Chest
Symposium on Lung CancerPatterns of Survival in Lung Cancer
Section snippets
Topographic Studies
For over two decades of teaching medical students, I have used a topographic classification of lung cancer1 (based on the actual location of the tumor in the lung), which correlates the symptoms, signs and radiographic findings. This classification has also proven to be very useful in studying the results of surgery and other therapy. The four divisions of this classification1 are: (1) cancer arising in the main bronchus; (2) cancer arising in the lobar bronchus; (3) cancer arising in the
Pleural Involvement
As noted in Figure 2, the subpleural location of the tumor offers the poorest opportunity for a five-year survival (approximately 8 percent of the cases in our experience1 and 7 percent in the series of Overholt et al10). We have had no patients who survived for five years when there was pleural fluid present with positive cytologic findings and pleural implants. In fact, it is rare for such a patient to survive for more than one year.
Although it is technically possible to strip the parietal
Conclusion
The survival of a patient with pulmonary carcinoma is the result of a complex interplay of factors involving the patient's immunologic status, the growth characteristics of the cancer, and the treatment employed. The location of the primary carcinoma of the lung, its size, the presence of metastasis to lymph nodes and distant metastasis, and the completeness of the resection each have an important bearing on survival. The increased growth potential of the poorly undifferentiated carcinomas
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Cited by (39)
Airway stenting: State of the art
2022, Revue des Maladies RespiratoiresThe modification of T description according to visceral pleural invasion and tumor size from 3.1 cm to 4.0 cm in non-small cell lung cancer: A retrospective analysis based on the SEER database
2021, Lung CancerCitation Excerpt :On the basis of few variables analyzed, we included all 7 variables into multivariable logistic regression model, which revealed that older age (ORs: 1.01, 95 % CI: 1.00−1.01, P = 0.009), female (ORs: 1.25, 95 % CI: 1.08−1.45, p = 0.002), worse differentiation grade (ORs: 1.25, 95 % CI: 1.08−1.45, p = 0.002) and larger TS (ORs: 1.16, 95 % CI: 1.00−1.35, p = 0.048) had higher incidence of VPI (Table 6). Visceral pleural invasion (VPI) was first proposed as an adverse prognostic factor for resected NSCLC in 1977, which demonstrated the significant correlation between VPI and prognosis [6–9]. Shimizu reported that VPI was a poor prognostic factor in NSCLC patient regardless of lymph nodes metastases [10].
Dyspnea management
2020, Revue des Maladies Respiratoires ActualitesThe Art of Rigid Bronchoscopy and Airway Stenting
2018, Clinics in Chest MedicineCitation Excerpt :Classic literature reports obstruction occurring in up to 20% of patients with bronchogenic carcinoma, with up to 40% developing complications over the course of their disease. Brewer’s25 1977 case series of 359 subjects (defined by chest radiograph), reported 20.3% (16.3%–24.9%) having central airways involvement at presentation and a further 49.1% (43.7%–54.3%) having lobar bronchial involvement. A recent review of index computed tomography scans in patients presenting consecutively with a new diagnosis of lung cancer to a UK hospital found that endobronchial disease was reported in 29% (95% CI 24.4–33.5), with a total of 7.6% (95% CI 4.9–10.2) of patients having involvement of a central airway.26
Place and role of the pleura in non-small cell lung cancer dissemination
2014, Revue de Pneumologie CliniqueRe-evaluation of the prognostic value of visceral pleura invasion in Stage IB non-small cell lung cancer using the prospective multicenter ACOSOG Z0030 trial data set
2012, Lung CancerCitation Excerpt :Visceral pleura invasion (VPI) appeared in the mid 1970s as a specific entity in the TNM classification of non-small cell lung cancer (NSCLC) [1].