• Title/Summary/Keyword: Lung surgery

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Robotic Surgery for Lung Cancer

  • Ambrogi, Marcello C.;Fanucchi, Olivia;Melfi, Franco;Mussi, Alfredo
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.201-210
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    • 2014
  • During the last decade the role of minimally invasive surgery has been increased, especially with the introduction of the robotic system in the surgical field. The most important advantages of robotic system are represented by the wristed instrumentation and the depth perception, which can overcome the limitation of traditional thoracoscopy. However, some data still exist in literature with regard to robotic lobectomy. The majority of papers are focused on its safety and feasibility, but further studies with long follow-ups are necessary in order to assess the oncologic outcomes. We reviewed the literature on robotic lobectomy, with the main aim to better define the role of robotic system in the clinical practice.

A Case of Finger Tip Metastasis in Patient with Double Primary Cancer of Lung and Lower Lip (폐와 입술의 이중 원발암을 가진 환자에서 손가락 끝으로의 전이 1례)

  • Ahn, Gun Hyung;Song, Jin Kyung;Ju, Hong Sil;Lim, Seong Yoon
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.2
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    • pp.69-72
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    • 2016
  • Lung cancer is one of high mortality malignancy. It is known that skin metastasis from lung cancer is uncommon. We report a very rare case of finger tip metastasis from double primary cancer of the lung and lower lip. A 79 year-old man diagnosed with non small cell lung cancer presented with protruding solid mass in his lower lip. It showed central necrosis with purulent discharge. It had appeared rapidly growing features. Simultaneously, another solid mass accompanying painful swelling without skin lesion was found in his left middle finger tip. Both two solid masses were moderately differentiated squamous cell carcinomas. Lower lip mass was a primary cancer, while middle finger tip mass was diagnosed with clinically metastatic cancer from lung or lower lip, which means that it had double primary cancer origin.

Clinical Outcomes after Upfront Surgery in Clinical Stage I-IIA Small Cell Lung Cancer

  • Hyeok Sang, Woo;Jae Won, Song;Samina, Park;In Kyu, Park;Chang Hyun, Kang;Young Tae, Kim
    • Journal of Chest Surgery
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    • v.55 no.6
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    • pp.470-477
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    • 2022
  • Background: Upfront surgery followed by systemic treatment is recommended to treat clinical stage I-IIA small cell lung cancer (SCLC), but data on the clinical outcomes are sparse. Thus, this study evaluated the stage migration and long-term prognosis of surgically treated clinical stage I-IIA SCLC. Methods: We retrospectively reviewed 49 patients with clinical stage I-IIA SCLC who underwent upfront surgery between 2000 and 2020. Additionally, we re-evaluated the TNM (tumor-node-metastasis) staging according to the eighth edition of the American Joint Committee on Cancer staging system for lung cancer. Results: The clinical stages of SCLC were cIA in 75.5%, cIB in 18.4%, and cIIA in 6.1% of patients. A preoperative histologic diagnosis was made in 65.3% of patients. Lobectomy and systematic lymph node dissection were performed in 77.6% and 83.7% of patients, respectively. The pathological stages were pI in 67.3%, pII in 24.5%, pIII in 4.1%, and pIV in 4.1% of patients. The concordance rate between clinical and pathological stages was 44.9%, and the upstaging rate was 49.0%. The 5-year overall survival (OS) rate was 67.8%. No significant difference in OS was found between stages pI and pII. However, the OS for stages pIII/IV was significantly worse than for stages pI/II (p<0.001). Conclusion: In clinical stage I-IIA SCLC, approximately half of the patients were pathologically upstaged, and OS was favorable after upfront surgery, particularly in pI/II patients. The poor prognosis of pIII/IV patients indicates the necessity of intensive preoperative pathologic mediastinal staging.

Diaphragm Translocation as Surgical Treatment for Agenesis of the Right Lung and Secondary Tracheal Compression

  • Kim, Dong Hee;Choi, Se Hoon
    • Journal of Chest Surgery
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    • v.49 no.1
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    • pp.59-62
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    • 2016
  • A 12-month-old boy was diagnosed with agenesis of the right lung. Mediastinal deviation progressed to the diseased side as the patient matured; therefore, tracheal distortion developed. As a result, tracheal compression developed between the vertebral body and aorta. The patient was repeatedly admitted to the hospital because of recurrent pulmonary infection and combined severe respiratory distress. Diaphragm translocation was performed to treat the patient. The postoperative course was favorable, and computed tomography scan findings and symptoms had improved at 1 year after surgery.

