Biomedical subjects

Kanji Nagai

Publications and source records attributed to Kanji Nagai.

At least 55 records · Page 3Linked to original sources

PubMed2004

hASH1 expression is closely correlated with endocrine phenotype and differentiation extent in pulmonary neuroendocrine tumors.

The human homolog 1 of the Drosophila neurogenic achaete-scute genes, hASH1, is specifically expressed in fetal pulmonary neuroendocrine cells and in some neuroendocrine tumor cell lines. However, no data have been gathered regarding its in vivo expression in tumors. hASH1 mRNA expression was investigated by in situ hybridization in 238 surgically resected lung carcinomas, and the correlations between hASH1 expression status and immunostaining results of neuroendocrine markers chromogranin A, neural cell adhesion molecule, gastrin-releasing peptide and calcitonin, and clinical outcome were analyzed. hASH1 expression was detected in 2/20 (10%) adenocarcinomas, 4/30 (13.3%) typical carcinoids, 11/13 (84.6%) atypical carcinoids, 38/67 (56.7%) large-cell neuroendocrine carcinomas and 56/78 (71.8%) small-cell carcinomas, respectively, but not in any squamous cell carcinoma (0/21) or large-cell carcinoma (0/9). The 2 hASH1+ adenocarcinomas also expressed multiple neuroendocrine markers. Thus, hASH1 expression was restricted to lung cancers with neuroendocrine phenotypes. However, not all neuroendocrine tumors expressed hASH1. Within the entities of large-cell neuroendocrine carcinoma and small-cell carcinoma, hASH1 expression correlated very closely with chromogranin A, gastrin-releasing peptide and calcitonin expression (P<0.0001, r=0.852), but was not related to neural cell adhesion molecule expression (P=0.8892), suggesting that hASH1 expression, at least in lung cancer, is associated with endocrine phenotype expression other than 'neuroendocrine differentiation' in a broad sense. The fact that hASH1 was virtually absent in almost fully differentiated typical carcinoids, but was expressed in most, if not all, less differentiated atypical carcinoids as well as large-cell neuroendocrine carcinomas and small-cell carcinomas, suggests that hASH1 expression in lung cancer imitates its early and transient expression in fetal development, and that hASH1 is instrumental in the establishment, but not in the maintenance, of a cellular endocrine phenotype. Finally, hASH1 expression correlated with a significantly shortened survival in small-cell carcinoma patients (P=0.041).

Adenocarcinoma↗

PubMed2004

Divergent cyclin B1 expression and Rb/p16/cyclin D1 pathway aberrations among pulmonary neuroendocrine tumors.

A total of 111 pulmonary neuroendocrine tumors comprising 13 typical carcinoids, five atypical carcinoids, 44 large-cell neuroendocrine carcinomas and 49 small-cell carcinomas were immunohistochemically studied for dysregulated cyclin B1 expression and disruption of the Rb/p16/cyclin D1 pathway (Rb pathway), and the results were correlated with tumor proliferation activity and clinical outcome. Overexpression of cyclins B1 and D1, respectively, was detected in no and 15% typical carcinoids, 20 and 20% atypical carcinoids, 84 and 32% large-cell neuroendocrine carcinomas, 84 and 10% small-cell carcinomas. Loss of Rb and p16 expression, respectively, was observed in no and 14% typical carcinoids, no and 40% atypical carcinoids, 49 and 18% large-cell neuroendocrine carcinomas, 84 and 8% small-cell carcinomas. In summary, 29% typical carcinoids, 20% atypical carcinoids, 78% large-cell neuroendocrine carcinomas and 93% small-cell carcinomas had Rb pathway aberrations. Rb pathway aberration was mostly attributed to Rb loss in small-cell carcinomas, while p16 loss and/or cyclin D1 overexpression besides Rb loss also played an important role in large-cell neuroendocrine carcinomas, while cyclin D1 overexpression was the only cause of Rb pathway aberration in carcinoid tumors. Thus, both cyclin B1-associated G2/M arrest and Rb-mediated G1 arrest are consistently compromised in high-grade large-cell neuroendocrine carcinoma and small-cell carcinoma, but are generally intact or occasionally altered in carcinoid tumor; the mechanisms involved in Rb pathway aberration among the tumor categories are different, reflecting a genetic divergence among the individual tumor categories. Cyclin B1 expression closely correlated with the Ki-67 labeling index either in the individual tumor categories or overall tumors (P < 0.0001, r = 0.742), suggesting that cyclin B1 is one of the key factors regulating cell proliferation in pulmonary neuroendocrine tumors. Neither cyclins B1 and D1, Rb, p16, nor Ki-67 correlated with patient survival in individual tumor categories, suggesting that the prognostic significance of these factors is tumor-type specific.

