[TREATMENT OF RESPIRATORY RESUSCITATION IN THORACIC SURGERY].
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Humans↗
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Results for “RESPIRATORY TRACT NEOPLASMS”
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Trends of cancer mortality in Europe, 1955-1989: II, Respiratory tract, bone, connective and soft tissue sarcomas, and skin.
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Adolescent↗
Digestive system cancer among persons subjected to occupational inhalation of asbestos particles: a literature review with emphasis on dose response.
Human data show a dose-response relationship between industrial exposure to asbestos and later development of cancer of the bronchus and lung and of cancer of the digestive tract. The data do not provide much evidence for a threshold or for the existence of a clearly "safe" level of exposure. Good dose-response data, with quantitative estimates of dose are uncommon; however, in all the literature reviewed only one paper did not support the conclusion that increased exposure to inhaled asbestos particles leads to increased digestive system cancer.
Air Pollutants, Occupational↗
Chemoprevention strategies for lung and upper aerodigestive tract cancer.
The field cancerization hypothesis suggests that carcinogen exposure affects the entire epithelial lining of the lungs and upper aerodigestive tract. The concept that common exposures place the entire epithelium at risk for the development of invasive cancer is supported both by the occurrence of premalignant lesions such as leukoplakia and squamous metaplasia, and by the development of multiple primary tumors within the field. Chemoprevention trials in lung and upper aerodigestive tract cancer have included studies to reverse premalignant lesions and to prevent second primary tumors. Promising results have been reported in both settings using the retinoid 13-cis-retinoid acid. Several clinical trials are in progress which attempt both to reduce cancer incidence and to determine the mechanisms and biological markers of successful chemoprevention.
Anticarcinogenic Agents↗
Premalignant changes in normal appearing epithelium in patients with squamous cell carcinoma of the upper aerodigestive tract.
Biopsy specimens of "normal" mucous membrane of patients susceptible to the effects of the carcinogens of tobacco revealed morphologic abnormalities on electron microscopic examination that were consistent with the concept that carcinogenesis is a multistep process of sequential neoplastic development extending over a long period of time. Such changes in the upper aerodigestive tract are probably tobacco induced and may be reversible if tobacco exposure is eliminated. Use of the electron microscope can provide the clinician with an accurate assay of the severity of mucosal alterations induced by tobacco. The ability to detect such morphologic abnormalities should provide another deterrant to smoking and a useful tool in the further study of these phenomena.
Adult↗
The influence of alcohol consumption on worldwide trends in mortality from upper aerodigestive tract cancers in men.
STUDY OBJECTIVES: To assess current trends in male mortality from cancers of the oral cavity/pharynx, oesophagus, and larynx (upper aerodigestive tract cancers), and relate these to past national consumption of alcohol and smoking of cigarettes. To assess the impact of current trends in alcohol consumption and tobacco smoking on likely future rates of these cancers. DESIGN: Mortality data for cancers of the oral cavity/pharynx, oesophagus, and larynx were obtained for the years 1955-89 in 25 countries located in North America, Australasia, Europe, and Japan. Information on past and current alcohol consumption was also obtained for these countries, while current national lung cancer rates were used as a proxy measure of past smoking levels. SETTING: The World Health Organization mortality database. MAIN RESULTS: National death rates from cancers of the oral cavity/pharynx, oesophagus, and larynx (considered together) are currently increasing among men and are most strongly associated with the level of per capita consumption of alcohol 20 years previously. They were less strongly associated with the level of alcohol consumption 10 years ago, and only very weakly associated with the current level of lung cancer mortality (a marker of past smoking habits). Regression analysis showed that the national rate of upper aerodigestive tract cancer could be estimated using information on past alcohol consumption and an interaction term between alcohol consumption and current lung cancer rates. Assuming stability in rates of lung cancer, the sizeable increase in alcohol consumption from 5 to 10 litres per capita each year that occurred in some countries during the 1960s and 70s means that increases of around 5 per 100,000 in the death rate from these cancers can be expected in these countries in the next decades. CONCLUSIONS: Previous alcohol consumption in a country is a strong predictor of deaths from cancers of the upper aerodigestive tract in men, and current increases in death rates can probably be related to increases in consumption which took place during the 1960s and 70s. Combined with a reduction in tobacco smoking, which is already taking place in some countries, reversing the trend of increases in consumption of alcohol has the potential for a sizeable impact on the burden of these cancers.
