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Masaru Takenaka,
Takeshi Hanagiri,
Shinji Shinohara,
Manabu Yasuda,
Yasuhiro Chikaishi,
Soich Oka,
Hidehiko Shimokawa,
Yoshika Nagata, Makoto Nakagawa,
Hidetaka Uramoto,
Tomoko So,
Sohsuke Yamada,
Fumihiro Tanaka
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ABSTRACT: BACKGROUND: OPN is a multifunctional glycophosphoprotein originally described as a secreted protein from malignant epithelial cells. This study focused on the clinical significance of preoperative serum level of OPN in NSCLC patients who underwent a complete resection. PATIENTS AND METHODS: The serum OPN level was assayed in 244 patients who underwent a complete resection of NSCLC by commercially available sandwich enzyme-linked immunosorbent assay kits. The patients were considered as a higher group, when the serum OPN levels exceeded 81.3 ng/mL. RESULTS: The patients included 166 male and 78 female subjects. The histologic types included 172 adenocarcinomas, 49 squamous cell carcinomas, and 23 other types of carcinoma. The serum level of OPN in male patients (92.6 ng/mL) was significantly higher than that of female patients (76.9 ng/mL). The OPN level of squamous cell carcinoma was significantly higher than that of adenocarcinoma. The OPN level was significantly elevated in patients with the pleural invasion or microvascular invasion than those without the invasion. The 5-year survival rate after surgery in the lower OPN group (82.0%) was a significant favorable prognosis than that in the higher OPN group (63.7%) (P < .0001). The 5-year survival rates in the lower OPN group at stage I NSCLC (88.1%) was significantly better than that in the higher OPN group (80.5%) (P = .0321). CONCLUSION: The preoperative serum OPN level was a useful predictor of an unfavorable prognosis, and it was found to be an independent prognostic determinant of outcome in patients who underwent surgery for NSCLC.
Clinical Lung Cancer 10/2012; · 2.94 Impact Factor
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Shinji Shinohara,
Takeshi Hanagiri,
Tetsuya So,
Manabu Yasuda,
Masaru Takenaka,
Yoshika Nagata,
Hidehiko Shimokawa, Makoto Nakagawa,
Hidetaka Uramoto,
Tomoko So,
Fumihiro Tanaka
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ABSTRACT: Thymomas are relatively rare tumors. In this study, we investigated the clinical features of patients who underwent surgical resection for thymoma.
This study clinicopathologically evaluated 54 consecutive patients who underwent a surgical resection of thymoma in our department between 1994 and 2006.
A complete resection was performed in 52 patients, while two patients underwent an incomplete resection due to pleural dissemination. Combined resection with adjacent organs was performed for the lung (n=6), pericardium (n=5), and large vessels (brachiocephalic vein in three, superior vena cava in two). The concomitant autoimmune diseases were observed in 20 patients (37%), and they included myasthenia gravis in 17 patients, macroglobulinemia in one, pemphigus vulgaris in one, and stiff person syndrome in one patient. The histologic types of the World Health Organization classification diagnosed as type A in four patients, type AB in 14, type B1 in eight, type B2 in 15, and type B3 in 11. There were 27, 17, eight, and two patients with Masaoka stages I, II, III, and IV, respectively. Four patients died, and the causes of death included recurrence of thymoma in two, gastric carcinoma in one, and respiratory failure due to myasthenia gravis in one patient. The overall survival rate at 10 years was 94.6% in patients with stages I and II disease and 77.1% in patients with stages III and IV disease.
Long-term survival can be expected not only for patients at early stages, as well as for patients with stages III and IV disease if surgical resection is completed macroscopically.