Biomarkers, Tumor↗

PubMed2004

Late pulmonary metastasis of renal cell carcinoma resected 25 years after nephrectomy.

A 50-year-old male underwent a left nephrectomy for clear cell type renal cell carcinoma (RCC) in February 1978. A right pulmonary metastasis was resected in February 1994. At that time, chest computed tomography revealed the presence of three small nodules in the left lung, but these were followed up as inflammatory lesions. In January 2002, a right pleural metastasis, which showed rapid growth, was detected and it was resected in June of the same year. A gradual growth was observed in the left lung nodules, and the patient underwent wedge resection of the left lung in March 2003, 25 years after nephrectomy. These nodules were diagnosed as metastatic RCC. Currently, the patient is doing well with no signs of recurrence, 8 months after the third metastasectomy.

Adenocarcinoma, Clear Cell↗

PubMed2004

Primary lung carcinoma with signet-ring cell carcinoma components: clinicopathological analysis of 39 cases.

The clinical and histologic profiles of primary lung carcinomas with signet-ring cell carcinoma (SRCC) components were analyzed. The SRCC components were seen in 39 cases (1.5%) of 2640 cases of surgically resected primary lung carcinomas. The patients' mean age was 54.6 years (range, 32-76 years), and the male-to-female ratio was 1.16:1.00. Twenty-six patients (66.7%) were smokers. The SRCC component was seen as part of an adenocarcinoma in 36 cases (acinar, 27 cases; mixed bronchioloalveolar and acinar, 9 cases) and as part of an adenosquamous cell carcinoma in 2 cases; one lesion consisted of only SRCC cells. The morphologic appearance of cancer nests containing SRCC was classified into three patterns: solid, tubuloacinar, and discohesive. Each case was composed of a varying proportion of these three patterns. The carcinomas with SRCC components were divided into two groups, according to those in which the SRCC component occupied <50% of the lesion (L-SRCC; n = 20) and those in which the SRCC component occupied > or = 50% of the lesion (H-SRCC; n = 19). The frequencies of blood vessel invasion, lymph vessel invasion, and lymph node metastasis were significantly higher in the H-SRCC group than in 1634 adenocarcinoma, and adenosquamous cell carcinomas (non-SRCC). The 5-year survival rates of patients non-SRCC, with l-SRCC, or with H-SRCC were 52.7%, 50%, and 28.4%, respectively. The 5-year survival rate of patients with H-SRCC and of patients without SRCC were significantly different. Based on these clinicopathologic characteristics, we classified primary lung carcinomas with SRCC components into the following two groups: 1) SRCC, in which the SRCC component occupies >or = 50% of the lesion, and 2) signet-ring feature, in which the SRCC components occupies <50% of the lesion.

Adenocarcinoma↗

PubMed2004

Engraftment of adult human lung tissue in nonobese diabetic/severe combined immunodeficient mice: a novel lung epithelial regeneration model.