Alcohol Drinking↗
Field cancerization in the aerodigestive tract--its etiology, manifestation, and significance.
Field cancerization of the mucous membranes of the aerodigestive tract frequently develops in response to tobacco and alcohol usage; it is characterized by a variety of premalignant and frankly malignant epithelial changes that may lead to the development of multiple primary cancers of the aerodigestive tract. Field cancerization can be demonstrated by supravital staining with toluidine blue or by electron microscopic study of random biopsies taken from apparently normal mucosa. Field cancerization should be taken into account in treatment planning of a patient with cancer so that all treatment options, including the use of radiation therapy, be kept open for as long as possible in the event that the patient may develop multiple primary tumors.
Alcoholism↗
A cohort study on second malignancies in gastrectomized patients with gastric cancer. I. Second malignancies other than cancer of the gastric remnant.
In a retrospective cohort study, a total of 235 (2.32 per cent) second malignancies were clinically observed in 10,138 patients during the average 8.8-year follow-up period. The patients had undergone gastrectomy for gastric cancer during 1960-1975, in seven different institutions. This observed number was smaller than the expected one of 340.9 (p less than 0.01). Among the 235, cancers of the gastrointestinal tract (111) were the most frequent and followed by respiratory (54) and urogenital (25) cancers. Twelve cases of malignant lymphoma and five of leukemia were also noted. With regard to adjuvant chemotherapeutic agents such as mitomycin-C (MMC), 5-fluorouracil (5FU) or its derivative Tegafur, and cyclophosphamide (EDX), no significant differences in the rate of second malignancies were obtained between the chemotherapy and non-chemotherapy groups. The occurrence rate of second malignancies tended to be higher in the Billroth II group than in the Billroth I, the significance of which is yet to be determined.
Adult↗
Molecular evidence of field cancerization in a patient with 7 tumors of the aerodigestive tract.
Exposure of the mucosa of the upper aerodigestive tract to carcinogens can induce genetic changes resulting in various independent clones of neoplastic growth, a concept defined as "field cancerization." The risk of developing multiple tumors in this compartment of the body is well established. We studied 6 distinct tumors of the upper aerodigestive tract of a single patient for loss of heterozygosity (LOH), microsatellite instability (MSI), p53 mutations, and K-ras codon 12 point mutations. We detected a unique pattern of LOH and p53 mutations in all 6 tumors. No tumor showed a K-ras mutation or MSI. The results support the mechanism of "field cancerization" and illustrate the potential power of molecular techniques to elucidate pathogenesis.
Aged↗
[Radiologic procedures for directing laser therapy in obstructions of the upper respiratory tract].
172 patients affected by obstructive diseases (malignant or benign) of the trachea and/or main bronchi and admitted to the hospital for a laser treatment of the lesions, underwent radiological investigations. All patients underwent one or more of the following examinations: routine chest radiography, tomography of the trachea or bronchi, CT of the lungs and mediastinum with axial scans (eventually completed by frontal and sagittal reconstructions). The radiological approach was extremely useful for selecting cases which had to be treated by laser therapy; it permitted to get information about the lumen and the wall of the airways, and about their relationship with all surrounding structures. Moreover, the cases examined permitted the bronchologist to assert the value of the x-ray examinations, either for a correct evaluation of the respiratory situation immediately following the treatment, or for a long term follow-up on all those patients who were affected by recurrent lesions.
