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Indications for an expandable metallic stent for tracheobronchial stenosis
334
Abstracts/Lang
Cancer I I (1994)
ofnonmplignantceuses,ond55pstieotshad59occurreacesofmaligoPnt disease. Late lung cancer recurrence was observed in 22 patients (concurrentwithMsophPIyngeolcancerinoneptientandwithlaryngeP1 cancer in one patient). Metachronous second lung cancer was noted in 20 patients (including concurrent colon cancer in one patient and metastatic recurrence in one patient). Other nonpuhuonary malignant tumors appeared in 13 patients. Including second lung cancer, 25 cancers of aerodigestive epithelium were observed in 23 patients. The malignancy-free survival advantage for patients with squamous cancer observed until 60 months after resection was not sustained at 60 months and beyond. At the time of last follow-up, 84 patients (27%) had died; 43 were free of malignancy, and 41 had malignancy (14 patients were alive with malignancy and 210 with no evidence of disease). These data reinforce two conclusions: (1) The probability of lung cancer recurrence or appearance of new lung cancer 5 years or mom after succcsstirl operation in this select subpopulation of patients with lung cancer is of concern. (2) The malignancy-free survival advantage of Patients with squamous cancer disappears after 5 years.
Indications for an expandable metallic stent for tracheobroncbial stenosis NomoriH. Kohayashi R, Koden K, hiorinaga S, Ogawa K. Depanment of Surgery. Saiseikai Central Hospital, Mita 1417. 108. ANI Thoru: Surg 1993;56: 1324-8.
Minato-ku, Tokyo
An expandable metallic stent was used in 9 patients with tracheobronchial stenosis. Of the 8 patients with malignant stenosis, 6 had extrinsic compression and 2 had intnduminal tumor invasion. The 1 patient with nonmalignant stenosis had postreconstruction bronchomalacia and granulation tissue affecting different parts of the tracheobronchial tree. Theexpandablemetallicstent successfully dilated tracheobronchial stenosis due to extrinsic tumor compression and malacia. However, it was not effective for stenosis due to intraluminal tumor invasion or granulation tissue becauseof the growth of tumor or granulation tissuebetweenthewiresofthestmt. However,anexpandahle metallic stent covered with Dacron mesh was effective in 1patient with intraluminal tumor invasion because tumor growth was bloched by the mesh. We conclude that an expandable metallic stmt is effective for tracheohronchial stenosis due to extrinsic tumor compression, but not for stenosis due to intraluminal tumor invasion or granulation tissue.
Surgical treatment of lung cancer in the octogenarian Gsaki T, Shirakuss T, Kodate M, Nakanishi R, Mitaudomi T, Ueda H. SecondDepmmetuofSurgery, SchoolofMcdicine, Univ. Occupational/ Environm. Health. I-I lseigaoka. Yahatanishi-ktt. Kitakyushu 807. Ann HOW surg 1994;57: 188-93. The purpose of this study was to investigate the value of surgical
treatment for hmg cancer in the octogenarian. Thirty-three patients 80 years of age or older (mean age. 82.4; range, 80 to 92 years; 25 men, 8 women) underwmt surgical resection in our units between 1974 and 199 1. The operative mortality rate was 3 %, and the 5-year surival rate was 32 96. The relative S-year survival rate (survival rateof our subjects/ that of matched population) was 61%. The mortality and long-term survival rates were. similar to those in younger patients. In this study, long-term survival had no signiticant dependence on stage of disease, histologic tumor type, or complete vemus incomplete resection. It was dependent mainly on Postoperative complications, in particular, cardiorespiratory complications (cardiac complications, p = 0.0005; respiratory comptications, p < 0.05). These data suggest that the octogenarian who suffers from lung cancer deserves the opportunity for a cure and the long-term benefits of surgical treatment, on the condition that no postoperative major cardiorespiratory complications set in.
323-344
Local recurrence after complete resection for non-small-cell cardnoma of the lung: Significance of local control by radiation treatment YpnoT, Ham N. Ichinose Y, Asoh H. Yokoyama H, Ohta M et al. Department of Chest Surgery. National Kyushu Canm
Center. 3-1-j
No~,Minomi~.F~815.J~~rdiov~s~rg1~4;107:~ 12. Of 471 patimts undergoing a complete resection for non-smallcell carcinoma of the lung between 1972 and 1989.40 patients (8.5%) hodlocPlrecu_ccswithwtextrPtho~icdistnnt -is. Excluding 8 patients who had malignant pleural effusion. we selected 32 patients (24 with hilar- mediastinal lymph node, 6 with bronchial stump, and 2 with chest wall recurrence) from the 40 patients and asses& the significance of local control by radiotherapy. The median length of survival after disease recurrence for these 32 patimts was 19 months. Of 29patientsgiven radiation treatment, 16whorespondedtothetreatment survived significantly longer than nonresponders (median survival time 27 months versus 6 months, p < 0.01). Univariate analyses of survival after recurrences in relation to various tktors revealed that sex and disease-free intervals were significant prognostic factors (p < 0.05) other than the effect of radiotherapy. A multivariate analysis showed that the effect of radiotherapy was the predominant prognostic factor. From these results, we conclude that local control with radiation is beneficial in patients with solely locally recurrent tumors in terms of improved survival.
