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ABSTRACT: Second operations were performed in 1961–1990 on 23 patients with non-small cell bron-chogenic carcinoma, constituting 2.5% of 906 who had undergone pulmonary resection for such tumor and 3.6% of the 641 with apparently curative surgery. The second operation was performed for recurrent tumor in 15 cases and for second primary tumor in eight. Five-year survival after the first operation was 30% in the former group and 88% in the latter (significant difference). Among the total 23 patients, this survival rate was 51%. The study indicates that an aggressive attitude to second surgical intervention is warranted. For early detection of second lesions, follow-up at maximally 6-month intervals should be continued for more than 5 years after the first operation.
07/2009; 26(1):73-78.
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ABSTRACT: We report herein the cases of two patients who underwent complete resection of a superior sulcus tumor (SST) plus adjuvant
brachytherapy, with the area to be irradiated determined by a computer program system designed to minimize unnecessary irradiation
to the normal components and to optimize the effect on the targeted area. Although the efficacy of brachytherapy on the inhibition
of local relapse needs to be observed over a long period, the selective and alternative use of delivering adjuvant brachytherapy
by this method appears to enhance the quality of life of patients with a SST.
Surgery Today 01/2001; 31(2):152-155. · 1.22 Impact Factor
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ABSTRACT: < 0.0001). The vessel densities in the primary and recurrent tumors of 2 of 3 long-term survivors were found to be relatively
low. These results indicate the high-grade malignant potential of recurrent tumors, which led us to conclude that the use
of CP should be carefully evaluated in patients with recurrence. Assessing the vasculature in primary tumors may be a useful
indicator for determining which patients could benefit from CP.
Surgery Today 12/1999; 30(2):134-138. · 1.22 Impact Factor
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ABSTRACT: n
= 4) or left (
n
= 3) upper sleeve
lobectomy. None of the patients treated surgically showed any
postoperative complication or recurrence of the tuberculosis. These
surgical results for endobronchial tuberculosis indicate the need for
early detection and operation. Bronchoscopy and computed tomography are
the methods of choice for accurate diagnosis of bronchial involvement
and assessment of the surgical indications. It is emphasized that
bronchoplastic surgery is the best treatment for bronchial stricture
involving bilateral main bronchi.
World Journal of Surgery 05/1997; 21(5):480-487. · 2.36 Impact Factor
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ABSTRACT: The role of surgery in the management of lung cancer with pleural dissemination is controversial. We performed a retrospective analysis of our patients with lung cancer and pleural dissemination who were treated surgically. Between 1973 and 1993, 1,206 patients with lung cancer underwent pulmonary resection at Kanazawa University Hospital. Among them, 40 (3.3%) had pleural dissemination without pleural effusion. The 1-, 3-, and 5-year survival rates for 38 patients (except 2 patients undergoing exploratory thoracotomy alone) were 51.5%, 19.4%, and 19.4%, respectively. The 1-year survival rate in the 10 patients who underwent pleuropneumonectomy was only 20%, and 9 of these patients died within 18 months postoperatively (1 patient has survived for 25 months). In contrast, the 1-, 3-, and 5-year survival rates for the 14 patients who underwent resection of the primary tumor plus parietal pleurectomy were 85.1%, 35.5%, and 35.5%, respectively, a significantly better outcome (P < 0.01). Seven patients are still alive (the longest survival time is 65 months with the disease). The average survival time in the seven fatal cases was 18 months. In patients with lung cancer accompanied by pleural dissemination, it is quite possible that local excision plus pleurectomy will be justified. © 1996 Wiley-Liss, Inc.
Journal of Surgical Oncology 12/1995; 61(1):1 - 6. · 2.10 Impact Factor
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ABSTRACT: Malignant fibrous histiocytoma (MFH) is a tumor which most often develops in the soft tissues of the extremities and retroperitoneum,
but very rarely originates in the mediastinum. We report herein the case of a 63-year-old man who underwent surgical resection
of a rapidly growing tumor in the right thoracic cavity which was diagnosed as an MFH of mediastinal origin on the basis of
histological findings, the definitive diagnosis ultimately being made by specific immunostaining.
