PubMed Health⌕ Search

Biomedical subjects

T Naruke

Publications and source records attributed to T Naruke.

At least 91 records · Page 5Linked to original sources

The importance of surgery to non-small cell carcinoma of lung with mediastinal lymph node metastasis.

In the past 25 years, 1,654 patients with non-small cell cancer underwent resection at National Cancer Center Hospital, Tokyo. A comparative study has been made of 5-year survival of patients who had pulmonary resection with and without mediastinal lymph node dissection. There were 426 patients (25.8% of the total) with N2 M0 disease. Of these, 345 underwent pulmonary resection with mediastinal lymph node dissection. The 5-year survival in this group was 15.9% (T1 N2 M0, 30.0%; T2 N2 M0, 14.5%; and T3 N2 M0, 12.9%). In the remaining 81 patients, who did not have mediastinal lymph node dissection, 5-year survival was 6.7%. Of the 426 patients with N2 M0 disease, 242 were select patients who underwent a curative operation with an overall 5-year survival of 19.2%. Sixty-six of them had squamous cell carcinoma and a 5-year survival of 30.8%; 153 had adenocarcinoma and a survival of 16.0%; 14 had large cell carcinoma and a survival of 12.8%; and 9 had adenosquamous cell carcinoma, and none survived 5 years. To improve the end results, it is important to perform as many curative operations with mediastinal lymph node dissection as possible. Histological cell type and tumor status must be taken into consideration.

Adult↗

Close correlation between restriction fragment length polymorphism of the L-MYC gene and metastasis of human lung cancer to the lymph nodes and other organs.

Restriction length fragment polymorphism of the L-MYC gene was examined in DNAs from lung cancer tissues and normal tissues of 51 Japanese patients with lung cancer. In individual patients, no difference was seen between the restriction length fragments of the two alleles of L-MYC [6-kilobase (kb) and 10-kb fragments in EcoRI digests] in lung cancer tissues and normal tissues. But a striking correlation was found between the restriction length fragment polymorphism pattern of L-MYC and the extent of metastasis, particularly to the lymph nodes at the time of surgery: Patients with only the L band (10 kb) had few lymph node metastatic lesions, whereas patients with either the S band (6 kb) or the S and L bands almost always had lymph node metastatic lesion. A similar correlation was found between the presence of the S band and metastases to other organs. This correlation was particularly marked in cases of adenocarcinoma. These results indicate a clear genetic influence on metastases and a consequent poor prognosis for certain patients of lung cancer; L-MYC restriction length fragment polymorphism is thus shown to be a useful marker for predicting the metastatic potential of human lung cancer.

Adult↗

[The role of surgery in the management of patients with small cell lung cancer].

Fifty-seven patients with small cell lung cancer were operated on at the National Cancer Center Hospital, Tokyo, between 1962 and 1986. Twenty-seven patients had oat cell type and thirty had intermediate cell type. The five-year survival rate of patients who were treated before 1979 (the first term) was only 11%, whereas the rate for patients treated after 1980 (the latter term) was 53%. No patient with oat cell type small cell lung cancer, treated in the first term, survived for three years after the operation. However, four patients with oat cell type lung cancer, treated in the latter term, survived for five years or more after surgery. The five-year survival rate of the patients with oat cell type lung cancer, who were treated after 1980, was 64%. The five-year survival rates for patients with intermediate cell type were 20% in the first term and 41% in the latter term. We have introduced CT and echography for the preoperative evaluation of patients and also perioperative intensive chemotherapy. Improvement of preoperative evaluation and intensive chemotherapy have yielded good results.

Adult↗

Prognosis and survival in resected lung carcinoma based on the new international staging system.

A new TNM staging system was proposed and the previous system has been revised recently. To evaluate the new TNM staging system for lung cancer, we analyzed records of 1737 patients who underwent pulmonary resection at the National Cancer Center Hospital, Tokyo. With regard to clinical stages, three patients had occult carcinoma; 821 patients had stage I disease; 248 patients, stage II; 465 patients, stage IIIA; 82 patients, stage IIIB; and 118 patients, stage IV. The 5-year survival rates for the respective stages were 50.1% for stage I, 31.2% for stage II, 20.2% for stage IIIA, 5.1% for stage IIIB, and 7.9% for stage IV. In terms of postoperative stages, four patients were classified in stage 0, 536 in stage I, 221 in stage II, 559 in stage IIIA, 159 in stage IIIB, and 258 in stage IV. The 5-year survival rates were as follows: stage I, 65.0%; stage II, 42.9%; stage IIIA, 22.2%; stage IIIB, 5.6%; and stage IV, 7.5%. In both the clinical stage and the postoperative stage, there were significant prognostic differences between stage I and stage II, stage II and stage IIIA, and stage IIIA and stage IIIB, but there was no significant difference in 5-year survival rates between stage IIIB and stage IV.