Asian Journal of Surgery 10/2012; 35(4):144-8. · 0.57 Impact Factor
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Takeshi Hanagiri,
Shinji Shinohara,
Masaru Takenaka,
Yoshiki Shigematsu,
Manabu Yasuda,
Hidehiko Shimokawa,
Yoshika Nagata, Makoto Nakagawa,
Hidetaka Uramoto,
Tomoko So,
Fumihiro Tanaka
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ABSTRACT: Hyaluronic acid (HA) has been proposed as a biochemical marker of malignant pleural mesothelioma (MPM). The present study focused on the implications of HA and CD44 interaction in the proliferation and invasiveness of MPM. The proliferation and invasive activity was evaluated in two human mesothelioma cell lines, ACC-MESO-1 and K921MSO, by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and the transwell chamber model. The knockdown of CD44 gene expression was accomplished by transfection of the cells with small interfering RNA. Flow cytometry revealed that both the ACC-MESO-1 and K921MSO cell lines highly expressed CD44. Treatment with HA enhanced the proliferation in both mesothelioma cell lines in comparison to cells without HA treatment. The treatment with HA (25 μg/ml) also significantly upregulated the invasion of both types of cells. The silencing of CD44 significantly abrogated the effect of HA treatment on the proliferation of ACC-MESO-1 cells and significantly suppressed the proliferation of K921MSO cells. HA-CD44 binding is important for the migration and proliferation of mesothelioma cells. Therefore, the HA-CD44 interaction is a potentially useful therapeutic target in MPM.
Tumor Biology 08/2012; · 1.94 Impact Factor
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Tetsuro Baba,
Hidetaka Uramoto,
Taiji Kuwata,
Masaru Takenaka,
Yasuhiro Chikaishi,
Souichi Oka,
Yoshika Nagata,
Yoshiki Shigematsu,
Hidehiko Shimokawa, Makoto Nakagawa,
Tomoko So,
Takeshi Hanagiri,
Fumihiro Tanaka
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ABSTRACT: PURPOSE: Information regarding the treatment of pleural lavage cytology (PLC)-positive patients is still limited. This study evaluated the efficacy of intrapleural chemotherapy (IPC) in PLC-positive patients. METHODS: Three hundred eighty-six of the 567 lung cancer patients who underwent surgery had undergone PLC after thoracotomy, following by a complete resection were evaluated. IPC was performed after surgery, and cisplatin or adriamycin was injected intrapleurally through the thoracic tube. RESULTS: The pathological diagnosis showed that 17 patients (4.4 %) were positive for (or suspected to have) malignancy in their PLC. The univariate and multivariate analysis showed that only pleural invasion was a significant predictor of a PLC-positive status. The 5-year overall survival in PLC-positive patients was 38 % and that in PLC-negative patients was 84 %. Both the univariate (p < 0.01) and multivariate (p = 0.045) analyses showed that the status of PLC was significantly associated with the overall survival. Eight of the 17 PLC-positive patients underwent IPC. The 2-year OS rate in the patients treated with IPC was 88 % and that of those without IPC was 44 (p = 0.04). CONCLUSION: IPC improved the postoperative survival in PLC-positive NSCLC patients, and a further prospective evaluation regarding this therapy is warranted.
Surgery Today 08/2012; · 1.22 Impact Factor
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Takeshi Hanagiri,
Yoshika Nagata,
Shoko Monji,
Shinji Shinohara,
Masaru Takenaka,
Yoshiki Shigematsu,
Hidehiko Shimokawa, Makoto Nakagawa,
Hidetaka Uramoto,
Tomoko So,
Fumihiro Tanaka
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ABSTRACT: BACKGROUND: The incidence of breast cancer has been increasing in Japan over the past three decades, and it is the currently the most common malignancy in Japan. This study investigated the temporal trends of the surgical outcomes in patients with breast cancer. METHODS: We evaluated 543 consecutive patients who underwent breast-cancer resection between 1980 and 2009. The temporal trends in the surgical outcome and clinicopathological features were evaluated separately for the periods covering 1980 to 1989, 1990 to 1999, and 2000 to 2009. RESULTS: The number of patients who underwent resection during these three respective periods were 133, 176, and 234, respectively. All patients were women. The percentage of patients at stages 0 or 1 was 63.2%, 58.5%, and 43.6%, respectively, during the three periods. The mean diameter of tumors in each period was 38, 29, and 30 mm, respectively. The percentage of tumors with positive ER expression was 62.5%, 64.3%, and 69.7%, respectively. In terms of surgical procedures, the use of Halsted's radical mastectomy decreased during each period: from 40.6% of cases to 8.5% and then to 0.4%, while the proportion of breast-conserving therapies increased, from 0% to 12.5%, and finally to 35.9%. The postoperative 10-year survival rates during the three periods were 75.9%, 83.5%, and 84.9%, respectively. The 10-year survival rates of patients with stage II disease during the three periods were 66.2%, 75.7%, and 90.7%, respectively. The prognosis of stage III disease in the three periods also showed a tendency toward improvement, increasing from 37.8% to 64.2%, and finally to 84.5%. CONCLUSION: The survival of patients with stage II and III disease has improved during the past 30 years. Along with the recent advances in drug therapy, the surgical treatment has become less invasive, often because of drug therapy-related modifications.
