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ABSTRACT: Background The aim of the present study was to evaluate the oncologic characteristics of pulmonary mucoepidermoid carcinoma (PMEC) and the efficacy of surgical resections.Materials and Methods The surgery for PMEC was performed in 23 patients at Asan Medical Center from January 2000 to December 2010. They accounted for 0.8% of all surgically resected pulmonary neoplasm in the center. The medical records of these patients were reviewed retrospectively.Results This study group was composed of 13 males (56.5%) and 10 females (43.5%). Median age was 41 years (range, 10 to 75 years). Complete resection with systematic mediastinal lymph node dissection was performed in all patients. There were three postoperative complications: atelectasis in one patient and chylothorax in two patients. There was no postoperative mortality. The median follow-up duration was 68 months (range, 13 to 115 months). In one patient, recurrent disease was found 73 months after surgery. All patients were followed without mortality until the end of this study. The 5- and 8-year disease-free survival rates were 100 and 90.9%, respectively.Conclusion Complete surgical resection with systematic lymph node dissection is an effective treatment for patients with PMEC and provides favorable prognosis.
The Thoracic and Cardiovascular Surgeon 04/2013; · 0.88 Impact Factor
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ABSTRACT: OBJECTIVE: The purpose of this study is to investigate the clinical characteristics, prognosis, and risk factors of patients in whom cervical lymph node cancer recurred after esophageal cancer surgery with 2-field lymph node dissection. METHODS: Between 2000 and 2010, 471 consecutive patients who had undergone esophagectomy with 2-field lymph node dissection for esophageal squamous cell carcinoma were enrolled in this study. RESULTS: Recurrence was seen in 96 patients. Isolated cervical lymph node recurrence (group A) developed in 21 patients, locoregional recurrence only and without cervical lymph node recurrence (group B) in 29, and distant recurrence with or without locoregional recurrence (group C) in 46 patients. The median times to recurrence after surgery in groups A, B, and C were 20, 16, and 12 months, respectively (P = .634). 2- and 5-year rates of isolated cervical lymph node recurrence were 4.1% and 5.6%, respectively. The median survival times from diagnosis of recurrence were 13, 7, and 5 months in groups A, B, and C, respectively. The difference in survival between groups A and C was statistically significant (P = .030). Upper thoracic esophageal cancer and positive recurrent laryngeal node at the time of initial surgery were independent risk factors for cervical recurrence-free survival as determined by univariate and multivariate analysis. CONCLUSIONS: This study shows that 2-field lymph node dissection can be performed with an acceptable rate of cervical lymph node recurrence. Patients with isolated cervical lymph node recurrence demonstrated longer survival from diagnosis of recurrence than patients with other sites of recurrence.
The Journal of thoracic and cardiovascular surgery 02/2013; · 3.41 Impact Factor
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ABSTRACT: The experience of a single-institution regarding surgery for small cell lung cancer (SCLC) was reviewed to evaluate the surgical outcomes and prognoses.
From July 1990 to December 2009, thirty-four patients (28 male) underwent major pulmonary resection and lymph node dissection for SCLC. Lobectomy was performed in 24 patients, pneumonectomy in eight, bilobectomy in one, and segmentectomy in one. Surgical complications, mortality, the disease-free survival (DFS) rate, and the overall survival rate were analyzed retrospectively.
The median follow-up period was 26 months (range, 4 to 241 months), and there was one surgical mortality (2.9%). Six patients (17.6%) experienced recurrence, all of which were systemic. Eight patients died during follow-up; four died of disease progression and the other four died of pneumonia or of another non-cancerous cause. The three-year DFS rate was 79.2±2.6% and the overall survival rate was 66.4±10.5%. Recurrence or death was significantly prevalent in the patients with lymph node metastasis (p=0.001) as well as in those who did not undergo adjuvant chemotherapy (p=0.008). The three-year survival rate was significantly greater in the patients with pathologic stage I/II cancer than in those with stage III cancer (84% vs. 13%, p=0.001).
Major pulmonary resection for small cell lung cancer is feasible in selected patients. Patients with pathologic stage I or II disease showed an excellent survival rate after surgery and adjuvant treatment. Prospective randomized studies will be needed to define the role of surgery in early-stage small cell lung cancer.
The Korean journal of thoracic and cardiovascular surgery. 02/2012; 45(1):40-4.
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ABSTRACT: We report a rare case of a 38-year-old woman with a bronchial carcinoid tumor arising from an intralobar bronchopulmonary sequestration. The vascular supply to the sequestered left lower lobe originated from the descending thoracic aorta. A left lower lobe lobectomy was performed. The findings of the pathological examination revealed an atypical carcinoid tumor that was immunopositive for chromogranin and synaptophysin. At the 3-year follow-up examination, the patient was healthy.
