BACKGROUND AND OBJECTIVEPleuropulmonary blastoma (PPB) is a rare malignant tumor with unique clinicopathological features. The aim of this study is to investigate the clinicopathological features, the diagnosis and differential diagnosis of pleuropulmonary blastoma.

METHODSFive cases of PPB were analyzed by light microscopy, immunohistochemistry and their clinical data, and the relative literatures were reviewed.

RESULTSFive cases of patients suffered from PPB were aged from 21 to 47 months (mean 32.8 months). Most of the masses were located in the thoracic cavities and 4 cases accompanied with pleural effusions. Histologically, these tumors included 1 case of type I PPB which showed pure cystic architecture; 2 cases were type II PPB which showed cystic and solid masses accompanied with rhabdomyoblastic differentiation and nodules of cartilage; the other 2 cases were type III PPB and characterized by absolute solid masses with anaplastic undifferentiated sarcomatous components. Immunohistochemical studies showed that tumor cells were positive for Vimentin and some for Desmin and Myogenin, the nodules of cartilage were positive for S-100. The tumor cells were negative for PCK, EMA and CD99.

CONCLUSIONPleuropulmonary blastoma is a rare and highly aggressive malignancy arising in the lung and pleural of infancy and early childhood. The type I, II and III PPB have unique clinicopathological features respectively. This kind of tumor should be distinguished from some benign and malignant diseases such as congenital cystic adenomatoid malformation (CCAM) and embryonal rhabdomyosarcoma.

Adult ; Female ; Humans ; Lung Neoplasms ; mortality ; pathology ; surgery ; Middle Aged ; Pleural Neoplasms ; mortality ; pathology ; surgery ; Pulmonary Blastoma ; mortality ; pathology ; surgery

BACKGROUNDThere are few reports discussing the surgical pathological characteristics of superficial endobronchial lung cancer (SELC) defined as cancer growth limited to the bronchial wall. Its prognosis and corresponding TNM staging have not been fully clarified. Little is known as to whether T status is impacted by the existence of associated atelectasis or pneumonia (which might be controversial, indicating either T1 or T2), and circumstantial invasion depth.

METHODSBetween 1988 and 2007, 81 out of 8817 surgically treated patients met SELC criteria; there was no detectable invasion beyond the bronchial wall. A retrospective review was performed and follow-up information was collected.

RESULTSThe overall five-year survival rate of 81 patients was 85.6%; for N0M0 (n = 67), N1M0 (n = 7) and N2M0 (n = 7) patients, they were 89.3%, 75.0% and 60.0%, respectively. Intraluminal tumor size measured from 0.4 to 3.0 cm; obstructive atelectasis or pneumonia was noted in 14 patients. The presence of tumor-associated obstructive atelectasis or pneumonia did not have a significant impact upon prognosis (P = 0.96), nor did the greatest diameter of the tumor (P = 0.70). Histology showed carcinoma in situ (level one) in 13 cases; invasion of the submucosal layer (level two) in 12, involvement of the muscular layer (level three) in 20, invasion into the space between the muscular layer and cartilage (level four) in 21, and bronchial cartilage infiltration in 15 (level five). In cases without lymphnode metastases, five-year survival was 100% for the first three levels and 84.0% and 61.3% for the level four and level five.

CONCLUSIONSRelative to TNM-based prognostic data, superficial endobronchial lung cancer exhibits increased five-year survival rates, and therefore should be placed at the forefront among tumors in the T1 class, regardless of tumor size or the presence of secondary obstructive atelectasis or pneumonia. Lymphnode metastasis is associated with a worse prognosis. Survival is negatively impacted by tumor infiltration depth into the bronchial wall.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; mortality ; pathology ; Female ; Humans ; Lung Neoplasms ; mortality ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Pneumonia ; mortality ; pathology ; Prognosis ; Pulmonary Atelectasis ; mortality ; pathology

