shimizu, M. Oda, Y. Hayashi. Y. Ohta, N. Ishikawa, Y. Watanabe. Department of Surgery Kanazawa University School of Medicine, Kanazawa, Japan The prevalence of multiple primary bronchogenic cancers, especially squamous cell carcinoma, has been increasing as a result of improvements in early detection and cancer therapy. We treated 14 patients with multiple squamous cell carcinoma of the tracheobronchial tree and lung, which corresponded to 2.2% of all squamous cell carcinoma patients undergoing resection. Two patients had peripheral secondary tumors and underwent segmentectomy or partial resection of the lung with good results. The secondary lesions were superficial and minute (less than 5 mm) in 3 patients, and treated with Nd-YAG laser ablation. Five patients had endobronchial tumors of the nodular or polypoid type with suspected deep Invasion or invasion extending beyond the bronchial wall based on the bronchoscopic findings. They underwent parenchymal-sparing limited bronchoplasty with excellent results. Three patients had more advanced tumor with massive invasion outside the bronchial wall without
416 u
Second patients
synchronous
M. Infante, M. Valente, G. Giudice, I. Cataldo, P. Macri’, M. Incarbone, Institute, Milan, la/y
lung
cancer:
A study
of 121
P.P. Brega Massone, C. Catanese, A.V. Bedini, G. Ravasi. Nat/. Cancer
A retrospective review was made of 121 consecutive cases with two synchronous anatomically distinct cancers of the lung who were seen at the National Cancer Institute of Milan, Italy, from 1979 to June 1996. In 24% of the patients (pts.) the second tumor was an unexpected finding at surgery planned for single lung cancer. The predominant histologic type was adenocarcinoma, and 60% of the pts. had two histologically similar cancers. Pts. were considered as resected when both tumors had been completely excised and unresected if no surgery or non curative surgery had been performed. 92 pts. (76%) were operated on and 73 (60%) were resected. 68 pts. underwent single operations, and 13 (14%) had staged procedures. Sublobar resections alone (16%) or combined with one lobectomy
The table shows the survival at 2 years 1997 stage grouping classification.
Pathologtcal stages (n)
Survival at 2 years
IA (68) If3 (199) IIB (119) IIIA (98) IIIB (103)
PS 0.89 0.73 0.60 0.48 0.33
(SE) (0.04) (0.04) (0.05) (0.05) (0.06)
n = number of patients; pS = probability of sur~al; confidence Interval at 95%.
according
to the
(Cl 95%)
Log-rank
(0.81-0.97) (0.65-0.81) (0.50-0.69) (0.38-0.57) (0.21-0.44)
0 0001
There were 8 patients in stage IIA ant 16 patients in stage IV. Due to the small number of patients, these stages were not included in this survival analysis. Conclusions: This preliminary survival analysis shows that there is a progressive degradation of the probability of survival confirming that more advanced stages have poorer prognosis. The 1997 stage grouping classification further defines more prognostic groups with significant survival differences in postoperative stages.
14131
Lung
cancer
in young
patients
N. Ishikawa, M. Oda, Y. Ohta, Y. Hayashi, S. Murakami, Dept. of Surgery Kanazawa Univ., Kanazawa, Japan
Y. Watanabe.
From 1960 to 1996, 1982 primary lung cancer patients were treated at our department. Thirty eight patients (1.9%) under 40 years of age were clinically evaluated. The patients ranged in age from 1340 tears (13-30 in 7 pts, 31-35 in 8, 36-40 in 23). There were 25 males and 13 females and the male to female ratio of the young patients was 1.9: 1, although that of the whole patients was 2.7: 1. Thirty cases were discovered with symptoms (cough, hemosputum, etc). Histologically there were 20 adenocarcinomas, IO squamous cell carcinomas, 2 carcinoids, 2 small cell carcinomas, 1 adenosqumous cell carcinoma, 1 large cell carcinoma, and 1 mucoepidermoid carcinoma. Clinical stages were stage I in 7 pts, stage II in 1, stage Ill A in 14, stage IIIB in 10, and stage IV in 6. Twenty nine patients (76%) underwent pulmonary resection wtth 7 curative and 22 nonculative operation. The over all 5-year survival rate after operation was 16.9% which tended to be worse than that of the whole patients (40.6%). Postoperative stages were stage I in 7 pts, stage II in 1, stage IIIA in 14, stage IIIB in 7 and stage IV in 2. The 5-year survival rates were 51.9%, 16.7%, O%, and 0% for stage I, stage IIIA, stage 1118, and stage IV respectively, whereas the 5-year survival rates of whole patients were 67.4%, 21.6%, 12.4% and 7.2% for stage I, stage IIIA, stage IIIB and stage IV respectively. Most of the young patients was discovered with symptoms and characterized by advanced stage. Prognosis of young patients with early stage was favorable and early detection of lung cancer is advocated even for young patients.