Tracheal sleeve pneumonectomy for bronchogenic carcinoma Roviaro GC, Varoli F, Rebuffat C, Scalambra SM. Vergani C, Sibilla E et al. Depatitnent of Surgery, Uniwrsity of Milan, S. Givreppe Hospital FbF, via S. Kttore 12.20123 Milan. J Tborac Cardiovasc Surg 1994; 107: 13-a. For a long time, primary tumors arising leas than 2 cm distal to the cuina have presented a contraindication to surgicel excision. Tracheal sleeve paeumoncctomy technique allows urinal resection and rcconstructionbutstillcorriesconsiderablepostoperativecomplications. From 1983 to 1992 we performed 27 right tracheal sleeve pneumonectomiea and one let?. Fourteea patients bad NO nodes, nine had N I, and five bad N2. No anastomotic complications, either tistula or stenosis, wereobserved. SucceasR11outcomedepends on meticulous attention to surgical details and careful anaesthetic msnagement with a newvmtilationtube.. Gnepatimtdir.dontbehvmty-secondpostoperative day from myocardial infarction. Complications inch&d pneumonia (one), vocal cord paresis (two), and pleural empyemswithout bronchial tistula (one). Conservative treatment allowed complete recovery from all complications. There are sevm patients alive at 4 years after operation and one at 5 years. Six patients have been disease-free for between I and 32 months. Two patients died free of disease at 13 and 42months. Twopatientsdiedofmediastinal recurrenceand IOofdistant mctastases within 6 and 54 months.
Surgical management of non-small-cell lung cancer with ipsihteral mediastinal node metastasis (TV2dieePse) Goldstraw P, Mannam GC, Kaplan DK. Michail P, Martini N. Todd TRJ et at. Royal BromptodNHLH. wney Street, London Sw3. J Th~rpc Cardiovssc Surg 1994; 107: 19-28. Retween 1979 and 1989,876 patients with non-small-cell lung carcinoma were referred to our unit for surgical treatment. One hundred forty-six patients were judged not suitable for surgical treatment on clinical, radiologic. oTbmnchoscopic findings. Cervical medidnowxpy or anterior mediastinotomy (or both) showed that 151 patients bad mediastinal involvement by invasion or memskma into the ipsihxtenl
Abstracts/Lang
Cancer I I (1994)
ofnonmplignantceuses,ond55pstieotshad59occurreacesofmaligoPnt disease. Late lung cancer recurrence was observed in 22 patients (concurrentwithMsophPIyngeolcancerinoneptientandwithlaryngeP1 cancer in one patient). Metachronous second lung cancer was noted in 20 patients (including concurrent colon cancer in one patient and metastatic recurrence in one patient). Other nonpuhuonary malignant tumors appeared in 13 patients. Including second lung cancer, 25 cancers of aerodigestive epithelium were observed in 23 patients. The malignancy-free survival advantage for patients with squamous cancer observed until 60 months after resection was not sustained at 60 months and beyond. At the time of last follow-up, 84 patients (27%) had died; 43 were free of malignancy, and 41 had malignancy (14 patients were alive with malignancy and 210 with no evidence of disease). These data reinforce two conclusions: (1) The probability of lung cancer recurrence or appearance of new lung cancer 5 years or mom after succcsstirl operation in this select subpopulation of patients with lung cancer is of concern. (2) The malignancy-free survival advantage of Patients with squamous cancer disappears after 5 years.
Indications for an expandable metallic stent for tracheobroncbial stenosis NomoriH. Kohayashi R, Koden K, hiorinaga S, Ogawa K. Depanment of Surgery. Saiseikai Central Hospital, Mita 1417. 108. ANI Thoru: Surg 1993;56: 1324-8.
Minato-ku, Tokyo
An expandable metallic stent was used in 9 patients with tracheobronchial stenosis. Of the 8 patients with malignant stenosis, 6 had extrinsic compression and 2 had intnduminal tumor invasion. The 1 patient with nonmalignant stenosis had postreconstruction bronchomalacia and granulation tissue affecting different parts of the tracheobronchial tree. Theexpandablemetallicstent successfully dilated tracheobronchial stenosis due to extrinsic tumor compression and malacia. However, it was not effective for stenosis due to intraluminal tumor invasion or granulation tissue becauseof the growth of tumor or granulation tissuebetweenthewiresofthestmt. However,anexpandahle metallic stent covered with Dacron mesh was effective in 1patient with intraluminal tumor invasion because tumor growth was bloched by the mesh. We conclude that an expandable metallic stmt is effective for tracheohronchial stenosis due to extrinsic tumor compression, but not for stenosis due to intraluminal tumor invasion or granulation tissue.
