PubMed Health⌕ Search

Biomedical subjects

Min-Hsiung Huang

Publications and source records attributed to Min-Hsiung Huang.

At least 19 recordsLinked to original sources
PubMed2006

Non-Hodgkin's lymphoma presenting as a large chest wall mass.

BACKGROUND: Malignant lymphoma presenting as a solitary chest wall mass is not frequently seen. Only a few case reports have been found in the English literature. The treatment for primary chest wall lymphoma remains unclear. METHODS: From 1991 to 2004, of 157 patients with initial presentation of isolated chest wall mass, non-Hodgkin's lymphoma was diagnosed in 7 of them. Patients with tumors arising from axillary lymph nodes or mediastinal lymphadenopathy with chest wall extension were excluded in the study. The clinical manifestation, management, and outcome of these patients were reviewed. RESULTS: There were 1 female and 6 male patients with a mean age of 66.5 years. The mean largest diameter of the mass was 10.3 cm. Four of these 7 patients had the chest wall lymphoma as the only site of disease. The other 3 patients had other organ involvement including lung, bone, or liver. The pathologic diagnoses were malignant lymphoma in 2 patients and diffuse large B-cell lymphoma in 5 patients. Three patients with chest wall lymphoma as the only site of disease had tumor excision followed by adjuvant chemotherapy. No recurrence or metastasis was noted for these 3 patients. The mean follow-up period was 102 months. The other patient with chest wall lymphoma as the only site of disease, who had chemotherapy as the initial treatment, remained free of disease for 6 months after treatment. The other 3 patients with other organ involvement who were managed with chemotherapy with or without radiotherapy died of disease after a mean survival of 20 months. CONCLUSIONS: Malignant lymphoma presenting as a large chest wall mass is not common. Although the primary treatment of choice for lymphoma with or without chest wall involvement is chemotherapy, surgery followed by adjuvant chemotherapy can provide satisfactory outcome for some patients in whom the chest wall lymphoma was the only site of disease.

Adult↗
PubMed2006

En bloc resection for lung cancer with chest wall invasion.

BACKGROUND: The aim of this study was to retrospectively assess the results of en bloc chest wall plus lung resection for patients with non-small cell lung cancer (NSCLC) invading the chest wall. METHODS: From January 1986 to December 2000, of 1,820 patients having surgery for NSCLC, 42 (2.3%) patients with neoplasms involving the chest wall underwent en bloc chest wall and lung resection. Patient demographics, preoperative symptoms, operative procedures, tumor cell type and size, removed nodal status, and pathologic stage were summarized. The 5-year survival rates of the groups were compared. RESULTS: Postoperative staging revealed 28 were T3N0M0, 4 were T3N1M0, and 10 were T3N2M0. The in-hospital mortality rate was 11.9% (5/42). The mean age was 79.0 +/- 2.8 years in the patients who died of complications, which was significantly older than the mean age of 67.9 +/- 8.1 years in the patients who survived the surgery (p = 0.005). The overall 5-year survival was 28.4%. The 5-year survival was significantly longer in the patients with negative (N0) nodal metastasis than in those with N1 and/or N2 nodal metastasis (39.6% versus 7.1%, p = 0.01). Eleven patients had tumor involvement of the parietal pleura. Thirty-one patients had tumor involvement of the soft tissue and/or bone. There was no significant difference of 5-year survival rate between the patients with involvement of the parietal pleura only and the patients with involvement of the parietal pleura and the soft tissue and/or bone (10.9% versus 33.5%, p = 0.94). CONCLUSION: En bloc resection for bronchogenic carcinoma invading the chest wall provides a favorable prognosis in cases without nodal metastasis. Significant postoperative mortality is associated with old age (> 80 years). The 5-year survival rate is not significantly different between the patients with involvement of the parietal pleura only and the patients with involvement of the parietal pleura and the soft tissue and/or bone.

Adult↗
PubMed2006

Management of primary chest wall tumors: 14 years' clinical experience.