Surgery Today 01/1994; 24(4):368-370. · 1.22 Impact Factor
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ABSTRACT: A clinical analysis of small-sized lung cancers with advanced disease was conducted on a total of 58 patients: 34 diagnosed as T1N2, 6 as T1N3, 9 as T1M1, and 9 as T4 due to pleural dissemination. The cumulative 5-year survival rate after surgery for the 34 patients with a T1N2 lesion was 17.4%. Of these 34 patients, 24 underwent a curative operation resulting in a 5-year survival rate of 23.7%, but the remaining 10 patients, who underwent a non-curative operation, had a 5-year survival rate of 0%. Extended lymph node dissection for N3 disease has only been performed in recent years, so it is not yet clear whether it will affect the survival rate or not. T4 disease due to pleural dissemination and T1M1 disease associated with intrapulmonary metastasis encountered at thoracotomy could be expected to have relatively long-term survival with the combined use of systemic immunochemotherapy after surgery. In cases diagnosed as T4 due to pleural dissemination, we have recently employed resection of the primary lesion with parietal pleurectomy as the standard operative procedure. For cases of T1M1 with intrapulmonary metastasis confined to the same lobe as the primary lesion, a lobectomy is usually performed, while for cases with intrapulmonary metastasis extending to another lobe, a lobectomy with enucleation of metastatic nodules or pneumonectomy is most often performed instead of an exploratory thoracotomy.
Surgery Today 12/1993; 24(1):19-23. · 1.22 Impact Factor
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ABSTRACT: Nucleolar organizer regions (NORs) were investigated in lung carcinomas by silver staining. This method was applied to 111 lung carcinoma specimens, including 40 with squamous cell carcinoma (SCC), 42 with adenocarcinoma (ADENO), 8 with adenosquamous carcinoma (ADESQ), 8 with small cell carcinoma (SMCC), 6 with large cell carcinoma (LGCC), and 7 with typical carcinoid tumors (CAOID). The mean AgNOR counts of ADENO, SCC, ADESQ, SMCC, and LGCC were significantly higher than those of the normal bronchial surface and those of the glandular or alveolar epithelium. The mean AgNOR count of CAOID was significantly higher than those of the normal glandular and alveolar epithelium but not that of the surface epithelium. The mean AgNOR count of SCC was significantly higher than that of bronchial squamous metaplasia, and the count of SMCC was significantly higher than that of CAOID. Within the same cancer category, the mean number of AgNORs increased in parallel with the histological tumor grades. These results indicate that the AgNOR method is useful for differentiating lung carcinoma from its normal counterparts and for evaluating histological tumor grades in the same lineage of lung carcinoma.
Surgery Today 05/1993; 23(6):486-490. · 1.22 Impact Factor
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ABSTRACT: As preoperative adjuvant therapy for advanced lung cancer, bronchial arterial infusion (BAI) of a chemotherapeutic agent was
administered to patients with stage IIIa and IIIb hilar lung cancer. The infusion modality was changed for each term, from
a single drug infusion, to a two drug infusion and then a three drug infusion, and the combination of infused drugs was selected
in accordance with cell types. A significant radiographic shrinkage was observed after BAI therapy by the single, two and
three drug infusions, being noted as 40.7 per cent, 61.8 per cent and 83.9 per cent, respectively. The effect on squamous
cell carcinoma was more prominent than on other cell types. Upon microscopic examination of the resected specimens, significant
histo-pathological effects were observed in 57.7 per cent of the patients who received single or two drug infusions, while
the rate increased to as high as 92.2 per cent in the patients who received the three drug infusion. The histological effects
of BAI therapy were also most marked in squamous cell carcinoma. It is of special interest that 5 of the 10 patients who received
the three drug infusion of Carboquone (CQ)+ Mitomycin C (MMC)+Nimustine-HCL (ACNU) for squamous cell carcinoma, showed complete
disappearance of viable cancer cells at the tumor site; something which was never observed after the single and two drug infusions.
It was therefore concluded that BAI therapy for advanced lung cancer should be reappraised through the modification of infusion
methods.
Surgery Today 04/1990; 20(1):27-35. · 1.22 Impact Factor
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ABSTRACT: In a patient with metachronous multiple primary lung cancer, bilateral lobectomy was performed, using bronchoplastic procedures.