Surgical treatment of lung cancer in the octogenarian Gsaki T, Shirakuss T, Kodate M, Nakanishi R, Mitaudomi T, Ueda H. SecondDepmmetuofSurgery, SchoolofMcdicine, Univ. Occupational/ Environm. Health. I-I lseigaoka. Yahatanishi-ktt. Kitakyushu 807. Ann HOW surg 1994;57: 188-93. The purpose of this study was to investigate the value of surgical
treatment for hmg cancer in the octogenarian. Thirty-three patients 80 years of age or older (mean age. 82.4; range, 80 to 92 years; 25 men, 8 women) underwmt surgical resection in our units between 1974 and 199 1. The operative mortality rate was 3 %, and the 5-year surival rate was 32 96. The relative S-year survival rate (survival rateof our subjects/ that of matched population) was 61%. The mortality and long-term survival rates were. similar to those in younger patients. In this study, long-term survival had no signiticant dependence on stage of disease, histologic tumor type, or complete vemus incomplete resection. It was dependent mainly on Postoperative complications, in particular, cardiorespiratory complications (cardiac complications, p = 0.0005; respiratory comptications, p < 0.05). These data suggest that the octogenarian who suffers from lung cancer deserves the opportunity for a cure and the long-term benefits of surgical treatment, on the condition that no postoperative major cardiorespiratory complications set in.
323-344
Local recurrence after complete resection for non-small-cell cardnoma of the lung: Significance of local control by radiation treatment YpnoT, Ham N. Ichinose Y, Asoh H. Yokoyama H, Ohta M et al. Department of Chest Surgery. National Kyushu Canm
Center. 3-1-j
No~,Minomi~.F~815.J~~rdiov~s~rg1~4;107:~ 12. Of 471 patimts undergoing a complete resection for non-smallcell carcinoma of the lung between 1972 and 1989.40 patients (8.5%) hodlocPlrecu_ccswithwtextrPtho~icdistnnt -is. Excluding 8 patients who had malignant pleural effusion. we selected 32 patients (24 with hilar- mediastinal lymph node, 6 with bronchial stump, and 2 with chest wall recurrence) from the 40 patients and asses& the significance of local control by radiotherapy. The median length of survival after disease recurrence for these 32 patimts was 19 months. Of 29patientsgiven radiation treatment, 16whorespondedtothetreatment survived significantly longer than nonresponders (median survival time 27 months versus 6 months, p < 0.01). Univariate analyses of survival after recurrences in relation to various tktors revealed that sex and disease-free intervals were significant prognostic factors (p < 0.05) other than the effect of radiotherapy. A multivariate analysis showed that the effect of radiotherapy was the predominant prognostic factor. From these results, we conclude that local control with radiation is beneficial in patients with solely locally recurrent tumors in terms of improved survival.
Tracheal sleeve pneumonectomy for bronchogenic carcinoma Roviaro GC, Varoli F, Rebuffat C, Scalambra SM. Vergani C, Sibilla E et al. Depatitnent of Surgery, Uniwrsity of Milan, S. Givreppe Hospital FbF, via S. Kttore 12.20123 Milan. J Tborac Cardiovasc Surg 1994; 107: 13-a. For a long time, primary tumors arising leas than 2 cm distal to the cuina have presented a contraindication to surgicel excision. Tracheal sleeve paeumoncctomy technique allows urinal resection and rcconstructionbutstillcorriesconsiderablepostoperativecomplications. From 1983 to 1992 we performed 27 right tracheal sleeve pneumonectomiea and one let?. Fourteea patients bad NO nodes, nine had N I, and five bad N2. No anastomotic complications, either tistula or stenosis, wereobserved. SucceasR11outcomedepends on meticulous attention to surgical details and careful anaesthetic msnagement with a newvmtilationtube.. Gnepatimtdir.dontbehvmty-secondpostoperative day from myocardial infarction. Complications inch&d pneumonia (one), vocal cord paresis (two), and pleural empyemswithout bronchial tistula (one). Conservative treatment allowed complete recovery from all complications. There are sevm patients alive at 4 years after operation and one at 5 years. Six patients have been disease-free for between I and 32 months. Two patients died free of disease at 13 and 42months. Twopatientsdiedofmediastinal recurrenceand IOofdistant mctastases within 6 and 54 months.
Surgical management of non-small-cell lung cancer with ipsihteral mediastinal node metastasis (TV2dieePse) Goldstraw P, Mannam GC, Kaplan DK. Michail P, Martini N. Todd TRJ et at. Royal BromptodNHLH. wney Street, London Sw3. J Th~rpc Cardiovssc Surg 1994; 107: 19-28. Retween 1979 and 1989,876 patients with non-small-cell lung carcinoma were referred to our unit for surgical treatment. One hundred forty-six patients were judged not suitable for surgical treatment on clinical, radiologic. oTbmnchoscopic findings. Cervical medidnowxpy or anterior mediastinotomy (or both) showed that 151 patients bad mediastinal involvement by invasion or memskma into the ipsihxtenl