Adolescent↗
Incidence of hypercalcemia in patients with malignancy referred to a comprehensive cancer center.
BACKGROUND: Hypercalcemia is a serious and not infrequent complication of malignant diseases; precise information about the incidence of hypercalcemia is not readily available. The study was designed to determine the incidence of hypercalcemia in patients with cancer. METHODS: Retrospective analysis was done of laboratory data from 7667 patients registered at M.D. Anderson Cancer Center for the first time during 1989 for whom serum calcium levels were determined during the first 2 months after registration. RESULTS: Severe hypercalcemia (serum calcium level of more than 12.0 mg/100 ml) was present in 40 patients (0.52%); it occurred most often in patients with renal cell cancer (1.42%) and non-small cell lung cancer (1.03%). Less frequent diagnoses were multiple myeloma (0.79%), leukemia (0.63%), non-Hodgkin lymphoma (0.26%), and cancer of the gastrointestinal tract (0.20%). Moderate hypercalcemia (calcium levels of 10.8-12.0 mg/100 ml) was present in 48 patients (0.63%); it occurred most often in patients with renal cell cancer (3.30%) and multiple myeloma (2.38%). Less frequent diagnoses were non-small cell lung cancer (0.89%), non-Hodgkin lymphoma (0.79%), leukemia (0.63%), and cancer of the gastrointestinal tract (0.51%). The presence of hypercalcemia was associated with increased frequency of distant metastases, bone metastases, and increased mortality consistent with other studies of the prognostic effect of this complication. CONCLUSIONS: Hypercalcemia may appear as a frequent complication in patients with cancer at some time during the course of their disease, but its incidence is relatively low.
Adolescent↗
[Prospects and indications for the prevention of respiratory tract tumors].
Respiratory cancers are suitable targets for primary prevention, since their causes are largely known and can be eliminated. Reasonable short-term objectives include the reduction of tobacco use (and alcohol abuse), the control of exposure to carcinogens in the workplace, as well as the reduction of air pollution in the general environment. The International Agency for Research on Cancer has estimated that in countries like Italy the elimination of cigarette smoking could reduce larynx cancer by 85% (if accompanied by a decrease in alcohol consumption), and lung cancer by 80% in males and 60% in females. An almost complete elimination of exposure to carcinogens in the workplace could potentially reduce lung cancer by 10%, whereas eliminating exposure to asbestos could certainly reduce pleural cancer by more than 50%. The proportion of lung cancer attributable to pollution in the general environment is unclear. Preventive measures require legislative support. Since October 1991, stores throughout Italy, in compliance with a new law, started carrying the first cigarette packages that included warnings against the hazards of smoking. Not since Law 584 of 1975, which forbids smoking in public places, has such an important legislative measure been passed. As a consequence of Law 584, smoking in many public places (e.g. movie theaters and, more recently, domestic flights) is today unthinkable, and these restrictions have been widely integrated into the Italian way of life. In developed countries, there is no doubt that the reduction of cancer due to the elimination of tobacco would be greater than that due to eliminating exposure to risk factors in the workplace.(ABSTRACT TRUNCATED AT 250 WORDS)
Alcohol Drinking↗
[The origin of malignant tumors of the upper-airways, the digestion tract and the ear. Organ-resistance and organ-disposition (organotrophy) by the origin of malignant primary tumors (author's transl)].
Carcinomas of the nose, the trachea, the mouth, the esophagus and the middle ear are rarely observed. Those of the larynx and of the bronchial system are more often found. The reason for this cannot be related to differing contacts with carcinogenic substances. The differences in frequence ar dependent on the varied resistance and disposition of the organs involved (Organotrophy, Histotropy). This is comparable to the incidence of epithelial and mesenchymal tumors. The tissues do not only vary in their structure. The differences are found in 1. the velocity of cell regeneration, 2. the ability to repair nucleic acids, 3. the concentration of tissue specific proteins (chalones) inhibiting cell proliferation and tumor growth, 4. the increase of metabolism before and during cancerization, 5. the unspecific mesenchymal reaction, 6. the immunologic response against tumor cells, 7. the reactions on radiotherapy, 8. the affinity of tissue to chemical carcinogenic substances.