BACKGROUND: Primary chest wall tumor is rare but it encompasses tumors of various origins. We analyzed our experience with primary chest wall tumors with emphasis on its demographic presentation and management. METHODS: From 1991 to 2004, 62 patients with the diagnosis of primary chest wall tumors were enrolled. Lipoma, chest wall metastasis, direct invasion from nearby malignancy, infection, and inflammation of chest wall were excluded. The clinical features, management, and the outcome of these patients were retrospectively reviewed. RESULTS: There were 37 males and 25 females. Malignant and benign tumors were equally distributed. Chondrosarcoma and lymphoma were the 2 most common types of malignant chest wall tumors. The most common clinical symptoms were palpable mass (54.8%) and pain (40.3%). Nine of 31 patients (29.0%) with benign chest wall tumors were free of symptoms whereas patients with malignant chest wall tumors were all symptomatic (p = 0.002). A definite diagnosis was obtained in 21 of 26 patients (80.7%) who received nonexcision biopsy. All patients with primary chest wall tumors, except 6 who had medical treatment only, underwent surgical resection. Patients with malignant chest wall tumors were older than those with benign tumors (p < 0.001). The mean largest diameter of tumors was also larger in malignant tumors than in benign tumors (p = 0.04). CONCLUSION: Patients with primary malignant chest wall neoplasm were older than those with benign tumors. The mean size of malignant tumors was larger than that of benign tumors. Adequate surgical resection remains the treatment of choice for patients with primary chest wall tumors. Nonexcision biopsy should be reserved for patients with a past history of malignancy, suspicion of hematologic disease, and with high operative risk. For patients with isolated chest wall lymphoma, surgical resection followed by chemotherapy can be considered to obtain a better outcome.

Adolescent↗
PubMed2005

Copy number changes of target genes in chromosome 3q25.3-qter of esophageal squamous cell carcinoma: TP63 is amplified in early carcinogenesis but down-regulated as disease progressed.

AIM: By using comparative genomic hybridization, gain of 3q was found in 45-86% cases of esophageal squamous cell carcinoma (EC-SCC). Chromosome 3q25.3-qter is the minimal common region with several oncogenes found within this region. However, amplification patterns of these genes in EC-SCC have never been reported. The possible association of copy number changes of these genes with pathologic characteristics is still not clear. METHODS: Real-time quantitative PCR (Q-PCR) was performed to analyze the copy number changes of 13 candidate genes within this region in 60 primary tumors of EC-SCC, and possible association of copy number changes with pathologic characteristics was analyzed by statistics. Immunohistochemistry (IHC) study was also performed on another set of 111 primary tumors of EC-SCC to verify the association between TP63 expression change and lymph node metastasis status. RESULTS: The average copy numbers (+/-SE) per haploid genome of individual genes in 60 samples were (from centromere to telomere): SSR3: 4.19 (+/-0.69); CCNL1: 5.24 (+/-0.67); SMC4L1: 2.01 (+/-0.16); EVI1: 2.02 (+/-0.12); hTERC: 5.28 (+/-0.54); SKIL: 2.71 (+/-0.14); EIF5A2: 1.95 (+/-0.12); ECT2: 9.18 (+/-1.68); PIK3CA: 8.13 (+/-1.17); EIF4G1: 1.07 (+/-0.05); SST: 3.07 (+/-0.25); TP63: 2.51 (+/-0.22); TFRC: 2.42 (+/-0.19). Four clusters of amplification were found: SSR3 and CCLN1 at 3q25.31; hTERC and SKIL at 3q26.2; ECT2 and PIK3CA at 3q26.31-q26.32; and SST, TP63 and TFRC at 3q27.3-q29. Patients with lymph node metastasis had significantly lower copy number of TP63 in the primary tumor than those without lymph node metastasis. IHC study on tissue arrays also showed that patients with lymph node metastasis have significantly lower TP63 staining score in the primary tumor than those without lymph node metastasis. CONCLUSION: This study showed that different amplification patterns were seen among different genes within 3q25.3-qter in EC-SCC, and several novel candidate oncogenes (SSR3, SMC4L1, ECT2, and SST) were identified. TP63 is amplified in early stage of EC-SCC carcinogenesis but down-regulated in advanced stage of disease.