OBJECTIVES: Injury causes the disruption of homeostatic cell-cell interactions and epithelial regeneration is part of the threshold response. Due to the lack of a good animal model for the investigation of these mechanisms, the kinetics of cell proliferation after injury to the human respiratory tract are poorly understood. METHODS: To create a better model of human bronchioloalveolar epithelial regeneration, we engrafted adult human lung tissue into nonobese diabetic/severe combined immunodeficient (NOD/SCID) mice. Then the lung tissue was studied at various times up to 20 weeks after implantation. RESULTS: The xenografts of bronchiolar epithelium showed characteristic features, including positivity for specific human antigens, and extensive regeneration was observed within 8 weeks after implantation. In addition, a few alveolar type II epithelial cells expressing prosurfactant protein C were detected in some areas. The distal alveolar spaces were filled with protein-rich material and were markedly dilated. Abundantly ciliated secretory epithelium, which was similar to normal adult bronchiolar epithelium, was observed within 16 weeks after implantation in the mice. All of the human lung tissue specimens that were implanted subcutaneously into the backs of the mice developed well and remained viable for 20 weeks. Each type of adult human lung epithelial cell showed a different mode of proliferation. Bronchiolar epithelial cells proliferated earlier, with MIB-1 labeling of up to 20% of the cells in the grafts at 8 weeks, while alveolar type II cells proliferated later, with labeling of up to 5% of graft cells at 12 weeks. CONCLUSION: This model seems to allow adult human lung epithelial regeneration to be investigated in vivo over the long term.

Aged↗

PubMed2003

Weekly chemotherapy with cisplatin, vincristine, doxorubicin, and etoposide is an effective treatment for advanced thymic carcinoma.

BACKGROUND: Thymic carcinoma is a rare neoplasm that often disseminates or metastasizes. The role of chemotherapy in treating this malignancy is unclear. The purpose of the current study was to determine the efficacy and tolerability of a weekly chemotherapy regimen consisting of cisplatin, vincristine, doxorubicin, and etoposide (CODE) for the treatment of advanced thymic carcinoma. METHODS: The authors retrospectively reviewed 18 patients with thymic carcinoma who were treated between 1996 and 2002. Twelve of these patients had unresectable advanced diseases and received weekly chemotherapy according to the CODE regimen. The CODE regimen consisted of cisplatin (25 mg/m(2), intravenously [i.v.]; weekly administration), vincristine (1 mg/m(2), i.v.; administered during Weeks 1, 2, 4, 6, and 8), doxorubicin (40 mg/m(2), i.v.; administered during Weeks 1, 3, 5, 7, and 9), and etoposide (80 mg/m(2), i.v.; administered for 3 days during Weeks 1, 3, 5, 7, and 9). RESULTS: The responses of all 12 patients to the CODE regimen were assessed. A partial response was achieved in 5 patients, and the overall response rate was 42%. Only one patient experienced disease progression. The median progression-free survival period was 5.6 months (range, 2-39 months). The overall survival period ranged from 6 to 79 months, with a median survival period of 46 months. Based on the Kaplan-Meier method, the estimated 1-year and 2-year survival rates were 80% and 58%, respectively. The most common side effects were hematologic toxicities, and only mild nonhematologic toxicities were experienced. CONCLUSIONS: Weekly chemotherapy treatments according to the CODE regimen were effective and tolerated by patients with advanced thymic carcinoma.

Adult↗

PubMed2003

Osteoprotegerin/osteoclastogenesis inhibitory factor decreases human prostate cancer burden in human adult bone implanted into nonobese diabetic/severe combined immunodeficient mice.