Cell Transformation, Neoplastic↗
Multiple occurrence of carcinoma in the upper aerodigestive tract associated with esophageal cancer: reference to smoking, drinking and family history.
Smoking and drinking habits as well as family history were examined in 143 men with esophageal cancer, including 30 who had associated second cancers of the upper aerodigestive tract (UADT) and 113 who did not. The risk of second cancers of UADT associated with the main lesions of the esophagus was evaluated, using odds ratios (ORs). As a result, the ORs of second cancers for current smoking and drinking were 5.3 and 7.6 respectively. The ORs significantly increased to 12.7 and 14.7 in heavy smokers and in heavy drinkers respectively. Furthermore, the risk of second cancer also significantly increased (8-fold) in patients who had close relatives with UADT cancer, compared to those without family history of any cancer. However, there were no differences in smoking or drinking habits regardless of family history. Our data thus suggest that a family history of UADT cancer as well as heavy smoking and drinking are clearly associated with multiple occurrence of UADT cancer. Therefore, careful and frequent examination for appearance of any second lesions are required for patients in these high-risk groups.
Aged↗
Multiple synchronous and metachronous cancers of the upper aerodigestive tract: a nine-year study.
This retrospective study was based on 9,089 patients and includes 855 cases (9.4%) of multiple primary cancers treated between 1975 and 1983. Three hundred fifty (42.1%) of these multiple cancers were considered synchronous, while 480 (57.9%) were classified as metachronous. Fifty percent of the metachronous cancers occurred within 31 months after the first primary; the mean time between the first primary and the second primary was 45 months. Approximately 22% of second primaries were found more than 5 years after the initial tumor. Five-year survival rates were higher in metachronous cancers (55%) than in synchronous cancers (18%). Survival rates varied according to the treatment. In 49.4% of synchronous tumors the treatment had to be modified because of the presence of two cancers. In these patients, 5-year survival rates were as low as 8%. In synchronous cancers that required no modification of the treatment, the prognosis was better and the survival rate was 28%. The preferential anatomical location of the second synchronous and metachronous cancers is discussed for first primaries situated in the oral cavity (103 cases), the oropharynx (120 cases), the hypopharynx (92 cases), and the larynx (87 cases). Second primaries in the esophagus were mostly synchronous cancers while, in the lung, second cancers were more frequently metachronous tumors.
Age Factors↗
Impact of re-resection for inadequate margins on the prognosis of upper aerodigestive tract cancer treated by laser microsurgery.
OBJECTIVES: Positive or uncertain surgical margins left untreated have a distinct prognostic relevance in squamous cell carcinoma of the upper aerodigestive tract. An advantage of transoral laser microsurgery is that it can be easily repeated if inadequate resection margins are found postoperatively. The present study investigates the impact of laser surgical reresection on the outcome of patients. STUDY DESIGN: The authors conducted a retrospective unicenter study. METHODS: A review of 1,467 patients with squamous cell carcinoma of the upper aerodigestive tract who were initially treated by transoral laser microsurgery with curative intent between August 1986 and December 2002 was conducted. Locoregional control as well as TNM adjusted and overall survival were analyzed using the Kaplan-Meier method. RESULTS: Three hundred eighty-six patients have required reresection to obtain clear surgical margins, in 70 of whom residual carcinoma has been detected in revision specimens. Patients without need for revision and those in whom revision specimens were found tumor-free had an almost identical locoregional control (P = .4611). In patients with positive revision specimens, however, locoregional control was significantly worsened (P = .0058). Neither the need for reresection nor the detection of further tumor tissue in revision specimens affected TNM adjusted or overall survival. CONCLUSIONS: Survival of patients was similar whether clear resection margins were reached within the first surgical step or with revision surgery. However, patients in whom reresection specimens contained residual carcinoma had an increased risk of locoregional failure and should undergo a further reresection or at least a very close follow up.