Carcinoma, Squamous Cell↗
PubMed2005

Intramural lipoma of the esophagus.

Lipomas of the gastrointestinal tract are rare, and those of the esophagus are extremely rare. Indeed, fewer than 20 resected cases of esophageal lipoma have been reported in the literature. In the current case, a 71-year-old man presented with a 4-month history of a slight swallowing disturbance in the upper chest. Upper gastrointestinal endoscopy revealed a submucosal space-occupying mass, with normal mucosa, in the upper third of the thoracic esophagus; the mass was yellowish in color, soft in consistency, and about 3.5 x 3.0 cm in diameter. The patient underwent video-assisted thoracoscopic enucleation of the submucosal esophageal tumor, which pathologically, was proved to be a lipoma.

Aged↗
PubMed2004

Preoperative serum albumin level is a prognostic indicator for adenocarcinoma of the gastric cardia.

Among patients with adenocarcinoma of the gastric cardia, we noted that patients with higher preoperative serum albumin levels appeared to survive longer than patients with lower levels. Thus, we evaluated serum albumin as a prognostic factor for patient survival. From 1987 to 1997, 314 patients with adenocarcinoma of the gastric cardia underwent curative resection. Patient serum albumin levels were evaluated on the second day after admission, before any nutritional support. Patients were divided into two groups: those with normal serum albumin levels (>3.5 g/dl) and those with abnormal serum albumin levels. The perioperative mortality and morbidity were 5.7% (18 of 314) and 22.3% (70 of 314), respectively. The surgical resectability rate was significantly better among patients with normal serum albumin levels (P < 0.001). The 5-year overall survival rate of patients with normal serum albumin levels was also better than those with abnormally low serum albumin levels (38.4% versus 19.1%, P=0.0003). In each cancer stage, the 5-year survival rate of patients with normal serum albumin levels was better than that among those with hypoalbuminemia. By multivariate analysis, serum albumin level and the pathologic T, N statuses were independent factors correlated with prognosis. Preoperative serum albumin level correlated highly with resectability and survival. Patients with abnormal serum albumin levels had worse survival than did those with normal serum albumin levels. We recommend that postoperative adjuvant therapy be given to all patients with hypoalbuminemia preoperatively.

Adenocarcinoma↗
PubMed2004

Pulmonary hamartoma.

BACKGROUND: Pulmonary hamartoma is the most common type of benign lung tumors. We retrospectively reviewed the clinicopathological features of 61 patients with pulmonary hamartomas undergoing surgical resection in our institution. METHODS: From 1971 to 2002, 61 patients with 62 pulmonary hamartomas underwent surgical resection in the Division of Thoracic Surgery, Taipei Veterans General Hospital. 45 were men and 16 were women (approximately in 3:1 ratio). Their mean age was 56.9 years (range 20 to 77 years). The medical records of these patients were reviewed. The information collected using a standardized data-collection form consisted of the age at presentation, gender, initial manifestations or symptoms, history of tobacco consumption, location of hamartoma, size of the lesions, state of calcification in the hamartoma, the results of preoperative bronchoscopic examination, operative procedures and pathological report of intra-operative frozen section. All available histological slides were reviewed by the same pathologist to reconfirm the diagnosis of pulmonary hamartoma. RESULTS: Of the 61 patients with pulmonary hamartoma, 41 patients were clinically asymptomatic, 16 patients had new onset of respiratory symptoms and 4 patients had chronic cough. One patient had synchronous 2 separate lesions. The hamartomas were equally distributed in the pulmonary lobes with the mean transverse diameter of 1.8 cm measured in operation (range 0.2 to 5.0). No tumor recurrence developed after resection in our series. The mean follow-up was 8.9 years. CONCLUSIONS: The vast majority of pulmonary hamartomas represent as solitary pulmonary nodule. Definite diagnosis and the treatment can be achieved by surgical resection with minimal morbidity. No tumor recurrence was encountered in the follow-up period.

Adult↗
PubMed2004

Managements of locally advanced unresectable thymic epithelial tumors.

