• Journal of Chest Surgery
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• v.54 no.4
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• pp.258-262
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• 2021

Mediastinal lymph node dissection is an important part of lung cancer surgery that provides accurate nodal staging and may improve survival outcomes. The minimally invasive approach, such as video-assisted thoracic surgery (VATS) lobectomy for patients with non-small cell lung cancer, has become a standard operation worldwide. VATS mediastinal lymph node dissection should be thorough and accurate to ensure the completeness of lung cancer surgery. Herein, the author describes techniques for VATS mediastinal lymph node dissection.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4639-4643
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• 2012

The burden of lung cancer in terms of mortality is the highest among all types of cancers globally. The present study aimed to evaluate lifestyle related habits, clinico-pathological profile and treatment details of lung cancer patients who were registered at Malabar Cancer Centre (MCC), Kerala, during the calendar year 2010. A retrospective evaluation was made from medical records to gather data from 281 registered lung cancer cases in 241 males and 40 females, with a male to female ratio of 6.03: 1. Approximately 89% of the cases were above 50 years of age. Among males about 91% of the cases were smokers and 62% of them had a chronic smoking habit. Adenocarcinomas, squamous cell carcinomas, non-small cell carcinomas and small cell cancers accounted for 10.7, 13.9, 17.0 and 5.7% respectively. Out of 281 cases around 67% were diagnosed with distant metastasis and the remainder had regional lymph node involvement. However, no statistically significant difference was observed for secondary site of tumor according to gender. As majority of the cases reported at MCC were in an advanced stage of the disease, histology of the secondary site from supraclavicular lymph nodes or liver was taken for diagnosis. Initiation of population based screening for early detection of cancer, and primary and secondary prevention strategies for reducing the prevalence of tobacco consumption are high priorities to reduce the lung cancer burden in Kerala.

• Journal of Chest Surgery
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• v.47 no.2
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• pp.77-93
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• 2014

Lung cancer is one of the most common malignant tumors, and it has the highest death rate. Oncothermia is a feasible and successful treatment for lung cancer. Results show a remarkable survival benefit for patients, with a good quality of life. The treatment has no, or in some cases mild, side-effects and could decrease the adverse effects of the complementary treatment. Applying oncothermia together with other treatment methods could increase the effects and result in better performance. A comparison of studies demonstrates a good correspondence in the data, which strengthens the reliability of the studies, and clearly shows the feasibility of the application of oncothermia to treating all kinds of pulmonary malignancies including non-small-cell and small-cell primary tumors, and all of the metastatic diseases of the pulmonary system.

• Tuberculosis and Respiratory Diseases
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• v.40 no.6
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• pp.646-652
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• 1993

Background: Lung cancer and chronic obstructive lung disease often coexist in the same person who are elderly and cigarette smoking. There are several reports that the presence of chronic obstructive pulmonary disease constitutes an independent risk factor for the development of lung cancer. Moreover, the association between mucus hypersecrtion and lung cacer has been reported. Method: In 72 cases with primary lung cancer which were confirmed histopathologically at Chonbuk University Hospital from August 1986 to July 1991, We evaluated the relationship between spirometry and lung cancer characteristics. Results: Six cases(8.3%) showed normal lung function, 16(22.2%) cases showed pure restrictive lung disease, 46(63.9%) cases showed moderated obstructive lung disease and 4(5.6%) cases showed severe obstructive lung disease. $FEV_1$(%) was lower in central type than in peripheral type, lower in advanced non-small cell cancer and lower in subjects with phlegm. $FEV_1$/FVC(%) was higher in small cell cancer than in squamous cell cancer and higher in patients without previous pulmonary disease than with previous pulmonary disease. But there was no statistically significant difference in lung function according to histologic types and smoking history. Lung cancers with $FEV_1$/FVC less than 75% consisted of 35 cases of squamous cell cancer, 7 of small cell cancer(14%), 5 of adenocarcinoma(10%), 2 of large-cell carcinoma and 1 of unclassified carcinoma. Squamous cell carcinoma occured more in patients with $FEV_1$/FVC<75% than with $FEV_1$/FVC$\geq$75%(p<0.05). Conclusion: It was suggest that low $FEV_1$/FVC, as reflection of obstructive lung disease, may be at greater risk for squamous cell carcinoma in cigarette smoker.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.319-323
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• 2012

Objective: To explore the feasibility of shrinking field technique after 40 Gy radiation through 18F-FDG PET/CT during treatment for patients with stage III non-small cell lung cancer (NSCLC). Methods: In 66 consecutive patients with local-advanced NSCLC, 18F-FDG PET/CT scanning was performed prior to treatment and repeated after 40 Gy. Conventionally fractionated IMRT or CRT plans to a median total dose of 66Gy (range, 60-78Gy) were generated. The target volumes were delineated in composite images of CT and PET. Plan 1 was designed for 40 Gy to the initial planning target volume (PTV) with a subsequent 20-28 Gy-boost to the shrunken PTV. Plan 2 was delivering the same dose to the initial PTV without shrinking field. Accumulated doses of normal tissues were calculated using deformable image registration during the treatment course. Results: The median GTV and PTV reduction were 35% and 30% after 40 Gy treatment. Target volume reduction was correlated with chemotherapy and sex. In plan 2, delivering the same dose to the initial PTV could have only been achieved in 10 (15.2%) patients. Significant differences (p<0.05) were observed regarding doses to the lung, spinal cord, esophagus and heart. Conclusions: Radiotherapy adaptive to tumor shrinkage determined by repeated 18F-FDG PET/CT after 40 Gy during treatment course might be feasible to spare more normal tissues, and has the potential to allow dose escalation and increased local control.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2875-2878
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• 2014