This case may be one of very few such cases reported in the literature. A 56-year-old man with squamous cell carcinoma was
surgically treated for lung cancer. At the first operation, right upper lobectomy with wedge resection of the right main bronchus
was performed, as the tumor occupied the orifice of the right main bronchus. Six months later, re-operation for stricture
at the anastomotic line was done because of granulation. By means of sleeve resection of the strictured right main bronchus,
the airway was reconstructed. The patient remained well for five years, then a similar cancer at the orifice of the left lower
lobe and bulging into the left main bronchus became evident. Left lower sleeve lobectomy was done for the second primary cancer.
The postoperative course was uneventful and he is well with no signs of recurrence 6 years and 10 months after the first operation
and 19 months after the second sleeve lobectomy
Surgery Today 04/1986; 16(1):56-61. · 1.22 Impact Factor
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ABSTRACT: As an operative procedure for the correction of funnel chest in adult and adolescents, a strut method using AO-plates was
used. All of the concaved parts of the sternum, costate, and cartilages contributing to the formation of the deformity were
osteotomized to mobilize and elevate the deformed part. A vertical plate was used for fixation of the transected sternum,
and three transverse plates were used as the portions which are curved appropriately to remodel the reconstructing chest wall.
These plates were removed twelve to eighteen months after implantation. To date, thirty-one patients have undergone this repair.
For the first eight, a single transverse plate was used, however, re-retraction of the region around the transverse plate
became evident in the long term follow-up. Therefore, two or three plates were inserted for an improvement. When three transverse
plates were used, retraction at the costal arch was relieved. Although a second operation is required to removal of the plates,
we hold the view that this is the most effective operative procedure for the correction of funnel chest in adults and adolescents.
Surgery Today 01/1984; 14(6):472-478. · 1.22 Impact Factor
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ABSTRACT: Histopathological and succinic acid dehydrogenase (SAD) activity changes, and the electron spin resonance (ESR) were examined
in the brains of dogs exposed to various hypothermic conditions. A simple hypothermic cardiac arrest of 5 min duration occurred
in the group subjected to 28°C, and normal SAD activity was noted in dogs exposed to 1-hour extracorporeal circulation under
normothermia. In cases of a hypothermia below 28°C, a decrease in enzyme activity, marked histopathological changes and the
disappearance of the ESR signal were observed. In dogs killed immediately after induction of 20°C hypothermia, the histopathological
changes were primarily ischemic in nature, while in dogs killed at 1–12 month intervals after the experiments, irreversible
gliosis was dominant. Our findings suggest that, to avoid brain damage under conditions of deep hypothermic circulatory arrest,
the critical range is between 26–28°C for rectal, and approximately 28–30°C for brain temperature.
Surgery Today 04/1982; 12(1):61-70. · 1.22 Impact Factor
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ABSTRACT: A 79-year-old male was admitted to the hospital with the complaint of bloody sputum. Chest X-ray revealed an abnormal shadow in the right upper lobe. Macroscopically, the lesion measured about 3.5 x 2.5 x 2.0 cm with a central cavity containing pus. Histologically, the lesion was composed of interlacing fibroblastic proliferation with abundant plasma cell infiltration and central cavitation. The inner surface of the cavity wall was partially covered by bronchial epithelial cells; there was no cartilage found, suggesting that the lesion had developed from chronic inflammatory processes in relation to ectatic bronchioles. Since the pathogenesis of plasma cell granuloma (PCG) has not been well established, it is probable that this case represents one stage in the development of classic PCG.
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ABSTRACT: A case with primary plasmacytoma of the lung is described. The patient, a 55-year-old Japanese female, who simultaneously had a pulmonary plasmacytoma and bladder carcinoma. The bladder tumor was treated with transurethral resection. Pathologically, the bladder tumor was a non-invasive, papillary transitional cell carcinoma, grade II. The lung tumor was located in the right upper lobe and upper lobectomy was performed. The tumor measured 2.8 x 2.7 x 2.0 cm and had a white-yellowish cut surface. Histologic, electron microscopic and immunohistochemical examinations of the lung tumor revealed monoclonal proliferation of plasma cells (IgA, lambda light chain). There was no evidence of multiple myeloma.
