Resection For Bronchogenic Carcinoma Research Articles

A phase I study of intrapleural Corynebacterium parvum after complete resection of bronchogenic carcinoma

Corynebacterium parvum (C. parvum) was instilled into the pleural space via the chest tube in 11 patients after curative resection for lung cancer. Doses were escalated from 20–70 mg in approximately every third patient in an attempt to determine the maximum tolerated dose. Fever and chest pain were the only toxicities encountered; severity and duration were not dose-related. Six of seven surgical stage I patients were alive and free of recurrence with a median follow-up of 2 1/2 years. A single patient developed light-chain-producing multiple myeloma 1 year after C. parvum injection.

Segmental Resection for Bronchogenic Carcinoma: A Surgical Alternative for the Compromised Patient

Over a twenty-year period, 44 patients with peripheral bronchogenic carcinoma who were unable to tolerate major pulmonary resection underwent segmentectomy as an alternative to nonoperative management. There were 2 immediate postoperative deaths. Of 31 patients eligible, 36% survived five years, and the mean survival time approached four years. Excluding those patients with undifferentiated small cell carcinoma, segmental resection in this compromised group offered a good chance for cure while providing reasonable palliation, and this procedure should be considered as a surgical option to other modalities of treatment commonly offered to these individuals.

Influence of Empyema after Resection for Bronchogenic Carcinoma and Survival (Cooperative Study in Japan)

6, 349 surgical cases of bronchogenic carcinoma collected from 48 institutions in Japan were analysed, and the following results were obtained: 1) The rate of pneumonectemy to lobectcmy was 1:4.5 in 2, 437 cases of curative operation, 1:2.0 in 1, 399 cases of semicurative operation, and 1:2.5 in total. Cases of pneumonectcmy were more on the left side, whereas cases of the right lobectomy were about twice as much as cases of the left one. 2) Postoperative empyema occurred in 178 cases (2.8%). The incidence was significantly higher in cases of the right pneumonectomy than in cases of the left pneumonectomy, and in cases of pneumonectomy than in cases of lobectomy. 3) Out of 114 patients who had suffered from postoperative empyema before 5 years or more, 15 died within 30 days. The incidence of hospital death increased as the clinical stage or the grade of curability worsened. 4) Five-year survival rate of the patients who had suffered from postoperative empyema was 50% in 34 cases of stage I, 44% in 25 cases of stage II, 19% in 32 cases of stage III, and nil in 5 cases of stage IV; and, 59% in 32 cases of curative operation, 58% in 19 cases of semicurative operation, and 9% in 45 cases of noncurative operation. As a whole, the rate was 35% in all 96 cases excluding 15 cases which died within 30 days and 3 other cases of unknown TNM classification. This rate was about the same as the average of the 6 previously reported results. The total of both figures is significantly higher than that of 1, 258 cases collected from the National Cancer Center Hospital and 3 other representative hospitals in Japan. Accordingly, it appears that postoperative empyema has a favorable influence on the survival of the patients.

Four decades of experience with resections for bronchogenic carcinoma at the Massachusetts General Hospital

Experience at the Massachusetts General Hospital (MGH) with resections for primary lung carcinoma is brought up to the clinical staging era (1971) with a 5 year cumulative survival statistic of 30 percent for the period 1964 through 1970. Comparison of four decades of experience reveals no change in cumulative survival for pulmomary resections for primary lung carcinoma in the years 1941 through 1970. Attention is directed to the hospital mortality rates for pneumonectomy and lobectomy and to the principal causes for these rates. Lymph node metastasis continues to be the single most ominous predictor of potential survival after pulmonary resection for carcinoma, particularly for all non-squamous cell types.

Long-term survival in bronchogenic carcinoma

In this report, we shall review the clinical and pathological features of 64 patients who survived 10 years or longer after resection for bronchogenic carcinoma. Most of these patients had either adenocarcinoma or bronchioloalveolar carcinoma. None of them had oat cell carcinoma. In many of the long-term survivors, there were pathological findings generally considered to indicate a poor chance for survival. Thus we believe that curative resection for bronchogenic carcinoma should be attempted whenever feasible to offer the patient every hope of long-term survival.

EVALUATION OF THE RISK IN PULMONARY RESECTION FOR BRONCHOGENIC CARCINOMA

Abstract Preoperative pulmonary function test results in 258 patients who underwent pulmonary resection for bronchogenic carcinoma were studied in relation to postoperative mortality from cardiopulmonary complications. Poor outcome of surgery was related to the maximal breathing capacity value below 59 per cent of the predicted normal, age over sixty-nine years, and abnormal electrocardiographic findings. Combinations of these factors were associated with a very high mortality (56 per cent). This group of patients needs further evaluation on an individual basis to identify the risk of pulmonary resection. A formula to predict the risk of surgery based on the maximal breathing capacity value is suggested. Values for one second forced expiratory volume and vital capacity were of no use in predicting the outcome of surgery.