Background: Lung cancer is one of the commonest and most lethal cancers throughout the world. The majority of the patients present at advance stage and are not suitable for curative intent treatment. Even among patients with localized disease, there has been underutilization of curative treatment modalities. The aim of this study was to analyze the radical treatment utilization rates in patients with non small cell lung cancer (NSCLC) treated at our centre. Materials and Methods: We analyzed case records of 104 patients with a pathologically confirmed diagnosis of NSCLC having stage 1-3B disease who were treated at our centre over last 3 years, to assess the utilization of curative treatment modalities i.e. surgery or radical radiotherapy. Results: The median age of this cohort was 58 years. Out of 104 patients only 33 (31.7%) received curative intent treatment, 14 undergoing curative resection and 19 receiving radical doses of radiotherapy. The baseline characteristics of both the groups (with or without radical treatment) were not different. Major factors associated with underutilization with curative treatment were progressive disease or loss of follow up after chemotherapy and inappropriate use of TKI and/or palliative radiotherapy in patients with stage 1-3B disease. Patients who did not receive radical treatment had inferior PFS and OS than those who received radical treatment. Conclusions: In our practice we observed gross underutilization of curative intent treatment modalities in patients with NSCLCs which is associated with inferior survival.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.12
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• pp.4865-4869
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• 2014

Objective: This study evaluated the expression level of high mobility group box-B1 (HMGB-1) and matrix metalloproteinase-9 (MMP-9) in non-small cell lung cancer (NSCLC) inmorder to reveal any relation with development and prognosis. Methods: NSCLC and normal tissues were selected from 30 patients at age of 30-73, and used for RT-PCR and Western blot analyses of HMGB-1. A total of 100 paraffin embedded NSCLC tissues were also isolated from patients through surgical resection, and used for detection of HMGB-1 by immunohistochemistry. In addition, 50 samples were also applied for MMP-9 detection, and 30 normal tissues were considered as controls. Correlation analysis of HMGB-1 and MMP-9 was carried out by Pearsons correlation coefficient. Results: The average expression level of HMGB-1 in NSCLC patients was significantly higher than in normal lung tissues. In addition, patients in III-IV period exhibit significantly higher positive rate of HMGB-1 when compared with I-II period cases. Furthermore, a positive correlation with HMGB-1 was found in the expression of MPP-9. Conclusion: HMGB-1 was highly expressed in NSCLC, which may become a prognostic and predictive marker for NSCLC. Besides, MPP-9 was positively correlated with HMGB-1.

• Journal of Korean Traditional Oncology
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• v.14 no.1
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• pp.45-52
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• 2009

Lung cancer is the most common primary tumor of brain metastasis. Metastasis to the brain is a frequent complication of non-small cell lung cancer (NSCLC) occuring in 12 ~ 18% of patient. The incidence of brain metastasis is rising because of longer survival of cancer patients as a result of the increase in early diagnosis of primary tumors and aggressive management, and improvements in imaging quality and accessibility such as widespread use of MRI. The most common symptoms are gradual onset of headache, focal weakness, and mental changes. Surgery, chemotherapy, radiotherapy and steroid therapy are treatment of NSCLC with brain metastasis. We report a patient with NSCLC metastasis to the brain. This patient underwent chemotherapy, radiotherapy and steroidtherapy. However, the patient requested oriental medical treatment for the patient's continuous headache and disease. We administered Banhabaekchulchoenma-tang gagambang with Allergen-removed Rhus Verniciflua Stokes(aRVS). The patient showed remarkable improvement in terms of frequency and severity of headache. Further study will be needed in order to determine the long-term effectiveness of oriental medical treatment on cancer patient with headache.

• Tuberculosis and Respiratory Diseases
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• v.57 no.3
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• pp.284-288
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• 2004

Central diabetes insipidus (DI) is a disease caused by insufficient release of antidiuretic hormone. Central DI with lung cancer is very rare. Most of them are caused by the pituitary metastasis, and rarely, by the paraneoplastic syndromes. Central DI is diagnosed by the water deprivation test. The treatment consists of surgical resection, radiotherapy and administration of desmopressin. We report an unusual case of central DI with non-small cell lung cancer. The diagnosis was confirmed by water deprivation test. After the administration of desmopressin, the urine osmolarity was increased. The patient's symptoms and urine osmolarity were improved by intranasal desmopressin.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4661-4666
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• 2013

Background: The wide spectrum of clinical features in advanced stages of non-small cell lung cancer (NSCLC) probably contributes to disparities in outcomes because of different prognostic variables significant for stage IIIB/IV patients. Hence the aim of this study was to check for favorable response of patients to various chemotherapeutic combinations with respect to patient survival in stage IIIB and stage IV NSCLC disease. We selected those patients for our study who were receiving treatment with paclitaxel, gemcitabine or etoposide in combination with platinum based drugs. Materials and Methods: Seventy-two patients who visited the hospital from June 2009 to November 2012 with confirmed diagnosis of lung cancer were included, and data were collected for follow up and classified according to treatment received with respect to patients' regimen and response, and overall survival. This study analyzed tumor variables that were associated with clinical outcome in advanced NSCLC patients who were undergoing first-line chemotherapy for stage IIIB/IV NSCLC. Results: Comparative data on various parameters like age, gender, stage, histology, site of disease, metastatic site and chemo-regimens was analyzed; these parameters predicted variable significant improvement for overall survival ($p{\geq}0.05$). One and two year survival rates were 20.8% and 15.3%. Conclusions: In this study we found slight improvement in survival rates in NSCLC and clinical outcomes with one combination (carboplatin+paclitaxel). Overall there were only marginal differences in survival rates for other chemo-regimens evaluated in this study.