Human prostate cancer frequently metastasizes to bone, where it gives rise to osteoblastic bone metastases with an underlying osteoclastic component and subsequent bone pain. However, the importance of osteoclastogenesis in the development of prostate cancer bone lesions in humans is unclear. Osteoprotegerin/osteoclastogenesis inhibitory factor (OCIF) is a member of the tumor necrosis factor receptor family and a novel secreted protein, and it is a negative regulator of osteoclast differentiation, activation, and survival both in vitro and in vivo. In the present study we used a model in which human LNCaP prostate cancer cells that give rise to osteoblastic bone tumors were injected directly into the intramedullary space of human adult bone implanted into nonobese diabetic/severe combined immunodeficient mice to investigate whether the new bone-resorption inhibitor osteoprotegerin/OCIF would inhibit the development of new bone tumors and the progression of established osteoblastic bone tumors. The mice were given consecutive daily s.c. injections of recombinant human OCIF (rhOCIF; 100 micro g/mouse/day) for 2 weeks starting either immediately or 2 weeks after injection of the LNCaP cells. In both protocols, rhOCIF markedly inhibited both the development of bone tumors and the progression of established bone tumor foci quantified by histological examination. Histomorphometrical analysis revealed that rhOCIF markedly reduced the number of osteoclasts and the size of the tumors at the bone sites, but that it had no effect on the local growth of s.c. LNCaP tumors or on LNCaP cell proliferation in culture. These findings demonstrate that osteoclasts play an important role in bone tumor by prostate cancer, and that rhOCIF decreases the LNCaP prostate cancer burden selectively in bone, suppresses the progression of established tumor lesions, and prevents the development of new lesions. These results suggest that inhibition of osteoclastic bone resorption may be an effective therapy for the treatment of prostate cancer that has colonized bone.

Animals↗

PubMed2003

Depression and psychological distress in patients during the year after curative resection of non-small-cell lung cancer.

PURPOSE: There have been few psychosocial studies of patients after curative resection of non-small-cell lung cancer (NSCLC). The purpose of this study was to clarify the clinical course of depression and psychological distress of such patients during the year after surgery and to identify predictors of their long-term outcome. PATIENTS AND METHODS: A total of 212 patients completed assessments during a 12-month follow-up period after curative resection of NSCLC. Psychological measurements at 1, 3, and 12 months after surgery were conducted using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (ed 3), Revised, and the Profiles of Mood States (POMS) scale. Univariate and multivariate analyses were used to identify predictors of psychological outcome according to these two methods of assessment. RESULTS: The prevalence of depression did not change during the year after curative resection (range, 4.7% to 8.0%). The total POMS score was also unaltered during the year after surgery: the anger-hostility (P <.001) and tension-anxiety subscale scores (P <.026) had increased at 12 months, but the vigor-activity subscale score had also increased (P <.001). All predictors of psychological outcome at 12 months included a depression episode after the diagnosis of lung cancer or at 1 month after surgery. Less-educated status was also a significant predictor of depression at 12 months. CONCLUSION: These results suggest the need for psychosocial support even after curative resection of NSCLC and indicate that an approach that includes repetitive perioperative assessment of depression and careful attention to less-educated patients might be of benefit to patients in ameliorating depression and psychological distress during the year after curative resection.

Adult↗

PubMed2003

A long-term survivor of complete resection for stage IIB adenocarcinoma of the lung and chemoradiotherapy for postoperative metastasis to the abdominal rectus muscle.

We report long-term survival of very rare metastatic involvement and an unusual course of recurrent stage IIB lung adenocarcinoma. Nine months after surgery for stage IIB primary lung adenocarcinoma, a 64-year-old Japanese man was found to have a nodule in the abdominal rectus muscle, diagnosed histologically as carcinoma metastasizing from the lung. Through combined chemotherapy and subsequent radiotherapy, complete response of the metastatic lesion was achieved without serious adverse effects. Results continue to be favorable more than 7 years and 11 months following sequential chemoradiotherapy and 9 years and 4 months after surgery. Sequential chemoradiotherapy appears to have favorably affected this man's survival despite metachronous metastasis to the abdominal rectus muscle after complete resection for stage IIB primary lung adenocarcinoma.

Adenocarcinoma↗

PubMed2003

The proportion of consolidation to ground-glass opacity on high resolution CT is a good predictor for distinguishing the population of non-invasive peripheral adenocarcinoma.