Adolescent↗
Descriptive epidemiology of cancers of the upper respiratory tract in Los Angeles.
The descriptive epidemiology of cancer of three upper respiratory tract sites (lip; mouth and pharynx, excluding nasopharynx; and nose, sinus and nasopharynx) was explored using data from 1972-1976 from the population-based cancer registry covering Los Angeles County, California. In addition, the proportion of Los Angeles cases at each site which are explained by tobacco use was estimated using attributable risks calculated from previously published case-control studies. Causes of nontobacco-related cases are considered. Lip cancer was found to be a disease predominantly of white males with a male/female ratio of 9.8 for the lower lip and of 1.0 for the upper lip. Tobacco use is responsible for 60% of male lip cancers, and incidence rates of lip cancer after subtraction of the proportion of the incidence due to tobacco use were more than three times greater in men than in women. A hypothesis is proposed that an important etiologic factor is exposure to sun, wind and cold which results in chapping; this exposure is most intense for the lower lip; and the use of lip coverings in women protects their lips both from the sun and from chapping. Cigarette smoking was responsible for 51% of mouth and pharynx cancer in men and women in Los Angeles County, and after subtraction of the proportion of the incidence due to smoking, rates in men and women were similar. Factors such as poor dentition and nutritional deficiencies may help explain demographic characteristics such as the higher rates of mouth and pharynx cancer among men and women in the lower social classes and the secular decline in incidence rates. Cancers of the nose, sinus and nasopharynx were found to occur among workers in a wide range of occupations and industries which involved inhalation of dust, fumes and vapors. High incidence rates of nasopharynx cancer were observed among Chinese in Los Angeles and high rates of sinus cancer among Spanish-surnamed residents. Cancers at these sites appear to be related to the action of carcinogens on tissue chronically irritated by repeated upper respiratory infections or allergic responses. In addition racial differences in the physical structure of the nasal passage may influence where inhaled particles are deposited.
California↗
Marijuana use and the risk of lung and upper aerodigestive tract cancers: results of a population-based case-control study.
BACKGROUND: Despite several lines of evidence suggesting the biological plausibility of marijuana being carcinogenic, epidemiologic findings are inconsistent. We conducted a population-based case-control study of the association between marijuana use and the risk of lung and upper aerodigestive tract cancers in Los Angeles. METHODS: Our study included 1,212 incident cancer cases and 1,040 cancer-free controls matched to cases on age, gender, and neighborhood. Subjects were interviewed with a standardized questionnaire. The cumulative use of marijuana was expressed in joint-years, where 1 joint-year is equivalent to smoking one joint per day for 1 year. RESULTS: Although using marijuana for > or =30 joint-years was positively associated in the crude analyses with each cancer type (except pharyngeal cancer), no positive associations were observed when adjusting for several confounders including cigarette smoking. The adjusted odds ratio estimate (and 95% confidence limits) for > or =60 versus 0 joint-years was 1.1 (0.56, 2.1) for oral cancer, 0.84 (0.28, 2.5) for laryngeal cancer, and 0.62 (0.32, 1.2) for lung cancer; the adjusted odds ratio estimate for > or =30 versus 0 joint-years was 0.57 (0.20, 1.6) for pharyngeal cancer, and 0.53 (0.22, 1.3) for esophageal cancer. No association was consistently monotonic across exposure categories, and restriction to subjects who never smoked cigarettes yielded similar findings. CONCLUSIONS: Our results may have been affected by selection bias or error in measuring lifetime exposure and confounder histories; but they suggest that the association of these cancers with marijuana, even long-term or heavy use, is not strong and may be below practically detectable limits.
Adenocarcinoma↗