1,721,029 research outputs found
RELATION OF NEOVASCULARIZATION TO METASTASIS OF NON-SMALL-CELL LUNG-CANCER
No full textThe growth of a tumour beyond a certain size requires angiogenesis. We assessed whether intensity of angiogenesis correlates with metastasis of non-small-cell lung cancer by counting microvessels and grading their density within the initial carcinomas in 87 T1N0M0 patients. After radical surgery, metastases developed in 22. Both microvessel count and density grades correlated significantly with metastatic disease as well as tumour size and proliferative activity. The likelihood of metastasis increased as the vessel count increased. On multivariate analysis, the microvessel density count was the only independent predictor of metastasis
ADJUVANT CHEMOTHERAPY FOR T1-2NOMO SMALL-CELL LUNG-CANCER - SINGLE-AGENT OR COMBINATION CHEMOTHERAPY
No full textIn an attempt to address the schedule of adjuvant chemotherapy in surgically resected T1 or T2N0M0 small cell lung cancer, 12 patients were randomized to receive 6 courses of either single-agent (high-dose epirubicin) or combination (cyclophosphamide, epirubicin, and etoposide) chemotherapy, at 3-week intervals. No thoracic radiotherapy was administered while prophylactic cranial irradiation (30 Gy/10 fractions/2 weeks) was given. With a 25-month median followup, overall estimated 2-year and median survival were 83% and 26.5 months (range 16-34+), respectively. Ten patients are currently alive and disease free. No significant difference in 2-year survival was observed between the two adjuvant treatment modalities and median survival was 28 months (range 13-34+) for combination and 21 months (range 14-29+) for single-agent chemotherapy. Although at high doses, epirubicin resulted in a moderate clinical and histological cardiotoxicity and a remarkably reduced incidence of severe (WHO grades 3 and 4) treatment-related morbidity compared with the combination regimen. These preliminary results suggest that comparable survival and reduced toxicity might be expected with an active single-agent as adjuvant chemotherapy in T1 or T2N0M0 small cell lung cancer
MOST PERIPHERAL, NODE-NEGATIVE, NON-SMALL-CELL LUNG CANCERS HAVE LOW PROLIFERATIVE RATES AND NO INTRATUMORAL AND PERITUMORAL BLOOD AND LYMPHATIC VESSEL INVASION - RATIONALE FOR TREATMENT WITH WEDGE RESECTION ALONE
No full textWe investigated the tumor aggressiveness (intratumoral and peritumoral lymphatic and blood vessel invasion by tumor emboli) and proliferative activity (mitotic count) of 45 patients with peripheral, superficially seated, node-negative (T1-2 NO MO), non-small-cell lung cancer treated with wedge resection alone between January 1982 and June 1988. Most patients were male (n = 39) with T1 (n = 25), small (mean diameter, 2.6 +/- 0.8 cm), squamous (n = 24), right-sided (n = 29) tumors located in either upper lobe (n = 35). The surgical specimens were studied by immunohistochemical staining with a monoclonal antibody targeting the factor VIII-related antigen. None of the tumors had lymphatic peritumoral or intratumoral invasion. Seven neoplasms (15 %) harbored blood vessel invasion by tumor cells, all but one of these invasions were within the substance of the tumor. The median mitotic count was 8 mitoses per 10 high-power fields (range, 1 to 42 mitoses), significantly (p = 0.003) higher in patients with blood vessel invasion than in those without. With a 24-month minimum follow-up, projected 3- and 5-year survivals are 79 % and 68 %, respectively. Eleven patients had relapses and died of their tumors because of either local (n = 5) or extrathoracic (n = 6) recurrence; three patients died without tumors of comorbidity. Among the six tumors recurring in extrathoracic sites, five (83 %) harbored intratumoral (n = 4) or peritumoral (n = 1) blood vessel invasion. Both recurrence of disease and death from non-small-cell lung cancer were significantly (p = 0.0009) higher for tumors with blood vessel invasion. By univariate analysis, significant predictors of survival were tumor stage (T1 vs T2, p = 0.008), size (less-than-or-equal-to 2.6 cm vs >2.6 cm, p = 0.039), mitotic count (less-than-or-equal-to 8 vs >8 mitoses, p = 0.0007), and blood vessel invasion (absence vs presence, p = 0.0001). By multivariate analysis, however, only blood vessel invasion retained its level of prognostic significance (p = 0.006). Data demonstrate that peripheral, node-negative non-small-cell lung cancers have a low metastatic potential. Whenever anatomically feasible, wedge resection seems to be an appropriate method of primary treatment