OBJECTIVE: If non-invasive lung carcinomas are distinguishable on computed tomography (CT), limited surgery can be indicated before operation as a radical procedure. The purpose of this study is to define high resolution CT (HRCT) findings that indicate pathologic T1N0M0 tumor without vessel invasion. PATIENTS AND METHODS: We reviewed HRCT findings and pathological specimens of 98 consecutive patients underwent lobectomy or pneumonectomy with systematic hilar and mediastinal lymph node dissection from January 1996 to October 1999 for 101 pulmonary peripheral adenocarcinomas smaller than 3cm in diameter on HRCT. A total of 101 consecutive surgically resected peripheral adenocarcinomas of the lung measuring 3.0cm or less in the maximum dimension on HRCT were examined both radiologically and histologically. All CT scans ware reviewed by three chest radiologists or pulmonologists. The following parameters were measured on HRCT: the greatest diameter of tumor on found on all CT cuts (Td), the greatest diameter of consolidation found on all CT cuts (Cdmax), and the greatest diameter of consolidation found on a particular CT cut (Cd). Consolidation to tumor size ratio at respective maximum dimensions was calculated as Cdmax/Td, and consolidation to tumor size ratio on the slice image with the maximum tumor dimension was calculated as Cd/Td. One pathologist reviewed all pathological specimens to determine the size of tumor, evidence of vessel invasion, etc. without any information of HRCT, and we compared CT findings with pathological findings. RESULTS: There was a statistically significant difference between tumors with pathologic T1N0M0 adenocarcinoma without vessel invasion (least invasive disease: LID) and tumors with lymph node involvement or vessel invasion (invasive disease: ID) in each parameter. However, only when tumors with Cdmax/Td smaller than 0.5 were selected as LID tumors, could ID tumors be eliminated from the LID group. Five-year survival rate of this population is 95.7%. CONCLUSION: Consolidation to tumor size ratio at respective maximum dimensions was the best predictor of non-invasive peripheral adenocarcinoma.

Adenocarcinoma↗

PubMed2003

Frequent overexpression of the c-kit protein in large cell neuroendocrine carcinoma of the lung.

Overexpression of receptor-type tyrosine kinases in various cancers is associated with an aggressive tumor phenotype and poor outcome, but their expression had never been evaluated in large cell neuroendocrine carcinoma (LCNEC) of the lung. In the present study, we investigated the expression of three receptor tyrosine kinases, epidermal growth factor receptor (EGFR), c-erbB-2, and c-kit protein, by comparing surgically resected 40 LCNECs with other neuroendocrine (NE) lung tumors: 9 typical carcinoids (TCs), 5 atypical carcinoids (ACs), and 13 small cell lung carcinomas (SCLCs). None of the NE lung tumors showed expression of EFGR or c-erbB-2, but c-kit was overexpressed in 55% of the LCNEC tumor cells and 46% of the SCLC tumor cells. None of the clinicopathologic factors in either the LCNEC or SCLC patients correlated with c-kit overexpression. The finding that c-kit expression in LCNEC is similar to its expression in SCLC suggests that inhibition of c-kit may be effective as a therapy targeting LCNEC as well as SCLC.

Adenocarcinoma↗

PubMed2003

A randomized trial comparing induction chemotherapy followed by surgery with surgery alone for patients with stage IIIA N2 non-small cell lung cancer (JCOG 9209).

OBJECTIVE: We performed a prospective randomized trial in patients with potentially resectable stage IIIA N2 non-small cell lung cancer to confirm the efficacy of induction chemotherapy before surgical resection. METHODS: Patients with stage IIIA N2 non-small cell lung cancer, all with histologically or cytologically confirmed metastases to the ipsilateral mediastinal lymph nodes, were randomly assigned to receive either three cycles of induction chemotherapy (cisplatin at 80 mg/m(2) on 1 day and vindesine at 3 mg/m(2) on 2 days) followed by surgery or surgery alone. RESULTS: This trial was prematurely terminated because the accrual rate was too slow, which lowered the study's statistical power considerably. From June 1993 through April 1998, a total of 62 patients were enrolled, and 31 patients were assigned to each treatment group. The objective clinical response rate of induction chemotherapy was 28%. Complete resection was achieved in 20 patients in the induction chemotherapy group (65%) and 24 in the surgery alone group (77%). Median follow-up was 6.2 years. Median overall survivals were 17 months for the induction group and 16 months for the surgery alone group. The estimated 1-, 3-, and 5-year survivals, respectively, were 68% (95% confidence interval 51%-85%), 23% (95% confidence interval 8%-38%), and 10% (95% confidence interval 0%-20%) for the induction chemotherapy group and 65% (95% confidence interval 48%-82%), 26% (95% confidence interval 11%-41%), and 22% (95% confidence interval 7%-37%) for the surgery alone group. There was no statistically significant difference in survival between the groups (P =.5274). Treatment-related death was not observed in either group. CONCLUSION: This randomized trial to compare induction chemotherapy (cisplatin and vindesine) followed by surgery with surgery alone for patients with stage IIIA N2 non-small cell lung cancer did not demonstrate a survival difference between the groups, although this may have been because the statistical power was limited.