414 n
Treatment carcinoma
of multiple primary of the lung
squamous
107
lymph node metastasis, 1 patient underwent sleeve lobectomy with long survival, and the other 2 patients without operation died of bleeding or had recurrence. One patient with IIIA (T2 N2) secondary cancer who underwent lobectomy died 14 months after the second operation. The surgical treatment of multiple squamous cell carcinoma is justified and limited operation using bronchoplastic techniques provides superior results.
I
415
SE = standard error; Cl 95% =
Therapy
Platelet - Activating factor BN52021’s lung preservation clamped
(PAF) after
acether inhibitor the hilus was
Wu Xi, Gu Yongping. Department of Cardiothoracic Surgery, Affiliated Hospital of Nanjing Railway Medical College, Nanjing 210009, PR China Platelet-activating factor, identified as 1 -o-alkyl-2-o-acetyl-sn-glycero-3-phosphorylcholine. The PAF activities increased progressively after clamping hilum during pulmonary transplantatio#]. BNsscsr, a PAF inhibrtor, was isolated from the Ginkgo biloba tree. It inhibits most of the effects of PAF-acether, including leukocyte and platelet activation hypotension and bronchoconstriction and increased vassopermeation. Sixteen adult dogs were divided into four groups. The control groups: I. II. The BNszszt GROUPS: Ill. IV. In group I: The hilus of the left lung was clamped for 210 min without ischemia of the right lung. Lung ischemia was created in the group II by clamped the left hilum for 150 min, Subsequently reperfusion of the left lung was maintained for 120 min, while the right hilus was kept occlude. In group III the conditions were the same as in group I,
but the BNssss, (5 mgikg iv) was administered camped. In group I and Ill. The experimental result is as follows:
5 min before
the hilus was
Group
MDA (nmolimg) Phospholipase A2
PLAz (U)
Gap area vs whole area
I Ill
0.45 i 0.05 0 29 * 0.05
45.27f2.15 38.62 i 1 92
0.28 i 0.05 0.18 f 0.04
P < 0.01 I “S Ill Group
Oxygen content (ml/l00 ml blood) tn the left artial blood
Extravascular lung water vs ho blood dried luno (ml/o)
II IV
17.12+ 1 53 1897+1 26
6.36 + 0.28 4 46 * 0.47
In this study we used scanning electron microscopy to observe the endothelial cell in pulmonary arterial wall (x300). In Group I (control group) we found that the gap of cells have significant increase. In Group Ill (BNs2021 group) the gap of cells increase insignificantly and the arterial wall was invade by a few leukocytes the platelet-induced thrombi haven’t been found. BNssssr inhibits the PAF bioactivity, decreases the PAF content. Restrains PLAp activation indirectly. BN 52021 inhibits the generation of oxy gen-free radicals. The MDA content decrease. From our study we therefore conclude that PAF-acether inhibitor reduce pulmonary injury it is a safe preservation methods to prolong the ischemic tolerance of donor organs during pulmonary transplantation.
cell
S. Murakami, J. Shimizu, M. Oda, Y. Hayashi. Y. Ohta, N. Ishikawa, Y. Watanabe. Department of Surgery Kanazawa University School of Medicine, Kanazawa, Japan The prevalence of multiple primary bronchogenic cancers, especially squamous cell carcinoma, has been increasing as a result of improvements in early detection and cancer therapy. We treated 14 patients with multiple squamous cell carcinoma of the tracheobronchial tree and lung, which corresponded to 2.2% of all squamous cell carcinoma patients undergoing resection. Two patients had peripheral secondary tumors and underwent segmentectomy or partial resection of the lung with good results. The secondary lesions were superficial and minute (less than 5 mm) in 3 patients, and treated with Nd-YAG laser ablation. Five patients had endobronchial tumors of the nodular or polypoid type with suspected deep Invasion or invasion extending beyond the bronchial wall based on the bronchoscopic findings. They underwent parenchymal-sparing limited bronchoplasty with excellent results. Three patients had more advanced tumor with massive invasion outside the bronchial wall without
416 u
Second patients
synchronous
M. Infante, M. Valente, G. Giudice, I. Cataldo, P. Macri’, M. Incarbone, Institute, Milan, la/y
lung
cancer:
A study
of 121
P.P. Brega Massone, C. Catanese, A.V. Bedini, G. Ravasi. Nat/. Cancer
A retrospective review was made of 121 consecutive cases with two synchronous anatomically distinct cancers of the lung who were seen at the National Cancer Institute of Milan, Italy, from 1979 to June 1996. In 24% of the patients (pts.) the second tumor was an unexpected finding at surgery planned for single lung cancer. The predominant histologic type was adenocarcinoma, and 60% of the pts. had two histologically similar cancers. Pts. were considered as resected when both tumors had been completely excised and unresected if no surgery or non curative surgery had been performed. 92 pts. (76%) were operated on and 73 (60%) were resected. 68 pts. underwent single operations, and 13 (14%) had staged procedures. Sublobar resections alone (16%) or combined with one lobectomy