Long-term survival after surgical resection for bronchogenic carcinoma

Long-term survival after surgical resection for bronchogenic carcinoma

Resection of bronchogenic carcinoma involving thoracic wall

Summary and conclusions 1. The thoracic wall was involved by direct extension of primary carcinoma of the lung in 33 of 392 patients who underwent resection (pneumonectomy or lobectomy). 2. Of 19 patients who had block resection of chest wall, 5 lived over 2 years. Three of these patients lived from 4 to 14 years without known recurrence of cancer. 3. In these 19 patients, the carcinoma was of squamous cell or undifferentiated cell type. 4. Extrapleural resection in 14 patients provided poor palliation, with the longest survivor living 19 months. 5. Although chest wall involvement probably indicates a less favorable outlook, such invasion does not make a patient categorically incurable by surgery. 6. If cancer of the lung, which involves chest wall, is otherwise resectable with prospect of cure, then resection must include chest wall rather than only extrapleural dissection. 7. Chest wall resection in the presence of invasion of ribs or muscle offers a measure of palliation not obtained by extrapleural dissection alone, with or without postoperative irradiation.

HYPERCALCEMIA SECONDARY TO A PRIMARY HEPATOMA.

THE DIAGNOSTIC spectrum of hypercalcemia 1 has become increasingly complex since 1956 when Connor and associates 2 reported the subsidence of hypercalcemia after the resection of bronchogenic carcinoma in two patients. Subsequently, a wide variety of malignancies without skeletal involvement has been associated with hypercalcemia. 3,4 In many cases, as illustrated by this case report, death has resulted from hypercalcemia rather than from the invasive effects of the tumor. The separation of such cases from primary hyperparathyroidism is frequently the most difficult diagnostic problem in the hypercalcemic patient. The following is apparently the first case report of hypercalcemia secondary to a localized primary hepatoma. Report of a Case A 23-year-old white male beautician (UH-794-312) was transferred from a psychiatric hospital for the evaluation of hepatomegaly and somnolence on April 9, 1964. The patient had a six-year history of immoderate alcoholic ingestion and drank up to two pints of whisky per

BILATERAL PULMONARY RESECTION FOR METASTATIC HEPATOMA.

SINCE 1938, when Churchill and Barney 1 reported the successful resection of a metastatic lung lesion originating from a renal cell carcinoma, the presence of lung metastases from certain primary lesions is no longer considered an absolute contraindication to pulmonary resection. The patient they reported subsequently survived 24 years, and died of a myocardial infarction. Recognition that resection of pulmonary metastases could be done with a subsequent cure rate similar to that observed following resection for bronchogenic carcinoma has led to further evaluation of the feasibility of resection of pulmonary metastases. Thirteen patients have undergone pulmonary resection for metastatic tumor at the Virginia Mason Hospital since 1949. One patient initially operated on in 1954 is of sufficient interest to warrant a case report. Report of a Case A 28-year-old secretary, during a routine postpartum examination in March 1954, was found to have a firm, mobile, abdominal mass, 10 × 12

Lung function studies in pulmonary tuberculosis

Summary The results of respiratory function tests in 41 cases of pulmonary tuberculosis are presented. Those obtained after operation showed that the M.V.V. had been reduced by 16·6 per cent. after pneumonectomy, by 9·4 per cent. after lobectomy and by 15 per cent. after segmental resection. Thorocoplasty caused a reduction of 24·9 per cent. Of 10 post-operative deaths in this series, 6 were due to respiratory insufficiency. The relatively small loss of function in these cases is in contrast with the larger loss of function following resection for bronchogenic carcinoma.

Extended resection of bronchogenic carcinoma. A reappraisal and suggested plan of management.

SINCE 1933 surgical resection has provided the most hopeful method of preventing inevitable death from bronchogenic carcinoma. Despite efforts to reduce delay between insidious onset and treatment the tumor has often advanced beyond the confines of the lung at the time of diagnosis. Technical resection of such an advanced lesion has been increasingly possible with the use of intrapericardial dissection, bronchoplastic and thoracoplastic reconstruction as well as cardiovascular technics. Such extended resection has been justified by Chamberlain et al.,1 Smith,2 Thomas3 and others as the only hope for cure or in lieu of cure as a means of palliation. The . . .

Survival rates following resection for bronchogenic carcinoma.

Survival rates following resection for bronchogenic carcinoma.

Preservation of lung tissue by means of bronchoplastic procedures

1. 1. Bronchoplastic procedures are feasible and are indicated under certain conditions to preserve healthy lung tissue. A traumatic, inflammatory, or neoplastic lesion of the bronchus does not always require resection of all of the lung tissue supplied by the bronchus. 2. 2. The authors have used a variety of procedures to restore bronchial continuity in eighteen patients. The bronchial lesions so treated include traumatic occlusion, acute traumatic rupture, tuberculous stenosis, adenoma and carcinoma. 3. 3. The indications for the use of bronchoplastic procedures with resection for bronchogenic carcinoma in nine patients were inadequate pulmonary reserve in three, to extend operability in two, and deliberately for small centrally located lesions in four patients. One operative mortality occurred due to inadequate pulmonary function following resection of an entire lung, coryna and trachea. Three patients died of carcinoma within one year of the operation. The remaining five patients, in four of whom the operation was performed deliberately, are alive and well one, five, fourteen, sixteen and twenty-one months, respectively.