Adult↗

PubMed2003

Calcification in large cell neuroendocrine carcinoma of the lung.

BACKGROUND: The aim was to investigate the prevalence of intratumoral calcification in large cell neuroendocrine carcinoma (LCNEC) and to review computed tomography (CT) and histological findings. PATIENTS AND METHODS: From August 1992 through March 2000, 35 out of 1183 surgically resected lung cancer patients were histologically diagnosed as having LCNEC at our institute. We reviewed the plain radiographs and CT scans of these 35 LCNEC patients. In LCNEC cases with intratumoral calcification, we examined the size, number, distribution and pattern of intratumoral calcifications visible on the CT scans and the histological features. RESULTS: Three cases (9%) exhibited calcification. The calcifications were recognized by CT scans alone. The CT scans showed punctate or eccentric intratumoral calcifications, which are considered to be a malignant feature, in all three cases. In two cases, the calcifications were histologically confirmed to be located within the necrotic areas of a tumor nest. CONCLUSION: We found three LCNEC cases with intratumoral calcification. The prevalence of LCNEC calcification was similar to that in previous reports on lung cancer. The mechanism of the intratumoral calcification in our LCNEC cases is speculated to be dystrophic calcification.

Aged↗

PubMed2003

Clinicopathologic characteristics of peripheral squamous cell carcinoma of the lung.

Squamous cell carcinoma of the lung can be divided into two types according to the location of the primary site: the central type and the peripheral type. The clinicopathologic factors in the peripheral type of lung squamous cell carcinoma have not yet been fully evaluated. A total of 204 surgically resected lung squamous cell carcinomas were reviewed with special reference to their location, histologic characteristics based on tumor growth patterns, and clinicopathologic factors. The central type and the peripheral type accounted for 95 and 109 cases, respectively. Although the patient population of the peripheral type was older, with a lower pathologic stage, lower lymphatic vessel involvement, and lymph node metastasis, the Kaplan-Meier survival proportions did not differ significantly between these two groups. Based on the histologic growth pattern, the peripheral type was classified under three subgroups as follows: 1). the alveolar space-filling type, 2). the expanding type, and 3). the combined type. Among these three types, the alveolar space-filling type showed neither lymphatic vessel invasion nor lymph node metastasis and had the most favorable prognosis. The central and peripheral types of lung squamous cell carcinoma have different clinicopathologic characteristics and should be classified under respectively different categories.

Adult↗

PubMed2003

[A case of well-differentiated nonmucinous adenocarcinoma of the lung with an 18-year clinical course before surgery].

A 56-year-old woman was referred for an abnormally dense area in the right upper lung field detected at medical checkup. This shadow had been pointed out frequently since she was 38 years old, but no pathological diagnosis of lung cancer had been given. The size of the abnormal area had gradually increased over the 18 years. Since lung cancer was suspected on the basis of the radiographic findings, she underwent open lung biopsy. Pathologically, the tumor tissue showed a lepidic growth pattern on the wall of preexisting alveoli; and formation of fibrotic foci caused by the collapse of alveoli and the microscopic destruction of the elastic fiber framework were seen in the tumor. There was no vascular invasion or lymphatic infiltration in the tumor. It was diagnosed as well-differentiated nonmucinous adenocarcinoma, p-T2 N0 M0. Although this tumor was untreated for 18 years from the first detection using chest radiography, the critical invasive features were not in evidence pathologically.