BACKGROUND: Though the surgical treatment of stage IIIB lung cancer is not generalized due to low complete remission rate high morbidity and mortality there are several reports on the improvement of long term survival after preoperative and postoperative adjuvant therapy. In this study we analyzed the prognostic factors affecting long term survival after surgical treatment of stage IIIB lung cancer MATERIAL AND METHOD: We analyzed the long term survival for age pathology invaded mediastinal organ n stage type of operation complete or incomplete resection and adjuvant therapy through a retrospective review of patients underwent surgical treatment. RESULT: From 1990 to 1998 56 patients(51/male 5/female0 with stage IIIB lung cancer were trated surgically. Forty two patients underwent radical resection and morbidity and mortality were 17% 12% respectively. The survival rate for overall patients and the radical resection group were 9% 12% respectively. In the radical resection group excluding explothoracotomy only(n=14) and the surgical mortality patients(n=5) the age the type of operation celly type resectability and N stage had no influence on the long term survival. The survival rate of radical resection group was significantly better than that of the explothoracotomy only group(p=0.04) The long term survival rate of postoperative combination therapy group was significantly better than chemotherapy or radiotherapy alone(p=0.04) CONCLUSION: Age type after surgical treatment of stage IIIB lung cancer. We conclude that combined modality of adjuvant treatment after radical resection of stage IIIB lung cancer seems to offer better long term survival in selective patients. The numbers of patients involved was small. Nevertheless these preliminary findings indicate questions that will need to be experienced further in larger studies.
Drug Therapy ; Humans ; Lung Neoplasms* ; Lung* ; Mortality ; Neoplasm Staging ; Pathology ; Radiotherapy ; Retrospective Studies ; Survival Rate

BACKGROUND: The purpose of this study is to compare the survival time of non-small cell lung cancer (NSCLC) patients with different organ metastasis. Among all cancers, the morbidity and mortality of lung cancer is the highest worldwide, which may caused by local recurrence and distant metastasis, and the location of metastasis may predict the prognosis of patients. METHODS: A total of 117,542 patients with NSCLC diagnosed between 2010 and 2014 were enrolled from Surveillance, Epidemiology, and End Result (SEER) databases, and the relationship between distant metastasis and survival time was retrospectively analyzed. RESULTS: Of all the 117,542 patients diagnosed with non-small cell lung cancer, 42,071 (35.8%) patients had different degrees of distant metastasis during their medical history, including 26,932 single organ metastases and 15,139 multiple organ metastases, accounting for 64.0% and 36.0% of the metastatic patients respectively. Compared with patients with no metastasis, whose median survival time was 21 months, the median survival time of patients with metastases was 7 months (lung), 6 months (brain), 5 months (bone), 4 months (liver), and 3 months (multiple organ) respectively, and the difference was significant (P<0.001, except liver vs multiple organ P=0.650); Most patients with NSCLC (88.4%) eventually died of lung cancer. CONCLUSIONS Distant metastasis of NSCLC patients indicates poor prognosis. In NSCLC patients with single organ metastasis, the prognosis of lung metastasis is the best, and liver metastasis is the worst, and multiple organ metastasis is worse than single organ metastasis.
Aged ; Aged, 80 and over ; Bone Neoplasms ; mortality ; secondary ; Brain Neoplasms ; mortality ; secondary ; Carcinoma, Non-Small-Cell Lung ; mortality ; pathology ; Female ; Humans ; Liver Neoplasms ; mortality ; secondary ; Lung Neoplasms ; mortality ; pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Retrospective Studies

OBJECTIVETo evaluate the survival rate after pulmonary resection for metastatic colorectal cancer(CRC).

METHODSClinical data of 77 patients with pulmonary metastasis from CRC between January 2005 and October 2008 in the Zhongshan Hospital, Fudan University were retrospectively analyzed.

RESULTSThere were 38 patients with synchronous pulmonary metastasis, of whom 2 underwent resection for pulmonary metastasis. The median survival time of two groups was 25 months and 18 months, which was not significantly different (P=0.33). There were 39 cases of metachronous pulmonary metastasis, of whom 28 received pulmonary metastasis resection. The 1-year and 3-year survival rates of 2 groups were 93.3% and 58.5%, and 38.8% and 19.1%, respectively. The median survival time of two groups was 26.7 months and 8 months, and the difference was statistically significant (P=0.004).

