• Journal of Chest Surgery
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• v.36 no.6
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• pp.436-438
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• 2003

Multiple primary lung cancer is classified into a synchronous primary lung cancer or a metachronous primary lung cancer. Both are rarely encountered disease entities. We report our surgical experience of each one case of synchronous and metachronous primary lung cancer.

• Journal of Chest Surgery
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• v.24 no.4
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• pp.376-381
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• 1991

From June 1979 to July 1988 for 9 years, total 440 cases of lung cancer[including biopsy and surgical specimen] of the Pusan Paik hospital were examined for the clinical and pathology study. The findings of the study are as follows; [1] The incidence of lung cancer started to increase from 1982, and it again remarkably increased since 1987. Such increase was solely brought by the increase of male lung cancer. Male and female ratio is 5.6: 1. [2] Histopathologically, the most prevalent type is squamous cell carcinoma[60.ado], and next are adenocarcinoma[15.6%] and small cell carcinoma[15.0%]. But in female alone, the most prevalent type is adenocarcinoma[40.3%], and next are squamous cell carcinoma[37.3%] and small cell carcinoma[11.9%]. [3] The absolute number of adenocarcinoma are approximately equally distributed among both sexes until 60 years of age. Above 61 years of age, mostly male was shown while female was not. Most probably, many female patient.- of that old age simply did not visit general hospitals for surgery in Korea. [4] Surgical treatment was performed in 8% of total cases of lung cancer. And most cases showed stage I progression of the cancer. Average size of the cancer was 5 cm in diameter in the operated 35 cases suggesting that the cancer could be detected more than 10 years ago before the time of surgery. [5] Lung cancer affected more in the right lung [right: left=1.6: 1], and each upper lobe of both lungs are affected about 1/4 of cases indicating that about 1/2 of all lung cancer develop from the upper lobes. [6] There are more nonsmokers[67.6%] among the lung cancer patients[male 64.6%, female 82.1%]. Probably, this will mean that there are other potent carcinogenic agents in our environment like automobile exhaust beside tobacco smoke. For the past history of lung disease other than cancer, tuberculosis is the most prevalent disease[16.1%, male 17.4%, female 9.0%]. Most of them is probably not related etiologically though this possibility is not completely denied.

• Korean journal of aerospace and environmental medicine
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• v.31 no.2
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• pp.57-59
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• 2021

For nonsmall cell lung cancer (NSCLC), surgery is indicated only for stage 3 as a curative measure. Even so, there is a high risk of recurrence following stage 3 lung cancer surgery, a third (33.9%) of patients experienced a cancer recurrence mostly within 2 years after surgery. The median survival time for all stages reaches only 21.9 months. For people undergoing surgery for stage 3A NSCLC, a pre-operative course of (neoadjuvant chemotherapy) can improve survival times, by improving the resectability and lowering the risk of recurrence. Pleural metastases are frequently associated with tumors of the lung and breast. Chest radiographs and computed tomography scans of pleural metastases can present as an effusion or smooth or nodular pleural thickening. In the absence of irregular or nodular pleural thickening, it is difficult to distinguish a benign from a malignant pleural effusion. To treat lung cancer, tyrosine kinase inhibitors (TKIs) recently have been used to cope with genetic mutations, apart from cytotoxic anticancer drugs. Compared to cytotoxic drugs, they are effective, have fewer side effects, and are easy to administer. Airman must have no cancer disease to apply for Class-I medical certification. Specifically, if previously operated on cancer, the cancer should not remain in the body at present, and the disease free state should persist at least one year after all kinds of anti-cancer treatments including adjuvant chemotherapy are completed. Here, this case deals with a 41-year-old pilot who has ATP license who had stage 3A NSCLC. The pilot underwent curative lung cancer surgery (lobectomy) a year ago and showed suspicious pleural metastasis at the time of his application for certification and was still using an unauthorized TKI agent alectinib (Alecensa; Roche, Basel, Switzerland).