BACKGROUND: Surgery is the treatment of choice for thymic epithelial tumors (TET), but the resectability is about 60-70%. For those with locally advanced unresectable TETs (LAU-TETs), some controversies about the prognostic factors and treatment modalities existed. The aims of this study are to elucidate the roles of various therapeutic options and to determine the survival and prognostic factors of LAU-TETs. METHODS: Twenty-seven patients diagnosed with LAU-TETs underwent treatment in Taipei Veterans General Hospital between 1979 and 1997. Multiple treatment modalities, including surgical intervention, irradiation and chemotherapy, were advocated for these patients. The clinicopathological factors and the effects of the treatment modalities were evaluated retrospectively. RESULTS: Twenty seven cases of LAU-TETs, included 18 thymomas (12 at stage III and 6 at stage IVa) and 9 thymic carcinomas (4 at stage III and 5 at stage IVa), were enrolled for study. The overall 5-year and 10-year survival rates were 54.6% and 35.1%, respectively. Patients receiving debulking surgery and those with irradiation dosage higher than 4400 cGy had significantly better survivals (P = 0.021 and P = 0.016, respectively). CONCLUSIONS: Aggressive debulking surgery and sufficient irradiation dosage provide better survivals for patients with LAU-TETs, especially for those with thymoma.

Adult↗
PubMed2004

Effectiveness of short-term antibiotic prophylaxis on postoperative recovery course after pulmonary lobectomies.

BACKGROUND: Postoperative pneumonia is a major cause of mortality and morbidity after lung surgery. The effectiveness of prophylactic antibiotics for preventing postoperative pneumonia and the recovery course after pulmonary lobectomy is still not clarified yet. We conducted this study to evaluate the effectiveness of prophylactic antibiotics on the post-operative recovery course after pulmonary lobectomies. METHODS: Forty-five cases undergoing pulmonary lobectomies between June 2002 and January 2003 were enrolled in this prospective study. Each patient received prophylactic antibiotics of cefuroxime and sisomicin. Sputum culture upon admission and swab culture from the bronchus cut-end during operation were obtained. The clinical vital signs including heart rates, respiratory rates and core body temperature in the postoperative recovery courses were analyzed. RESULTS: Four (8.9%) patients developed pneumonia after lobectomies, and pneumonia occurred only in patients who had positive culture results from bronchial cut-end. The organisms cultured from the sputum seemed to be controlled by prophylactic antibiotics. All the organisms cultured in the bronchus cut-end differed from those in the sputum; it denoted these pathogens were inoculated during anesthesia for surgical operation. The postoperative vital signs including tachycardia and fever improved gradually in the initial 3 days. Patients with pneumonia sustained significant higher fever than the non-pneumonic patients during postoperative course. CONCLUSIONS: The short-term combination of cefuroxime and sisomicin offers sufficient effectiveness in prophylaxis of pneumonia after pulmonary surgery. Positive bronchial cut-end cultures were related to the post-lobectomy pneumonia significantly. Body temperature was the most useful presenting vital sign for early detection of the postoperative pneumonia.

Adenocarcinoma↗
PubMed2004

Surgical results of upper thoracic esophageal carcinoma.