CONCLUSIONSurgical resection can improve the survival rate in patients with pulmonary metastasis from colorectal cancer.

Colorectal Neoplasms ; mortality ; pathology ; surgery ; Female ; Humans ; Lung Neoplasms ; mortality ; secondary ; surgery ; Middle Aged ; Neoplasm Metastasis ; Retrospective Studies ; Treatment Outcome

BACKGROUND: Small cell lung cancer (SCLC) is highly malignant and prone to bone marrow metastasis in early stage, but its related reports are limited. This study analyzed the clinical feature, laboratory examination, treatment and prognosis of SCLC patients with bone marrow metastasis. METHODS: The clinical data of 26 SCLC patients with bone marrow metastasis were analyzed retrospectively. Prognostic factors were evaluated. RESULTS: The median age of 26 patients was 57 years and the median time from diagnosis of SCLC to confirmed bone marrow metastases was 8 d. Most patients (96.2%) were accompanied by other organ metastases. The most common laboratory abnormalities were elevated lactate dehydrogenase in 19 cases (73.1%), thrombocytopenia and elevated alkaline phosphatase respectively in 11 cases (42.3%) and anemia in 7 cases (26.9%). Twenty patients had received chemotherapy and the remaining 6 patients had not. Of this group, 16 patients received at least 2 cycles of chemotherapy after the diagnosis of bone marrow metastasis. The median survival time was 15.7 wk (0.1 wk-82.9 wk) after diagnosis of bone marrow metastasis. The survival of patients with chemotherapy was significantly better than that of those without chemotherapy (χ²=33.768, P<0.001). Multivariate analysis showed that no chemotherapy was independent poor prognostic factors (P<0.05). CONCLUSIONS The SCLC patients with bone marrow metastasis have short survival, whereas chemotherapy can extend the survival of patients.
Aged ; Bone Marrow ; pathology ; Bone Marrow Neoplasms ; mortality ; pathology ; secondary ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; Retrospective Studies ; Small Cell Lung Carcinoma ; pathology

BACKGROUND/AIMS: We made a systematic review and evaluation of endoscopic cryotherapy of endobronchial tumors, investigating safety and efficacy. METHODS: Qualified studies regarding endoscopic cryotherapy of lung tumors were systemically evaluated using available databases according to predefined criteria. RESULTS: In total, 16 publications were included in the final assessment. A narrative synthesis was performed because a formal meta-analysis was not viable due to the lack of controlled studies and study heterogeneity. Overall success rates for significant recanalization of the obstruction were approximately 80%, although they varied, depending on disease status in the patient population. Complications from the procedure developed in 0-11.1% of cases, most of which were minor and controlled by conservative management. Although limited data were available on comprehensive functional assessment, some studies showed that respiratory symptoms, pulmonary function tests, and performance status were significantly improved. CONCLUSIONS: Endoscopic cryotherapy was found to be a safe and useful procedure in the management of endobronchial tumors although its efficacy and appropriate indications have yet to be determined in well-designed controlled studies.
Bronchial Neoplasms/mortality/pathology/*surgery ; *Bronchoscopy/adverse effects ; Cryosurgery/adverse effects/*methods/mortality ; Humans ; Lung Neoplasms/mortality/pathology/*surgery ; Neoplasm Staging ; Risk Assessment ; Treatment Outcome