The Korean journal of thoracic and cardiovascular surgery. 12/2011; 44(6):444-7.
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ABSTRACT: This study was performed to assess the clinical feasibility and surgical outcomes of video-assisted mediastinoscopic lymphadenectomy in the treatment of resectable lung cancer.
Between July 2004 and December 2009, we retrospectively analyzed 108 consecutive video-assisted mediastinoscopic lymphadenectomies in lung cancer patients from a prospectively collected database. Ninety-seven (89.8%) patients underwent combined operation during the same anesthesia and six (5.3%) patients underwent a staged operation for the resection of lung cancer and systematic lymphadenectomy. We reviewed the indication and duration of video-assisted mediastinoscopic lymphadenectomy, its complication, combined or staged operation type, the number of dissected lymph nodes and nodal stations, and pathologic staging of the mediastinal node.
Mean operative time of video-assisted mediastinoscopic lymphadenectomy was 39.8 ± 12.3 min (range of 14-85 min). Mean number of resected lymph nodes was 16.0 ± 7.7 (range of 3-37). In video-assisted mediastinoscopic lymphadenectomy, the rates of lymph node dissection of stations 4R, 4L, and 7 were 71.3%, 88.0%, and 100%, respectively, whereas the rates of dissection of lymph nodes in station 2R and 2L were only 22.2% and 17.6%, respectively. There was no operative mortality. We identified five complications of recurrent nerve palsy.
Video-assisted mediastinoscopic lymphadenectomy is a clinically feasible procedure with acceptable complication rate and provides more accurate staging of mediastinal node in lung cancer patients. It may be also an excellent supplementary technique used for complete mediastinal node dissection at minimal invasive surgery for cancer resection, especially with left-sided video-assisted thoracoscopic lobectomy.
European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 05/2011; 40(6):1483-6. · 2.40 Impact Factor
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Zhao Chen,
Takaaki Sasaki,
Xiaohong Tan,
Julian Carretero,
Takeshi Shimamura,
Danan Li,
Chunxiao Xu,
Yuchuan Wang,
Guillaume O Adelmant,
Marzia Capelletti, [......],
Christa Borgman,
Seung-Il Park, Hyeong Ryul Kim,
Robert Padera,
Jarrod A Marto,
Nathanael S Gray,
Andrew L Kung,
Geoffrey I Shapiro,
Pasi A Jänne,
Kwok-Kin Wong
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ABSTRACT: Genetic rearrangements of the anaplastic lymphoma kinase (ALK) kinase occur in 3% to 13% of non-small cell lung cancer patients and rarely coexist with KRASor EGFR mutations. To evaluate potential treatment strategies for lung cancers driven by an activated EML4-ALK chimeric oncogene, we generated a genetically engineered mouse model that phenocopies the human disease where this rearranged gene arises. In this model, the ALK kinase inhibitor TAE684 produced greater tumor regression and improved overall survival compared with carboplatin and paclitaxel, representing clinical standard of care. 18F-FDG-PET-CT scans revealed almost complete inhibition of tumor metabolic activity within 24 hours of TAE684 exposure. In contrast, combined inhibition of the PI3K/AKT and MEK/ERK1/2 pathways did not result in significant tumor regression. We identified EML4-ALK in complex with multiple cellular chaperones including HSP90. In support of a functional reliance, treatment with geldanamycin-based HSP90 inhibitors resulted in rapid degradation of EML4-ALK in vitro and substantial, albeit transient, tumor regression in vivo. Taken together, our findings define a murine model that offers a reliable platform for the preclinical comparison of combinatorial treatment approaches for lung cancer characterized by ALK rearrangement.
Cancer Research 10/2010; 70(23):9827-36. · 7.86 Impact Factor
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ABSTRACT: Positron emission tomography has proven to be an invaluable tool for diagnosing and staging non-small cell lung cancer. The authors analyzed relationships between the preoperative maximum standardized uptake values (SUVmax) of masses and early recurrence rates in patients with stage I pulmonary adenocarcinoma.
One hundred and seven patients with stage I pulmonary adenocarcinoma who underwent curative resection between September 2003 and June 2007 were enrolled in this study. All patients underwent preoperative positron emission tomography (PET). The relation between mass SUVmax values and recurrence prior to May 2008 was analyzed retrospectively.
At diagnosis 57 patients had stage Ia disease and 50 stage Ib disease. The overall recurrence rate was 16% (17/107). The patients were divided into quartiles by SUVmax values (group 1; SUVmax<1.2, group 2; 1.2</=SUVmax<2.4, group 3; 2.4</=SUVmax<4.6, and group 4; 4.6</=SUVmax). The 3-year disease-free survival (DFS) rate was significantly lower in higher SUVmax quartiles (i.e., 100%, 92%, 78% vs 62% for groups 1, 2, 3, and 4, respectively; p=0.000, log-rank test). The median SUVmax of the 74 patients with a tumor of </=3 cm was 2 (range 0.6-2.9), and among these patients, an SUVmax of </=2.0 was found to be correlated with a higher DFS rate (100% vs 79%, p=0.006). Thirty-three patients had a mass of >3 cm and a median SUVmax of 4 (range 2-19.9), and among these, an SUVmax of </=4.0 was also found to be correlated with a higher DFS rate (83% vs 46%, p=0.025).