Adenocarcinoma↗

[Prognostic factors in lung cancer].

For 1,886 cases, out of total 1,982 lung cancer cases, which had been admitted to and undergone resection at National Cancer Center Hospital during the period between May, 1962 and December, 1987, excluding cases of multiple primaries and low grade malignancies, prognostic factors have been reviewed and examined. Prognosis does not depend on only one factor, but many complicated factors, however, 5 year survival rate was very good for stage I and stage II cases, for which curative resection could have been performed. There have been difference histologically in prognoses between cases of squamous cell carcinoma, adenocarcinoma, large cell carcinoma and small cell carcinoma, but prognoses of stage I and II cases were good in the group, for which curative resection was possible. Prognostic factors of lung cancer cases can be epitomized by staging of the disease and histological type and it is evident from the review on these cases that early detection, early treatment and indication of curative resection should be pursued as much as possible.

Adult↗

[Clinical and basic studies on the treatment of cancer metastasis].

Lung resection for metastatic lung tumors from cancers of other organs has shown a significant curative success rate among affected patients. Hepatectomy also shows promise as a good curative approach for patients with liver metastasis from cancers of various abdominal organs. Descriptive data and their analysis of metastases by Bross and Viadana indicate a cascade spreading process. The fact that key-sites such as the lung and/or liver which, for some time, have proved a stumbling block to the generalization of cancers by metastases, has led to the success of therapy for metastasis in the clinical field. Chemotherapy as an adjuvant therapy to surgery for key-site metastatic foci is anticipated to raise future cure rates.

Humans↗

Papillary adenoma of type 2 pneumocytes.

A case of papillary adenoma of type 2 pneumocytes is reported. A 57-year-old man had an unusual coin lesion in the periphery of the right lung without any symptoms. When detected in a mass survey examination, it was approximately 1.5 cm in diameter, well circumscribed, and located in S4, involving the sixth-order bronchus of B4. Light-microscopic examination revealed cuboidal tumor cells arranged in a papillary pattern. Ultrastructurally, the cells had characteristic osmiophilic lamellar bodies. By immunoperoxidase staining, the tumor cells were shown to have intracytoplasmic surfactant apoproteins. The postoperative course was uneventful, and there is no evidence of disease 8 years later.

Cystadenoma↗

A clinico-pathological study of surgical treatment for small cell carcinoma of the lung.

Thirty-seven patients with histologically confirmed small cell carcinoma (SCLC), who underwent surgical resection at the National Cancer Center Hospital between 1963 and 1983, were reviewed. They were divided into two groups, 25 patients who were operated on between 1963 to 1979 and 12 who were operated on between 1980 and 1983. When these two groups were compared, a significant difference in 5-year survival was found (8% vs 50%). An accumulation of various factors including adjuvant chemotherapy was considered to contribute to the improvement in survival. After carefully analyzing these factors, we have come to the conclusion that adjuvant chemotherapy was the most important factor among them. An additional six patients with SCLC, who were operated on in 1984 and 1985, were also studied. They were either those who were given an adequate dose of combination chemotherapy before surgical resection or those whose local carcinoma which recurred after complete response was achieved by chemotherapy and/or chest radiation was surgically removed. In two cases, a tumor-like mass which was clearly visible on X-ray film and in the surgeon's hand at the time of thoracotomy revealed a histopathological "cure." In another two cases, tissue diagnosis of SCLC which was obtained without thoracotomy before chemotherapy and/or radiation was started was reported as NSCLC after the resected specimen was histo-pathologically examined. In both of them, the cancer tissue was made up of NSCLC of small cell type. A discrepancy between clinical TNM after treatment and pathological TNM was noted in two cases. Microinvasion and micrometastases, which were the reasons for the discrepancy, are considered to be a core of eventual recurrence following induction of complete response.

Actuarial Analysis↗

[Postoperative prophylactic irradiation of lung cancer].

Eighty-three patients with resected lung cancer were studied to determine whether postoperative prophylactic irradiation improves survival. All patients had mediastinal lymph node metastases and underwent relative curative surgery. Thirty patients received postoperative irradiation, and another 52 were followed without further treatment. The 5-year survival rate was 19.2% in the surgery alone group and 20% in the postoperative irradiation group. No increase in survival time was noticed in the postoperative irradiation group. The 5-year survival rate was not influenced by histologic types, presence or absence of subcarinal lymph node metastases and right or left thoracotomy in either group.

Adenocarcinoma↗