Adenocarcinoma↗

PubMed2002

Screening for lung cancer with low-dose helical computed tomography: anti-lung cancer association project.

PURPOSE: Because efficacy of lung cancer screening using chest x-ray is controversial and insufficient, other screening modalities need to be developed. To provide data on screening performance of low-dose helical computed tomography (CT) scanning and its efficacy in terms of survival, a one-arm longitudinal screening project was conducted. PATIENTS AND METHODS: A total of 1,611 asymptomatic patients aged 40 to 79 years, 86% with smoking history, were screened by low-dose helical CT scan, chest x-ray, and 3-day pooled sputum cytology with a 6-month interval. RESULTS: At initial screening, the proportions of positive tests were 11.5%, 3.4%, and 0.8% with low-dose helical CT scan, chest x-ray, and sputum cytology, respectively. In 1,611 participants, 14 (0.87%) cases of lung cancer were detected, with 71% being stage IA disease and a mean tumor diameter of 19.8 mm. At repeated screening, the proportions of positive tests were 9.1%, 2.6%, and 0.7% with low-dose helical CT, chest x-ray, and sputum cytology, respectively. In 7,891 examinations, 22 (0.28%) cases of lung cancer were detected, with 82% being stage IA disease and a mean tumor diameter of 14.6 mm. The 5-year survival rate for screen-detected lung cancer was 76.2% and 64.9% for initial and repeated screening, respectively. CONCLUSION: Screening with low-dose helical CT has potential to improve screening efficacy in terms of reducing lung cancer mortality. An evaluation of efficacy using appropriate methods is urgently required.

Adult↗

PubMed2002

Postoperative morbidity, mortality, and survival in lung cancer associated with idiopathic pulmonary fibrosis.

BACKGROUND: Although postoperative morbidity and mortality rates in patients with lung cancer have decreased with advances in perioperative management, those patients with idiopathic pulmonary fibrosis (IPF) remain at a high risk of complication and death. The frequency of postoperative morbidity and mortality rates in patients with lung cancer who have IPF have seldom been reported, however. METHODS: A retrospective study of 711 patients with lung cancer who had undergone surgical resection was conducted. Medical records were retrospectively compared for factors that might affect postoperative morbidity and mortality in patients with and without IPF. RESULTS: Of the 711 patients with lung cancer, 53 (7.5%) had IPF. The patients with IPF had pulmonary morbidity and mortality more frequently than those without IPF (26% versus 9.1%, P < 0.01; 8% versus 0.8%; P < 0.01). The 5-year survival was 43% among patients with IPF and 64.2% among those without IPF. Overall survival in patients with IPF was significantly lower than in those without IPF (P < 0.01), but disease-free survival was similar in the groups. Thirty-five percent of the deaths (8 of 23) were not related to lung cancer in those patients with IPF, compared with 18% (35 of 199) of the deaths among those without IPF (P = 0.048). CONCLUSION: Patients with IPF showed markedly higher postoperative pulmonary morbidity and mortality than those without IPF. The survival rate of patients with IPF was lower because of pulmonary complications. Careful preoperative evaluation and perioperative management are required to achieve optimal surgical outcome in patients with lung cancer who have IPF.

Adenocarcinoma↗

PubMed2002

Encapsulated thymoma metastasizing to a pectoralis major muscle.

An extensive review of the literature suggests that ours is the first case of encapsulated thymoma metastasizing to a skeletal muscle. A 43-year-old man underwent thymothymectomy for encapsulated Masaoka's stage I thymoma. Four years after complete resection, the tumor metastasized to the left pectoralis major muscle. Although a few reports exist on encapsulated thymoma metastasizing to a distant site, the literature does not describe encapsulated thymoma metastasizing to a skeletal muscle insofar as we could find.

Adult↗