BACKGROUND: Due to its anatomical location, carcinoma of the upper thoracic esophagus (i.e. below the thoracic inlet and above the carina) often results in early invasion of adjacent structures and precludes radical resection. The prognosis of carcinoma of the upper thoracic esophagus was considered worse than that of distal esophagus. There are few studies specifically addressing the prognostic factors in the surgical treatment for carcinoma in this location. Herein we report a retrospective study conducted to analyze the result of surgical treatment for carcinoma of the upper thoracic esophagus. METHODS: From January 1983 to December 2002, 298 cases were diagnosed with upper thoracic esophageal carcinoma in our institute. Among them, 78 cases underwent operation with curative intent and were enrolled for study. RESULTS: The tumors were stage I in 7.7%, stage II in 42.3%, stage III in 33.3% and stage IV in 12.8%. The postoperative morbidity and mortality rates were 59.0% and 6.8%, respectively. Pulmonary complication was the most common morbidity and also the leading cause of postoperative death. The overall median survival time after surgery was 13.1 months. The 1-, 3- and 5-year survival rates were 53.9%, 28.7% and 21.4%, respectively. There was an improvement in surgical result over time. The 5-year survival rate improved from 13.6% in the earlier 10-year period to 37.6% in the latter 10-year period (p = 0.0493). Univariate analysis revealed 5 positive prognostic factors: tumor length (p = 0.0012), pT status (p = 0.0274), pN status (p = 0.001), pathologic stage (p = 0.0322) and R category (p = 0.0009). Multivariate analysis identified pN status, R category and tumor length as independent prognostic indicators. In patients receiving neoadjuvant therapy, the 5-year survival rate after surgery was 23.4%, which was similar to those undergoing surgery alone (p = 0.5174). For patients with advanced tumor stages (ie. pT > 3, pN > 0, pM > 0) or with residual tumors (R1/2 resection), the 5-year survival rates were significantly different in patients with and without postoperative adjuvant chemoradiation therapy (16.0% vs. 0%, p = 0.0045). CONCLUSIONS; For carcinomas in the upper thoracic esophagus, the prognosis was dismal. Surgical resection remains the treatment of choice. In addition to lower resectability, the postoperative morbidity and mortality rates were relatively high. The length of tumor extension, status of lymph node involvement and radicality of surgery were independent prognostic factors.

Adult↗
PubMed2004

Mucoepidermoid tumors of the lung: analysis of 11 cases.

BACKGROUND: Mucoepidermoid tumors (METs) of the trachea and bronchi are rare. They derive from the minor salivary gland tissue of the proximal tracheobronchial tree, and their clinical behaviors are still controversial. Herein, we analyze 11 cases of MET to investigate its clinicopathological characteristics. METHODS: The medical records and pathological examinations of patients diagnosed with MET from May, 1995 to May, 2001 at the Division of Thoracic Surgery in Taipei Veterans General Hospital were retrospectively reviewed. RESULTS: There were 11 patients (7 male and 4 female) aged from 19 to 79 years, with a peak at the seventh and eighth decade. The mean age at diagnosis was 58.9 years, and 9 of these 11 patients were symptomatic. No surgical mortality occurred. Three patients with low-grade tumors were all young females (less than 30 years). They were all alive without evidence of disease recurrence until the date of analysis, whereas the 5-year survival of 8 patients with high-grade tumors was only 25%. Six patients with high-grade tumors received adjuvant therapy, but their prognoses remained poor. CONCLUSIONS: In the current study, METs occurred more frequently in male patients. Young female patients were preponderant to have low-grade tumors and therefore associated with better prognosis. Histological grading of the MET and the ability to achieve an anatomic resection are 2 most important factors that affect prognosis. Adjuvant therapy seems not to be effective in patients with high-grade MET.

Adult↗
PubMed2004

Gastric schwannoma.

Gastrointestinal mesenchymal tumors are a group of tumors originated from the mesenchymal stem cells of the gastrointestinal tract, consisting of gastrointestinal stromal tumors (GIST), leiomyomas or leiomyosarcomas or schwannomas. Gastric schwannoma is a very rare gastrointestinal mesenchymal tumor, which represents only 0.2% of all gastric tumors and 4% of all benign gastric neoplasms. We report a 24-year-old girl who suffered from an episode of upper gastrointestinal bleeding. The endoscopic examination showed a round submucosal tumor with a central ulceration and bleeding over the high body of the stomach. Surgical resection of the tumor was performed. The pathological examination revealed a picture of spindle cell tumor that was strongly positive for S-100 protein stain, and non-reactive for CD34, CD117, actin, HHF-35, desmin, melan-A and HMB-45, consistent with gastric schwannoma. The literature is reviewed.

Adult↗
PubMed2004

Pulmonary metastasectomy for hepatocellular carcinoma.