Patients with higher preoperative SUVmax values have significantly higher recurrence rates. Our findings indicate that even in stage I adenocarcinoma patients, mass size and SUVmax are related to higher rates of recurrence, and thus, these patients require more attentive observation after curative resection.
European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 02/2009; 35(4):712-6; discussion 716-7. · 2.40 Impact Factor
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ABSTRACT: With expansion of lung cancer screening by computed tomography (CT) and increased incidence of adenocarcinoma, we encountered more peripheral nodules to be identified. We evaluated detection rates of the melanoma antigen genes (MAGE) RT-nested PCR using a common MAGE A1-6 primer in bronchoscopic washing samples from patients with bronchoscopically invisible peripheral nodules, and compared with those of conventional cytology and percutaneous needle aspiration biopsy (PCNB).
Forty-two patients with bronchoscopically invisible peripheral lung nodules were studied. Bronchoscopic washing specimens were collected by instilling 20ml of normal saline into a tumor bearing segment and retrieving samples. Samples were split and analyzed by MAGE RT-PCR and conventional cytology. A PCNB was performed in all but two patients. Twenty-eight lesions were diagnosed as lung cancers and 14 as benign lung diseases. We evaluated MAGE A1-6 RT-nested PCR, cytology, and PCNB results and analyzed them according to histologic cell types and tumor sizes.
In bronchial washing samples, the detection rates of MAGE A1-6 RT-nested PCR (67.9%) were higher than that of conventional cytology (21.4%, p=.04) and similar to that of PCNB (73.1%, p=.45) in 28 cancer patients. In terms of histologic types, the detection rates of MAGE A1-6 RT-nested PCR, conventional cytology, and PCNB were 78.6%, 21.4% and 64.3% in adenocarcinoma, 70%, 20% and 77.8% in squamous cell carcinoma, respectively. The sensitivity of conventional cytology was significantly lower than that of MAGE RT-nested PCR or PCNB regardless of tumor histology p=.04, p=.025, respectively, in adenocarcinoma; p=.035, p=.04, respectively, in squamous cell carcinoma). In terms of tumor size, the corresponding detection rates were 73.3%, 6.7% and 73.3% for tumors smaller than 3cm (N=15), and 61.5%, 38.5% and 72.7% for tumors larger than 3cm (N=13).
MAGE A1-6 RT-nested PCR showed higher detection rates in the bronchial washes of peripheral lung cancer patients than conventional cytology testing. This method is simple and robust, and it could be effectively utilized as a peripheral lung cancer detection tool in clinical laboratories.
Lung cancer (Amsterdam, Netherlands) 02/2009; 65(2):166-9. · 3.14 Impact Factor
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ABSTRACT: Caveolin-1, as a major component of caveolae, is involved in the regulation of cell cycle by impacting various signaling pathways. Previous studies of caveolin-1 in cancer showed two contrary results. In most in vitro studies, caveolin-1 played a role as a tumor suppressor. On the other hand, the elevated expression of caveolin-1 was often reported to be associated with poor clinical outcome in human studies. These results indicate differential biological functions of caveolin-1 depending on the development and progression stage of cancer in vivo.
To clarify the correlation between the clinicopathologic profiles of pulmonary squamous cell carcinomas and the expression of caveolin-1, 107 cases of formalin-fixed and paraffin-embedded tissues of pulmonary squamous cell carcinomas were immunohistochemically evaluated for the expression of caveolin-1 by the tissue-array method.
Caveolin-1 was expressed in 34 cases (31.7%) among 107 cases of pulmonary squamous cell carcinoma. The expression of caveolin-1 was statistically correlated with pathologic stage (stage I and II vs. III; P<0.001), pT (T1 and T2 vs. T3 and T4; P=0.001), and pN (N1 vs. N2 and N3; P=0.0143). The patients with caveolin-1 expression in pulmonary squamous cell carcinomas showed a poorer prognosis than those in caveolin-1-negative group (P=0.0345).
The expression of caveolin-1 is significantly correlated with advanced pathologic stage and poor prognosis in pulmonary squamous cell carcinoma. The results of current study suggest that the expression level of caveolin-1 may be a candidate factor for predicting prognosis in patients with pulmonary squamous cell carcinoma.
Lung Cancer 11/2003; 42(2):195-202. · 3.43 Impact Factor