World Journal of Surgical Oncology 06/2012; 10(1):108. · 1.12 Impact Factor
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Shinji Sminohara,
Takeshi Hanagiri,
Taiji Kuwata,
Masaru Takcenaka,
Soichi Oka,
Yasuhiro Chikainsi,
Yoshika Nagata,
Hidehiko Shimokawa,
Yoshiki Shigematsu, Makoto Nakagawa,
Hidetaka Uramoto,
Tomoko So,
Fumihiro Tanaka
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ABSTRACT: Pulmonary hamartoma is the most common tumor in benign lung neoplasm. We reviewed the clinical characteristics of 9 patients who had undergone surgical resection for pulmonary hamartoma between 2000 and 2009. There were 1 male and 8 female patients. The age of the patients ranged from 42 to 77 years old (mean 59). Calcification was not observed by computed tomography scan except in 1 patient. Although transbronchial lung biopsy (TBLB) was performed in 5 patients, no definitive diagnosis was obtained. Six patients underwent 18F-fluorodeoxyglucose (FDG)-positron emission tomography, and none of them showed any accumulation of FDG except for 1 patient. Concerning the operative procedures, a sleeve lobectomy was performed in 1 patient, a segmentectomy in 1, a lobectomy in 2, a partial resection of the lung in 3, and a nucleation in 2 patients. The postoperative courses were uneventful, and no findings of recurrence were observed in any of the patients after surgery. As a preoperative diagnosis of pulmonary hamartoma is often difficult in TBLB, it is necessary to perform surgical resection in the differential diagnosis of lung cancer or metastatic lung tumor, unless there are typical findings of pulmonary hamartoma in clinical imaging.
Journal of UOEH 03/2012; 34(1):41-6.
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ABSTRACT: We assessed the prognostic value of the 'Zone-classification' which has been proposed by the Japanese Association for Lung Cancer (JALC) for mediastinal nodal metastases in non-small cell lung cancer (NSCLC). Among 357 NSCLC patients who underwent curative surgery, 46 patients with pathological (p) N2 disease were divided into two groups as follows: 32 patients in whom the nearer zone was involved were classified as the pN2a-1 group, and 14 patients in whom the further mediastinal node station was involved were classified as the pN2a-2 group. The proportions of patients with non-adenocarcinoma histology, with multiple station metastases with the involvement of four or more nodes, and who underwent pneumonectomy, were higher in the pN2a-2 group. The 'Zone-classification' proved to be a significant prognostic factor in a univariate analysis (the 5-year overall survival rate, 7.1% for pN2a-2 versus 21.9% for pN2a-1; P < 0.01). A multivariate analysis confirmed that pN2a-2 sub-classification (hazard ratio 2.77; P = 0.03) and undergoing pneumonectomy (hazard ratio 4.86; P < 0.01) were independent and significant factors in predicting a poor prognosis. In pN2 NSCLC patients, the involved mediastinal zone according to the primary tumour site was important in prediction of survival.
Interactive cardiovascular and thoracic surgery 02/2012; 14(6):760-4.
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Shinji Shinohara,
Takeshi Hanagiri,
Masaru Takenaka,
Soichi Oka,
Yasuhiro Chikaishi,
Yoshiki Shigematsu,
Yoshika Nagata,
Hidehiko Shimokawa, Makoto Nakagawa,
Hidetaka Uramoto,
Tomoko So,
Fumihiro Tanaka
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ABSTRACT: Endobronchial lipoma is a rare, benign disease. When it causes chronic cough and pneumonia due to obstruction of the central airway, appropriate treatment is required. We herein report 2 cases of endobronchial lipoma successfully treated with a high-frequency electric snare through a flexible bronchoscope. Case 1, an 83-year-old man, visited a nearby hospital because of dyspnea on exertion. Chest computerized tomography revealed a tumor in the right main bronchus. He was referred to our hospital for further examination and treatment. Bronchoscopy showed a polypoid lesion in the right main bronchus. The tumor was resected by high-frequency electric snare through a flexible bronchoscope. Case 2 was an 83-year-old man who was diagnosed with pneumonia by a primary care physician on the basis of findings on chest computerized tomography. Bronchoscopy showed a polypoid lesion at the orifice of the right B6 bronchus, which caused segmental obstructive pneumonia. The tumor was bronchoscopically resected using a high-frequency electric snare and an neodymium-yttrium-aluminum-garnet laser. In both cases, the pathologic diagnosis was endobronchial lipoma.
