primary neoplasms of the lung

... represents one lung cancer case for every 3 million cigarettes smoked. Thus, primary carcinoma of the lung is a major health problem with a generally grim prognosis. Pathology The term lung cancer ... 60,514 cases of invasive lung cancer involving all races and both sexes obtained from the data for 1983–1987 of the S urveillance, Epidemiology, and End Results (SEER) Program of the National ... lung cancer. Four major cell types make up 88% of all primary lung neoplasms according to the World Health Organization classification (Table 85-1). These are squamous or epidermoid carcinoma,...

Ngày tải lên: 07/07/2014, 01:20

... smoking-related, further increases the risk of developing lung cancer. The lung cancer death rate is related to the total amount (often expressed in "cigarette pack-years") of cigarettes ... are clinically localized at the time of presentation may be cured with either surgery or radiotherapy. The beneficial role of chemotherapy in NSCLC is in palliation of symptoms and improving ... smoking. The prevalence of smoking in the United States is 28% for males and 25% for females, age 18 years or older; 38% of high school seniors smoke. The relative risk of developing lung cancer...

Ngày tải lên: 07/07/2014, 01:20

... cancers other than lung cancer, nor in lung cancers that have KRAS mutations. These EGFR mutations, often associated with amplification of the EGFR gene, usually confer sensitivity of these lung ... cases the development of EGFR TKI resistance is associated with the development of another mutation in the EGFR gene (T790M mutation), or amplification of the c-met oncogene. However, other ... syndrome) genes may develop lung cancer. First-degree relatives of lung cancer probands have a two- to threefold excess risk of lung cancer or other cancers, many of which are not smoking-related....

Ngày tải lên: 07/07/2014, 01:20

... inappropriate palliative rather than curative treatment. Often the paraneoplastic syndrome may be relieved with successful treatment of the tumor. In some cases, the pathophysiology of the paraneoplastic ... uncommon (1%), as are the renal manifestations of nephrotic syndrome or glomerulonephritis (≤1%). Chapter 085. Neoplasms of the Lung (Part 5) Clinical Manifestations Lung cancer gives rise ... and 97). Although 5–15% of patients with lung cancer are identified while they are asymptomatic, usually as a result of a routine chest radiograph or through the use of screening CT scans, most...

Ngày tải lên: 07/07/2014, 01:20

... 085. Neoplasms of the Lung (Part 6) Diagnosis and Staging Screening Most patients with lung cancer present with advanced disease, raising the question of whether screening would detect these ... (whether the tumor can be entirely removed by a standard surgical procedure such as a lobectomy or pneumonectomy), which depends on the anatomic stage of the tumor, and operability (whether the ... diagnosis of epithelial malignancy and distinguish small cell from non-small cell lung cancer. Staging Patients with Lung Cancer Lung cancer staging consists of two parts: first, a determination of...

Ngày tải lên: 07/07/2014, 01:20

... metastatic pulmonary tumor nodule(s) in the ipsilateral nonprimary tumor lobe(s) of the lung are classified as M1. Source: Adapted from CF Mountain. Revisions in the International System ... <1 Tumor (T) Status Descriptor T0 No evidence of a primary tumor TX Primary tumor cannot be assessed, or tumor proven by the presence of malignant cells in sputum or bronchial washings ... <2 cm distal to carina but without involvement of carina; or associated atelectasis or obstructive pneumonitis of entire lung for Staging of Lung Cancer. Chest 111:1710, 1997; with permission....

Ngày tải lên: 07/07/2014, 01:20

... Chapter 085. Neoplasms of the Lung (Part 8) Small Cell Lung Cancer A simple two-stage system is used. In this system, limited-stage disease (seen in about 30% of all patients with ... tuberculosis Chest x-ray CT scan of chest and abdomen CT or MRI scan of brain and radionuc lide scan of bone if any finding suggests the presence of tumor metastasis in these organs Fiberoptic bronchoscopy ... examination are used in staging. In part, the definition of limited- stage disease relates to whether the known tumor can be encompassed within a tolerable radiation therapy port. Thus, contralateral...

Ngày tải lên: 07/07/2014, 01:20

... if the patient would otherwise be considered for curative treatment. In SCLC, CT scans are used in the planning of chest radiation treatment and in the assessment of the response to chemotherapy ... Regional lymph node stations for lung cancer staging. (Used by permission from CF Mountain, C Dresler: Chest 111:1718, 1997.) Chapter 085. Neoplasms of the Lung (Part 9) Chest radiographs ... involvement; old radiographs are useful for comparison. CT scans of the thorax and upper abdomen are of use in the preoperative staging of NSCLC to detect mediastinal nodes and pleural extension...

Ngày tải lên: 07/07/2014, 01:20

... N2 disease Stage IB: discussion of risk/benefits of adjuvant CRx; not routinely given Chapter 085. Neoplasms of the Lung (Part 10) Staging of Small Cell Lung Cancer Pretreatment staging ... MRI scan and examination of the cerebrospinal fluid cytology are performed. If malignant cells are detected, radiotherapy to the site of compression and intrathecal chemotherapy (usually with ... within 2 cm of the carina (not curable by surgery but potentially curable by radiotherapy); metastasis to the contralateral lung; bilateral endobronchial tumor (potentially curable by radiotherapy);...

Ngày tải lên: 07/07/2014, 01:20

... regardless of whether the lesion is PET positive or negative, since slow-growing cancers such as BAC can be PET negative. The sample for histologic diagnosis can be obtained either at the time of ... allowing removal of the cancer and conservation of lung parenchyma, even if the bronchial margins are positive for carcinoma in situ. The 5-year overall survival rate for these occult cancers ... rate for these occult cancers is ~60%. Close follow-up of these patients is indicated because of the high incidence of second primary lung cancers (5% per patient per year). One approach to...

Ngày tải lên: 07/07/2014, 01:20

... doses of 60–64 Gy, while palliative thoracic radiation (see below) involves delivery of 30–45 Gy. The major dose-limiting concern is the amount of lung parenchyma and other organs in the thorax ... sometimes progress to pulmonary fibrosis. The risk of radiation pneumonitis is proportional to the radiation dose and the volume of lung in the field. The full clinical syndrome (dyspnea, fever, ... receive no other therapy but are at a high risk of recurrence (~2–3% annually) or developing a second primary lung cancer. Thus, it is reasonable to follow these patients with CT scans for the first...

Ngày tải lên: 07/07/2014, 01:20

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