Mediastinal (N2) lymph node involvement is heterogenous with huge variation in the extent and grouped together under stage IIIA. However, they showed a different survival even in the same stage. We tried to determine the prognostic implication of the multiple station N2 lymph node metastasis in stage IIIA N2 non-small cell lung cancer (NSCLC). The survival of stage IIIA N2 was analyzed according to the number of N2 station and their survival was compared with that of stage IIIB. In stage IIIA N2 NSCLC, multivariate analysis indicated that multiple station N2 was one of the independent prognostic factors for poor survival. The 5-yr survival of multiple station N2 IIIA (20.4%) was lower than that of single station N2 IIIA (33.8%) significantly (p=0.016). but when it was compared with that of stage IIIB (15.5%), there was no difference. Therefore, we suggest that multiple station N2 should be considered similar to stage IIIB disease with regard to predicting survival and accordingly should receive a new position in the TNM staging system.
Adult ; Aged ; Carcinoma, Non-Small-Cell Lung/*mortality/pathology ; Female ; Humans ; Lung Neoplasms/*mortality/pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Survival Rate

BACKGROUND AND OBJECTIVEThe new edition of the TNM staging for lung and pleural tumours has been finished, which put weight on the extent of primary tumor as one of the important prognosises. But little study has performed on the primary tumor extent < or = 2 cm. The aim of this study is to explore the prognosis of patients with tumor extent < or = 2 cm in stage I of non-small cell lung cancer, which helps us to choose the best treatment for these patients.

METHODSRetrospective study on the clinical response and survival time of whom underwent complete surgical resection and diagnosed as T1a of stage I NSCLC from 1998 to 2004 was analyzed. Data was analyzed by SPSS 17.0 software.

RESULTSOverall survival rate was 80.8%. By the study, age (P = 0.241), gender (P = 0.175), history of smoking (P = 0.845), pathologic type ( P =0.265), and systematic mediastinal lymphadenectomy (SML )(P = 0.918) or not, postoperative adjuvant chemotherapy or not ( P = 0.616) and visceral pleural invasion (P = 0.827) were not the prognosises of these patients. Only the tumor differentiation such as poorly differentiated was the important prognosis ( P = 0.01).

CONCLUSIONIn the tumor extent < or = 2 cm of stage I non-small cell lung cancer, the visceral pleural invasion maybe not influence the patients survival. The tumor differentiation is one of the important prognostic factors.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; mortality ; pathology ; Female ; Humans ; Lung Neoplasms ; mortality ; pathology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

OBJECTIVESTo identify predictors of survival following pneumonectomy for non-small cell lung cancer (NSCLC) and provide evidence for the revision of patient selection criteria.

METHODS81 cases of pneumonectomy for NSCLC from January 1990 to May 1996 at our hospital were reviewed retrospectively. There were 65 men (80.2%) and 16 women (19.8%), with a mean age 53.4 +/- 9.4 years (range 20 - 68 years). Predominant histological types included squamous cell carcinoma (54.3%), adenocarcinoma (24.7%), and squamoadenocarcinoma (17.3%). After follow-up for more than 5 years, data were examined using the chi-square test, Kaplan-Meier method, and Cox-mantel test. The possible factors affecting survival were tested with univariate and multivariate analysis.

RESULTSThe 5-year survival of N(0), N(1) and N(2) disease of NSCLC following pneumonectomy was (20.8 +/- 9.9)%, (15.4 +/- 10.0)% and (4.0 +/- 2.8)%, respectively. There was no perioperative death. The operative complications morbidity was 22.2%. Factors adversely affecting survival with univariate analysis included age over 60 years for right pneumonectomy, cardiopulmonary complications, adenocarcinoma, peripheral location, tumor greatest dimension more than 10 cm, chest wall involvement and N(2) disease. Factors adversely affecting survival with multivariate analysis included cardiopulmonary complications, greatest tumor dimension more than 10 cm, chest wall involvement and N(2) disease.

CONCLUSIONSPneumonectomy provides survival benefit with a high operative complications morbidity. Old age (>/= 60 years) for right pneumonectomy, cardiopulmonary complications, adenocarcinoma, and N(2) disease may be negative prognostic factors of long-term survival. Patient selection should be based on cardiopulmonary evaluation and the stage of disease.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; mortality ; pathology ; surgery ; Female ; Humans ; Lung Neoplasms ; mortality ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Staging ; Pneumonectomy ; Prognosis ; Retrospective Studies ; Survival Rate