Journal of bronchology & interventional pulmonology. 01/2012; 19(1):68-71.
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Masaru Takenaka,
Takeshi Hanagiri,
Shinji Shinohara,
Taiji Kuwata,
Yasuhiro Chikaishi,
Soich Oka,
Yoshiki Shigematsu,
Yoshika Nagata,
Hidehiko Shimokawa, Makoto Nakagawa,
Hidetaka Uramoto,
Tomoko So,
Fumihiro Tanaka
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ABSTRACT: The human epidermal growth factor receptor HER-2/neu (HER2) gene is a proto-oncogene involved in the signal transduction pathways leading to cell growth and differentiation. The present study focused on the clinical significance of the expression of HER2 in non-small cell lung cancer (NSCLC).
Consecutive specimens of 159 adenocarcinomas and 77 squamous cell carcinomas, from patients who had been treated by complete resection of NSCLC in our department between 2003 and 2005, were studied. The HER2 expression was evaluated by immunohistochemical staining with score of membranous staining being 0=none, 1=weak, 2=10-30% cells, 3≥30% cells stained.
The staining scores in adenocarcinoma were 0 in 121 patients (76.1%), 1 in 16 (10.0%), 2 in 17 (10.7%), and 3 in 5 patients (3.1%). The HER2 expression scores in squamous cell carcinoma were 0 in 74 patients (96.1%), 1 in 1 (1.2%), 2 in 1 (1.2%), and 3 in 1 patient (1.2%). The postoperative 5-year survival rate of patients with adenocarcinoma according to the expression of HER2 scores 0, 1, 2 and 3 was 75.3%, 77.8%, 76.5% and 20.0%, respectively. Patients with adenocarcinoma with score 3 staining had a significantly unfavorable prognosis compared to those with staining scores of 0-2 (p=0.0216).
HER2 overexpression (score 3) in adenocaricinoma was a significantly unfavorable prognostic factor. Since the number of NSCLC patients with HER2 overexpression was small, further investigations will be necessary to clarify the efficacy of molecular targeted therapy for this subgroup.
Anticancer research 12/2011; 31(12):4631-6. · 1.73 Impact Factor
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ABSTRACT: The purpose of the current study was to clarify the clinical role of insulin-like growth factor receptor-1 (IGF1R) in NSCLC.
Tumor specimens were collected from 285 patients who underwent complete resection for adenocarcinoma (AD, n = 182), squamous cell carcinoma (SCC, n = 77), and other histologic types of cancer (n = 26) of the lung. The expression of IGF1R and Ki-67 was evaluated by immunohistochemical (IHC) analysis.
Positive expression of IGF1R was detected in 87 (30.5%) of 285 cases, of which 43 (23.6%) of 182 cases were AD, 36 (46.8%) of 77 cases were SCC, and 8 (30.8%) of 26 cases were other histologic types (SCC vs. AD, p < .001; SCC vs. non-SCC, p < .001). Positive IGF1R expression was also identified in 20 (44.4%) and 67 (27.9%) of the patients with and without recurrence, respectively (p = .027). Multivariate logistic regression models indicated that positive staining for IGF1R expression was an independent factor in AD associated with tumor recurrence (p = .040) but not in NSCLC, SCC, and other types of cancer. A positive IGF1R expression tended to demonstrate a poor disease-free survival (DFS) in NSCLC according to the Kaplan-Meier DFS curves (p = .053). The tumors showing a positive expression of IGF1R were observed more frequently in tumors with a positive expression of Ki-67 than in the tumors with a negative expression of Ki-67 (p = .010).
IGF1R expression was associated with reduced DFS correlating with postoperative recurrence. In addition, a significant relationship was also observed between IGF1R and Ki-67 expression in NSCLC. However, in subgroup analysis, a significant correlation was not observed. IGF1R expression predicts postoperative recurrence in patients with AD, but not in those with non-AD of NSCLC.