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ABSTRACT: Seven patients (mean age, 50.7 +/- 20.4 years; range 21-77) with plasma cell granuloma (PCG) of the lung are reported. Cough and sputum were the most common presenting symptoms, followed by fever. Elevated erythrocyte sedimentation rate and serum C-reactive protein levels were found in all patients tested. Radiologically, five cases presented as solitary, well-circumscribed masses and two as ill-defined, pneumonia-like densities. One showed focal calcification. No predilection of occurrence was observed in either lobe of the lung. Histologically, the lesions consisted of a proliferation of mature plasma cells and reticulo-endothelial cells supported by a stroma of granulation tissue, with varying degrees of myxoid change or collagenization. Angioinvasion within the lesion was observed in 4 of the 7 cases. Immunohistochemical staining revealed the IgG-predominant polyclonal nature of the plasma cells, indicating a reactive inflammatory process rather than a neoplastic one. Electron microscopy confirmed the benign nature of the plasma cells with fibroblast and myofibroblast proliferation admixed with that of other inflammatory cells.
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ABSTRACT: Roentgenographically occult lung cancers (ROLCs) are rare but are usually curable if they are properly diagnosed and treated. Between 1977 and 2000, we treated 51 patients with early hilar lung cancer (as defined by the Japan Lung Cancer Society) of ROLC form. If the occurrence of cancer is confined to segmental bronchi, we preserve the lung tissue as far as possible by using a sleeve segmentectomy. Eight of the 51 patients underwent sleeve segmentectomy. All 8 of these patients were men who were heavy smokers and had a mean age of 64.9 years (range, 59-74 years). The cancerous locations were R-B6 in 4 patients, L-B(1+2+3) in 2 patients, L-B(4+5) in 1 patient, and L-B6 in 1 patient. Two patients had double cancers (synchronous in one case and metachronous in the other). All 8 of the patients had squamous cell carcinoma, 3 of whose lesions were carcinoma in situ. The segments resected were R-S(6) in 3 patients, L-S(1+2+3) in 2 patients, L-S(4+5) in 1 patient, L-S(6) in 1 patient, and R-S6 combined with the middle lobe in 1 patient. There were no cases of morbidity or mortality. However, 1 patient who had undergone a left lower lobectomy for synchronous advanced squamous cell carcinoma 4 months before R-S(6) sleeve segmentectomy for contralateral early hilar lung cancer died of recurrence in the mediastinal lymph nodes 63 months after the first operation. Two patients died of other causes: one of pneumonia 61 months after L-S(4+5) sleeve segmentectomy and the other of myelopathy 36 months after L-S(1+2+3) sleeve segmentectomy. The remaining 5 patients are alive and well 178, 121, 109, 94, and 14 months after surgery. Sleeve segmentectomy is a curative operation for early stage squamous cell carcinoma of the segmental bronchus that preserves pulmonary function and should be used to treat patients carefully selected for the correct indications.
International surgery 87(1):53-9. · 0.36 Impact Factor
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ABSTRACT: Background. Expression of autocrine motility factor receptor (AMFR) associates with increased cell migration and poor survival in certain types of human cancers. We assessed the possible correlation between AMFR, clinicopathologic features, and survival in stage I non–small cell lung cancer (NSCLC).Methods. AMFR expression was analyzed immunohistochemically, using a monoclonal antibody (3F3A) in tumor specimens from 97 patients with curative resection. Vascular endothelial growth factor (VEGF) expression was also examined after accounting for AMFR expression.Results. Out of 97 tumors, 38 (39.2%) were positively stained with AMFR. The AMFR expression was significantly associated with histologic type of tumor, mainly in adenocarcinoma. Overall survival of patients with AMFR-positive tumors was significantly worse than that of AMFR-negative tumors (p = 0.0050). The AMFR expression appears to be associated with VEGF expression. Patients who were AMFR positive and had high VEGF expression had a worse prognosis compared with the AMFR-negative and low VEGF-expression group (p < 0.0001). Multivariate analysis revealed an independent prognostic impact of AMFR on survival (p = 0.0039).Conclusions. These results indicate that evaluation of AMFR expression may provide useful guidance in follow-up of patients with NSCLC.
The Annals of Thoracic Surgery.