INFLUENCE OF T-STAGE AND N-STAGE ON LONG-TERM SURVIVAL IN RESECTABLE SMALL CELL LUNG-CANCER
No full textEffects of thymostimulin on chemotherapy-induced toxicity and long-term survival in small cell lung cancer patients
No full textThe effects of hymostimulin on chemotherapy-induced toxicity and long-term survival were studied in 26 evaluable patients with small cell lung cancer. Patients were randomly treated with six cycles of two alternating regimens (cyclophosphamide, 4'-epidoxorubicin, and etoposide; cisplatin and etoposide), with (n = 15) or without (n = 11) thymostimulin (1 mg/Kg i.m., days 7-14 of every cycle). Only complete responders received maintenance treatment, consisting of thymostimulin administered 1 mg/Kg i.m., twice weekly, until tumor relapse. Myelosuppression, fever and documented infectious episodes were significantly less severe in thymostimulin-treated patients, allowing the administration of significantly higher drug doses at shorter intervals between chemotherapy cycles; a significant improvement in complete response rate and survival were also observed. Results suggest that the addition of thymostimulin to standard chemotherapeutic regimens might be of benefit, in view of its favourable effects on toxicity and long-term survival
Prognostic significance of tumoral angiogenesis in completely resected patients with late-stage lung cancer (Stage IIIa-N2). Impact of adjuvant therapies in a subset of patients at high risk of recurrence.
No full textBACKGROUND:
Angiogenesis plays a critical role in human tumor growth and metastasis. Microvessel count (MC), as a measure of tumor angiogenesis, has been significantly correlated with metastatic disease in cutaneous, mammary, prostatic, head and neck, and early stage lung carcinoma.
METHODS:
Ninety-six consecutive patients affected by T1-3N2MO nonsmall cell lung carcinoma (NSCLC), who underwent radical surgery between March 1991 and March 1995 (in many cases followed by adjuvant therapies) were prospectively investigated to assess the prognostic significance of both traditional and new biologic parameters like proliferative activity, blood vessel invasion by tumoral cells, and neovascularization (estimated by the MC).
RESULTS:
With a median follow-up of 24 months, the projected 3-year survival was 42.1%. Forty-eight of the patients (50%) had already experienced a local (n=14) or systemic (n=34) relapse. The extent of resection (lobectomy vs. pneumonectomy; P=0.0045), the number of mediastinal lymph node levels (single vs. multiple; P=0.014), and the MC (on a X200 field; P=0.015) correlated significantly with metastatic disease. By univariate analysis, significant predictors of survival were: the extent of surgery (P=0.03), adjuvant therapy (P=0.05), and MC ( cut-off; P=0.00076). On multivariate analysis, however, only the MC (P=0.02) retained its level of prognostic significance.
CONCLUSIONS:
Our results provide evidence that neovascularization, estimated by the MC, can predict metastatic disease and survival in patients with completely resected T1-3N2M0 NSCLC, and may also be useful in patient selection for effective adjuvant treatment
mdm2 gene amplification and overexpression in non-small cell lung carcinomas with accumulation of the p53 protein in the absence of p53 gene mutations.
No full textEndothoracic sonography with color Doppler availability during video assisted thoracic surgery (videothoracoscopic operative staging with ultrasound color Doppler) for lung cancer staging.
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