Clinical Lung Cancer 11/2011; 13(2):136-42. · 2.94 Impact Factor
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Takeshi Hanagiri,
Kenji Ono,
Taiji Kuwata,
Masaru Takenaka,
Soichi Oka,
Yasuhiro Chikaishi,
Yoshiki Shigematsu,
Yoshika Nagata,
Hidehiko Shimokawa, Makoto Nakagawa,
Hidetaka Uramoto,
Tomoko So,
Fumihiro Tanaka
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ABSTRACT: Human DNA topoisomerases I and IIalpha (Topo-I and -II alpha) are essential for vital cellular processes such as DNA replication, transcription, translation, recombination, and repair. The purpose of this study was to investigate the clinical significance of the expression of Topo-I and Topo-II alpha. Twenty-nine specimens of esophageal squamous cell carcinoma from patients who had been treated by complete resection of the esophageal tumor were studied by an immunohistochemical analysis. High expression of Topo I and II alpha was identified in 48.7% and 55.2% of tumors, respectively. Neither the Topo-I nor -II alpha expression level had any association with clinical characteristics, including differentiation and the depth of tumor invasion, lymph node metastasis, or the patient prognosis. However, a significant positive correlation was observed between the expression levels of Topo-I and Topo-II alpha. Our study results underscore the potential role of topoisomerase expression in esophageal cancer and further exploratory investigation is necessary to evaluate topoisomerase expression as a surrogate marker in chemotherapy with topoisomerase inhibitor for esophageal cancer.
Journal of UOEH 09/2011; 33(3):205-16.
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ABSTRACT: Recently, we reported that overexpression of metastasis-associated colon cancer-1 (MACC1) mRNA may be a useful marker for predicting postoperative recurrence in patients with lung adenocarcinoma following surgery. However, the biological significance of mRNA overexpression is difficult to determine and is not widely used because mRNA expression analysis is relatively expensive and time- and labor-intensive. On the other hand, immunohistochemical (IHC) staining is easy to perform, well-established, inexpensive, and is a useful method which can be routinely applied in solid tumor diagnosis in clinical laboratories.
Tumor specimens were collected from 197 consecutive patients who underwent a complete resection for lung adenocarcinoma from 1998 to 2007. We analyzed the MACC1 status of the primary lung adenocarcinoma by IHC analysis.
The average postoperative observation period was 46.7 months. Forty (20.3%) of the 197 patients developed recurrences after surgery. Positive expression of MACC1 was identified in 129 (65.5%) patients. Furthermore, MACC1 IHC was positive in 33 (82.5%) out of the 40 patients and 96 (61.1%) out of the 157 patients, with and without recurrence, respectively (p=0.011). Both univariate and multivariate logistic regression models indicated that positive staining for MACC1 was an independent factor for tumor recurrence. Furthermore, positive staining for MACC1 was associated with poorer disease-free survival (DFS), according to the univariate survival analysis (p=0.080).
Positive staining for MACC1 expression in resected specimens was associated with a poorer DFS. Therefore, positive staining of IHC for MACC1 may be a useful marker for predicting postoperative recurrence in patients with lung adenocarcinoma following surgery.
Anticancer research 04/2011; 31(4):1141-5. · 1.73 Impact Factor
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ABSTRACT: Not all patients with lung cancer require postoperative adjuvant chemotherapy after a complete resection. However, no useful markers exist for either selecting appropriate candidates or for predicting clinical recurrence. The purpose of the present study was to clarify the clinical role of insulin-like growth factor receptor-1 (IGFR1) in lung adenocarcinoma. Tumor specimens were collected from 182 patients who underwent a complete resection for adenocarcinoma of the lung. The expression of IGFR1 was evaluated by immunohistochemistry. The genetic status of the epidermal growth factor receptor (EGFR) and K-ras genes was also investigated by PCR-based analyses. Immunohistochemistry and real-time PCR assays were used to evaluate the MET gene association with tyrosine phosphorylation and hepatocyte growth factor (HGF) status, and amplification, respectively. Positive expression of IGFR1 was detected in 43 (23.6%) of the 182 cases. A positive IGFR1 expression was also identified in 12 (42.9%) and 31 (20.1%) of the patients with and without recurrence, respectively (p=0.009). Logistic regression models indicated that positive staining for IGFR1 expression was an independent factor associated with tumor recurrence. IGFR1 expression was associated with a poorer disease-free survival (DFS). Multivariate analysis demonstrated positive IGFR1 expression to be independently associated with an increased risk for poor DFS. The tumors appearing positive for IGFR1 were more frequent among those with K-ras mutations when compared with the wild-type group. IGFR1 expression was associated with reduced DFS correlating with postoperative recurrence. Therefore, the expression status of IGFR1 can be a candidate surrogate marker to select patients who may benefit from adjuvant chemotherapy.