BACKGROUND: Hepatocellular carcinoma (HCC) is seldom resectable due to advanced status. Even though hepatectomy is feasible, a large proportional of patients may still develops extrahepatic recurrence. Pulmonary metastasis is the most common site of extrahepatic spread. Few articles have discussed the benefit of resection for lung metastasis after curative hepatectomy. We evaluated the general information and the result of lung resection for patients having lung metastasis after curative resection of HCC. METHODS: Six patients who underwent pulmonary metastasectomy for HCC at Taipei Veterans General Hospital between August 1995 and May 2004 were enrolled in the study. All of them had received the hepatectomy for primary HCC. The demographic information of patients, the site and number of extrahepatic recurrence, the method of surgical intervention and the outcome after surgery were retrospectively reviewed. RESULTS: There were 4 men and 2 women with the mean age of 47.3 years. All of them were HBV carriers. Five patients had multiple pulmonary metastases removed by wedge resection. Two patients had bilateral lung metastases upon diagnosis of extrahepatic recurrence. The mean duration of follow-up after hepatic resection was 75.0 +/- 25.1 months (32 to 104 months). The mean survival after pulmonary resection was 47.2 +/- 34.3months (1 to 94 months). Four patients are still alive and free of the disease. One patient is alive but with the disease. One patient who refused further aggressive treatment after resection of lung metastasis died of the disease 40 months after lung resection, 77 months after hepatic resection. CONCLUSIONS: Lung resection for the pulmonary metastasis of HCC can result in a favorable long-term survival when there is no other intrahepatic or extraphepatic recurrence of HCC. For patients with multiple lung metastases in different lobes or different lungs, aggressive surgical resection is recommended if complete resection can be achieved.

Adult↗
PubMed2003

Short-segment colon interposition for end-stage achalasia.

BACKGROUND: The reoperative procedures for achalasia vary. Repeat esophagomyotomy with or without antireflux procedure and esophageal resection of varying extent with reconstruction using stomach, jejunum, or colon have been reported. In this series, we have retrospectively reviewed our experience and reported the results with limited distal esophagectomy and short-colon interposition in the treatment of patients with recurrent symptoms of achalasia after prior failed esophagomyotomy. METHODS: Nine consecutive patients (5 men, 4 women; 27 to 74 years of age; mean, 52 years) with recurrent symptoms of achalasia and at least one failed prior esophagomyotomy underwent gastric cardiectomy, distal esophagectomy, and replacement with an at least 30-cm short-colon interposition through a left thoracoabdominal approach. Morbidity of the procedure and the length of hospital stay were recorded. The symptomatic evaluation, ability to have a meal, and overall patient satisfaction after the operations were assessed. RESULTS: Follow-up results were available in 8 patients. One patient had intestinal strangulation with graft failure 3 days after operation. Takedown of the graft and end-to-side esophagogastrostomy were successful. There was no mortality. Outcome assessment was completed at a median of 6 years (range, 1 to 12 years). Overall patient satisfaction was good in 6 patients, and fair and worse in 1 patient each. Most of the patients could have regular meals. Two patients had intermittent abdominal fullness after meals. Six of these 8 patients would have the operation again. CONCLUSIONS: Limited distal esophagectomy with short-colon interposition through a left thoracoabdominal approach is a safe and feasible alternative to near total esophagectomy in patients with achalasia who have prior failed esophagomyotomy. Improved alimentary function was observed in most of the patients after operation, which resulted in a better quality of life.

Adult↗
PubMed2003

Usefulness of low-dose spiral CT of the chest in regular follow-up of postoperative non-small cell lung cancer patients: Preliminary report.

OBJECTIVES: There is no consensus for the best postoperative follow-up in patients after complete resection of non-small cell lung cancer. Low-dose computed tomography of chest proves valuable in screening primary lung cancer and may be a useful tool in postoperative surveillance. METHODS: In part 1, 30 patients who underwent surgical resection of non-small cell lung cancer and were at the first (n = 14), second (n = 9), or fifth (n = 7) annual postoperative surveillance were selected chronologically and subjected to chest radiography, low-dose computed tomography, and standard-dose computed tomography to verify the diagnostic accuracy of low-dose computed tomography. In part 2, 43 patients were prospectively enrolled and followed up regularly after complete resection of non-small cell lung cancer. The follow-up protocol included physical examination, sputum cytology, serum carcinoembryonic antigen, chest radiography, and low-dose computed tomography every 3 months in the first 2 years postoperatively until tumor recurrence. RESULTS: In part 1, tumor recurrence was detected by standard-dose computed tomography in 7 cases. Low-dose computed tomography and chest radiography missed 1 and 5 of 7 cases, respectively. In part 2, tumor recurrence was found in 14 cases with 19 metastatic sites. Thirteen of the 14 (92.9%) cases were detected by scheduled visiting and 11 (78.6%) detected by low-dose computed tomography including the 7 without symptoms. Of the 19 recurrent sites found in 14 patients, 11 ones (57.9%) were detected by low-dose computed tomography. CONCLUSIONS: Low-dose computed tomography may be of considerable value in early detection of tumor recurrence in postoperative non-small cell lung cancer patients. Further large prospective studies are needed to verify this issue.