• Safety and Health at Work
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• v.12 no.2
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• pp.174-183
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• 2021

Background: Toluene diisocyanate (TDI) is a highly reactive chemical that causes sensitization and has also been associated with increased lung cancer. A risk assessment was conducted based on occupational epidemiologic estimates for several health outcomes. Methods: Exposure and outcome details were extracted from published studies and a NIOSH Health Hazard Evaluation for new onset asthma, pulmonary function measurements, symptom prevalence, and mortality from lung cancer and respiratory disease. Summary exposure-response estimates were calculated taking into account relative precision and possible survivor selection effects. Attributable incidence of sensitization was estimated as were annual proportional losses of pulmonary function. Excess lifetime risks and benchmark doses were calculated. Results: Respiratory outcomes exhibited strong survivor bias. Asthma/sensitization exposure response decreased with increasing facility-average TDI air concentration as did TDI-associated pulmonary impairment. In a mortality cohort where mean employment duration was less than 1 year, survivor bias pre-empted estimation of lung cancer and respiratory disease exposure response. Conclusion: Controlling for survivor bias and assuming a linear dose-response with facility-average TDI concentrations, excess lifetime risks exceeding one per thousand occurred at about 2 ppt TDI for sensitization and respiratory impairment. Under alternate assumptions regarding stationary and cumulative effects, one per thousand excess risks were estimated at TDI concentrations of 10 - 30 ppt. The unexplained reported excess mortality from lung cancer and other lung diseases, if attributable to TDI or associated emissions, could represent a lifetime risk comparable to that of sensitization.

• Korean Journal of Adult Nursing
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• v.28 no.1
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• pp.116-126
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• 2016

Purpose: Lung cancer patients are often stigmatized since lung cancer is closely associated with smoking, which is a self-administered life style. The stigma of lung cancer has been examined in some qualitative studies; however, their findings were diverse and not yet synthesized. Therefore, this meta-synthesis study aimed to explore how lung cancer patients experience stigma. Methods: A meta-synthesis method, as suggested by Sandelowski and Barroso in 2007, was applied by aggregating the findings after an evaluation according to consolidated criteria for reporting qualitative research (COREQ). Results: By synthesizing the findings of the selected seven papers, a synthesized theme was emerged as "experiencing external and internal distances, which mandates authentic and consistent supports." The four sub-themes included 'experiencing some distance from the surrounded world,' 'experiencing self-made distance between the disease and oneself,' 'the disease experience causes social isolation and loneliness,' and 'there is lack of supportive care for myself.' Conclusion: Health care providers should be more attentive to supporting lung cancer patients by providing more effective advocacy programs that improve patients' quality of life.

• Journal of the Korean Society of Radiology
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• v.83 no.5
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• pp.1168-1174
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• 2022

Immunoglobulin G4 (IgG4)-related disease is a rare systemic fibroinflammatory condition characterized by elevated serum IgG4 levels and infiltration of IgG4-positive plasma cells in various organs. IgG4-related lung disease shows varied radiologic features on chest CT. Patients usually present with a solid nodule or mass mimicking lung cancer; therefore, distinguishing between IgG4-related disease and other conditions is often challenging. Additionally, co-existing radiologic findings of IgG4-related lung disease may mimic metastasis or lymphangitic carcinomatosis of the lung. We report two cases of histopathologically confirmed IgG4-related lung disease mimicking lung cancer. Chest CT revealed a solid nodule or mass with ancillary radiologic findings, which suggested lung cancer; therefore, IgG4-related lung disease was radiologically indistinguishable from lung cancer in both cases. Measurement of serum IgG4 levels and clinical evaluation to confirm involvement of various organs may be useful to establish the differential diagnosis. However, surgical biopsy evaluation is needed for confirmation.