Experimental and therapeutic medicine 01/2011; 2(4):585-590.
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ABSTRACT: Not all patients with lung cancer require postoperative adjuvant chemotherapy after a complete resection. However, no useful markers for either selecting appropriate candidates or for predicting clinical recurrence exist.
Tumor specimens were collected from 183 consecutive patients who underwent a complete resection for lung adenocarcinoma from 2003 to 2007 in our department. We analyzed the thymidylate synthase (TS) and dihydrofolate reductase (DHFR) expressions in the primary lung adenocarcinoma by immunohistochemisty.
The strong expression of TS and DHFR was identified in 39 (21.3%) and 120 (65.6%) patients, respectively. The strong TS expression was identified in 11 (39.3%) of 28 patients and 28 (18.1%) of 155 patients in patients with and without recurrence, respectively (p=0.012). The strong DHFR expression was also identified in 23 (82.1%) and 97 (62.6%) of the patients with and without recurrence, respectively (p=0.045). Logistic regression models indicated the strong TS expression to be an independent factor for tumor recurrence. The strong TS and DHFR expression was associated with a poorer disease-free survival (DFS) according to the survival analysis. A multivariate analysis demonstrated the strong TS expression to be independently associated with an increased risk for poor DFS.
The strong TS expression may be a useful marker for predicting postoperative recurrence in patients with lung adenocarcinoma following surgery.
Lung cancer (Amsterdam, Netherlands) 10/2010; 72(3):360-4. · 3.14 Impact Factor
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ABSTRACT: We report a case of a multilocular anterior mediastinal cyst with rim calcification and severe adhesion to the adjacent organs. We excised the cyst completely, with resection of the left phrenic nerve, pericardium, and left lung because of the severe adhesion. Histological examination revealed that the multilocular cystic walls were composed of fibrous connective tissue and calcifications, but the lining epithelial cells were absent because of dystrophic calcification resulting from chronic inflammation. On the basis of the location and pathological findings, we diagnosed a multilocular mediastinal cystic tumor; most likely a multilocular thymic cyst. It is important to distinguish a multilocular thymic cyst from a unilocular thymic cyst because a multilocular thymic cyst may recur postoperatively and coexist with a thymic epithelial tumor. Dense adhesion to the surrounding mediastinal structures may make removal difficult, especially if there is rim calcification.
Surgery Today 02/2008; 38(1):52-5. · 1.22 Impact Factor
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ABSTRACT: We report the case of a 66-year-old woman with pulmonary Paragoniumus westermani showing false-positive fluorodeoxyglucose positron emission tomograpy (FDG-PET). Based on chest computed tomography and FDG-PET findings, we could not rule out the possibility of primary lung cancer. She underwent right middle and lower lobectomies as a primary lung cancer. As a possibility in the differential diagnosis of a pulmonary nodule with FDG-PET positive findings, paragonimiasis should be considered, although it is rarely seen.
General Thoracic and Cardiovascular Surgery 12/2007; 55(11):470-2.
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ABSTRACT: Lung cancer metastasis to the liver indicates a poor prognosis, and the majority of patients with metastatic disease to the liver are not indicated for surgery because of the number or distribution of metastases or the presence of extrahepatic disease. We herein describe a case of long-term survival after a surgical resection of liver metastases from lung cancer. Six months after surgery for Stage IB primary lung adenocarcinoma, a 71-year-old male was found to have a metastatic tumor in his liver. A hepatic resection for the metastatic tumor and another small metastatic foci found intraoperatively was carried out, and the tumors were pathologically diagnosed as liver metastases from lung cancer. The patient is presently alive and well without recurrence, as of 5 years and 2 months after the liver resection. This is the first report of the successful surgical treatment of liver metastasis from lung cancer.
The Japanese Journal of Thoracic and Cardiovascular Surgery 07/2004; 52(6):311-3.