Adult↗
PubMed2003

Long-term results of pathological stage I non-small cell lung cancer: validation of using the number of totally removed lymph nodes as a staging control.

OBJECTIVE: The number of totally removed lymph nodes during thoracotomy was used alternatively to represent the quality of lymphadenectomy in patients with pathologic stage I non-small cell lung cancer (NSCLC). We combined this new parameter with other well-established prognostic factors and performed multivariate survival analyses to validate its usage as a stage control. METHODS: Three hundred and twenty-one patients who underwent complete surgical resection for stage I NSCLC were reviewed retrospectively. Aside from the number of lymph nodes removed during thoracotomy, other well-known clinical and histopathological factors were also included as possible prognostic factors for analysis. Two survival analyses, overall death and cancer-related death as study end-point, were performed, using the Kaplan-Meier method and multivariable Cox's proportional hazard regression analysis. Stepwise method of variable selection was employed to choose the 'best' Cox proportional hazard model in each survival analysis. RESULTS: The overall 5- and 10-year survival rates were 48 and 35%, and the cancer-related 5- and 10-year survival rate was 63.3 and 58.3%, respectively. The number of totally removed lymph nodes during thoracotomy, tumor size and smoking history in multivariable analysis significantly affected both overall and cancer-related survival rates. Cell type of adenocarcinoma or large cell carcinoma was associated with a worse cancer-related survival compared with other histological types. CONCLUSIONS: The quality of lymphadenectomy, represented quantitatively by the number of totally removed lymph nodes during thoracotomy, may impact on a more accurate tumor stage, and will affect the survival rate for patients with stage I NSCLC as well as other well known clinical and histopathological factors.

Adult↗
PubMed2003

Sclerosing hemangioma of the lung: an analysis of 44 cases.

BACKGROUND: Sclerosing hemangioma is a rare benign lung tumor. Preoperative diagnosis of this tumor is difficult, and sometimes even intraoperative frozen sections cannot differentiate it from malignant tumors. Herein, we present our experiences in investigating its characteristics. METHODS: The medical records and pathological examinations of patients diagnosed with sclerosing hemangioma from 1982 to 2001 at the Division of Thoracic Surgery in Taipei-VGH were retrospectively reviewed. RESULTS: The incidence of sclerosing hemangioma in benign lung tumors resected during that period was 32.8%. There were 44 patients (7 male and 37 female) aged from 16 to 72 years, with a peak at fifth decade, and 72.7% of them were asymptomatic. Accurate preoperative diagnosis by chest CT could be achieved in only 20% (4/20) of patients, and malignancy could not be ruled out in 40% (8/20) of tumors. Histologically, this tumor exhibits four major patterns: solid, sclerotic, papillary and hemorrhagic. Five patients in this series had predominantly one pattern. At least two patterns existed in the remaining 39 patients, including eight patients who had tumors with all four patterns. There was no operative mortality or tumor recurrence despite that different operative methods were undertaken. CONCLUSIONS: Although rare, sclerosing hemangioma still accounts for the second common benign lung tumor in the current series. Chest CT and bronchoscopic examinations could not make accurate diagnosis preoperatively, and thoracotomy is usually indicated for definite diagnosis and treatment. Limited resection is warranted in view of uncommon tumor recurrence. In addition, multiple nodular lesions could not exclude the possibility of sclerosing hemangioma.

Adolescent↗