• Tuberculosis and Respiratory Diseases
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• v.77 no.6
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• pp.271-273
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• 2014

Disease flare-up after discontinuing epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) has been considered as a critical issue in lung cancer patients who have experienced radiologic progression after showing initial durable response. This is a case of systemic nocardiosis that occurred after chronic steroid use for radionecrosis from stereotactic radiosurgery. It was initially thought as a disease flare-up after stopping EGFR-TKI.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1197-1203
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• 2014

Background: Adenocarcinoma (ADC) is the most common histological type of lung cancer and its proportion is rising, especially in Asian non-smoking women. Recent studies suggest miR-25 may have diverse effects on the pathogenesis of different types of cancer. However, the role of miR-25 in lung cancer is still unknown. The aim of this study was to investigate the potential clinical value of miR-25 in non-smoking women with lung ADC. Patients and Methods: Quantitative RT-PCR was performed to evaluate the expression of miR-25 in 100 lung ADC tumor tissues and matched plasma samples and Pearson correlation tests were used to analyze the relationship between values. Associations of miR-25 expression with clinicopathological features were determined using the Student's t-test. To determine prognostic value, overall survival (OS) was evaluated using the Kaplan-Meier method. Univariate and multivariate analyses were performed using the Cox proportional hazard model. Results: Expression of miR-25 in tissue was found to be associated with lymph node metastasis (P=0.021) and disease stage (P=0.012). Moreover, high miR-25 expression was also associated with poorer overall survival of women with lung ADC (P=0.008). Conclusion: Tissue miR-25 expression may be associated with tumor progression and have prognostic implications in female lung ADC patients.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.175-178
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• 2014

Background: Resection rates of lung cancer are low in general and especially in countries like Nepal. Advanced stage at presentation and poor general condition of the patient are the usual causes. Materials and Methods: In this prospective observational study, one hundred cases of lung cancer who presented at the Thoracic Surgery Unit between October 2011 and October 2012 were included. Results: Those aged in the $6^{th}$ and $7^{th}$ decades together accounted for 72/100 patients. The male to female ratio was 2:1. There was a mean-$29.2{\pm}14.2$ pack yrs smoking history with only five non-smokers. Seventy-six patients presented with locally advanced disease while 21 had metastases. Only three had local disease. The average time between onset of symptoms to first contact with a doctor was $2.3{\pm}5.3$ months (range: 0-35.6 months). Average time between first contact to referral was $50.4{\pm}65.7$ days (range-0-365). Only three patients were resected, one after neo-adjuvant chemotherapy. Advanced disease was the cause of unresectability in 95 cases. One of three patients with local disease had pulmonary functions allowing the warranted resection. $N_2$ disease with $T_{1-3}$ on CT scan was found in 47. Three of these patients underwent mediastinoscopy and all confirmed uninvolved $N_2$. Conclusions: Lung resection rates in our center remain low. Late presentation leading to advanced disease and poor pulmonary reserves preclude resection in most cases. More liberal use of mediastinal staging and better assessment of pulmonary functions may allow us to improve resection rates.

• Tuberculosis and Respiratory Diseases
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• v.86 no.2
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• pp.120-132
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• 2023

Background: To systematically review studies on inhaled corticosteroids (ICS) and lung cancer incidence in chronic airway disease patients. Methods: We conducted electronic bibliographic searches on OVID-MEDLINE, EMBASE, and the Cochrane Database before May 2020 to identify relevant studies. Detailed data on the study population, exposure, and outcome domains were reviewed. Results: Of 4,058 screened publications, 13 eligible studies in adults with chronic obstructive pulmonary disease (COPD) or asthma evaluated lung cancer incidence after ICS exposure. Pooled hazard ratio and odds ratio for developing lung cancer in ICS exposure were 0.81 (95% confidence interval, 0.64 to 1.02; I²=95.7%) from 10 studies and 1.02 (95% confidence interval 0.50 to 2.07; I²=94.7%) from three studies. Meta-regression failed to explain the substantial heterogeneity of pooled estimates. COPD and asthma were variously defined without spirometry in 11 studies. Regarding exposure assessment, three and 10 studies regarded ICS exposure as a time-dependent and fixed variable, respectively. Some studies assessed ICS use for the entire study period, whereas others assessed ICS use for 6 months to 2 years within or before study entry. Smoking was adjusted in four studies, and only four studies introduced 1 to 2 latency years in their main or subgroup analysis. Conclusion: Studies published to date on ICS and lung cancer incidence had heterogeneous study populations, exposures, and outcome assessments, limiting the generation of a pooled conclusion. The beneficial effect of ICS on lung cancer incidence has not yet been established, and understanding the heterogeneities will help future researchers to establish robust evidence on ICS and lung cancer incidence.