Multiple Cavernous Hemangiomas of the Posterior Mediastinum, Lung, and Liver: A Case Report

  • Lee, Jang Hoon;Lee, Young Uk;Kang, Hee Joon
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.547-550
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    • 2021
  • A 71-year-old male patient visited Yeungnam University Hospital with abnormal chest computed tomography (CT) findings. Chest CT revealed multiple lung nodules and a posterior mediastinal tumor, the diagnosis of which was confirmed surgically. Magnetic resonance imaging (MRI) of the abdomen showed multiple small nodules, which were diagnosed as cavernous hemangioma in the liver based on the pathology results of the mediastinal and lung masses in combination with MRI findings. Cavernous hemangiomas are benign tumors that can occur throughout the body, mainly in the skin and subcutaneous tissue. The liver is the most common internal organ containing hemangiomas, whereas they are very rarely found in the lungs or mediastinum.

Mitochondrial Genome Microsatellite Instability and Copy Number Alteration in Lung Carcinomas

  • Dai, Ji-Gang;Zhang, Zai-Yong;Liu, Quan-Xing;Min, Jia-Xin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2393-2399
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    • 2013
  • Objective: Mitochondrial DNA (mtDNA) is considered a hotspot of mutations in various tumors. However, the relationship between microsatellite instability (MSI) and mtDNA copy number alterations in lung cancer has yet to be fully clarifieds. In the current study, we investigated the copy number and MSI of mitochondrial genome in lung carcinomas, as well as their significance for cancer development. Methods: The copy number and MSI of mtDNA in 37 matched lung carcinoma/adjacent histological normal lung tissue samples were examined by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) assays for sequence variation, followed by sequence analysis and fluorogenic 5'-nuclease real-time PCR. Student's t test and linear regression analyses were employed to analyze the association between mtDNA copy number alterations and mitochondrial MSI (mtMSI). Results: The mean copy number of mtDNA in lung carcinoma tissue samples was significantly lower than that of the adjacent histologically normal lung tissue samples (p<0.001). mtMSI was detected in 32.4% (12/37) of lung carcinoma samples. The average copy number of mtDNA in lung carcinoma samples containing mtMSI was significantly lower than that in the other lung carcinoma samples (P<0.05). Conclusions: Results suggest that mtMSI may be an early and important event in the progression of lung carcinogenesis, particularly in association with variation in mtDNA copy number.

Expression of MAGE A 1-6 and SSX 1-9 Genes in the Sputum and Cancer Tissue of the Lung Cancer Patients (폐암환자의 객담 및 암 조직에서 MAGE A 1-6와 SSX 1-9 유전자의 발현)

  • Lee, Yeun-Jae;Lee, Jang-Hoon;Lee, Jung-Cheul;Lee, Kwan-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.4
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    • pp.315-322
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    • 2011
  • Background: A variety of diagnostic modalities for lung cancer have been developed. To achieve efficient and early detection of lung cancer, we tried to measure the expression rates of the melanoma associated gene (MAGE) and synovial sarcoma on X chromosome (SSX) genes. Methods: We designed primers for the SSX gene. In addition to the pre-developed MAGE A primer, using an SSX gene primer was attempted to increase the detection rate. We obtained cancer tissues and cancer-free lung tissues from resected lung, sputum from lung cancer patients who had not undergone surgery, and sputum from healthy people and patients with benign intrathoracic diseases. Results: The sensitivity of the MAGE or SSX gene RT-PCR to identifying cancer tissue of the 69 lung cancer patients was 95.2% for squamous cell carcinoma (scc), 87.0% for adenocarcinoma, and 100% for small cell carcinoma. The mean sensitivity value was 94.2% (p=0.001). For adenocarcinoma, the additional use of the SSX gene resulted in a higher expression rate than MAGE alone (87% vs. 69.6%). The expression rate for the cancer-free lung tissue was 14.3% in scc, 17.4% in adenocarcinoma, and 25.0% in small cell carcinoma. In the induced sputum of 49 lung cancer patients who had not undergone surgery, the expression rate for one of the two genes was 65.5%. The expression rate for the sputum of healthy people and benign intrathoracic diseases by MAGE or SSX gene reverse transcription polymerase chain reaction (RT-PCR) was 3.8% and 17.7%. Conclusion: Detecting lung cancer using the expression of MAGE and SSX genes in lung cancer tissue has high sensitivity.

Relationships between EGFR Mutation Status of Lung Cancer and Preoperative Factors - Are they Predictive?

  • Usuda, Katsuo;Sagawa, Motoyasu;Motono, Nozomu;Ueno, Masakatsu;Tanaka, Makoto;Machida, Yuichiro;Matoba, Munetaka;Taniguchi, Mitsuru;Tonami, Hisao;Ueda, Yoshimichi;Sakuma, Tsutomu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.657-662
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    • 2014
  • Background: The epidermal growth factor receptor (EGFR) mutation status of lung cancer is important because it means that EGFR-tyrosine kinase inhibitor treatment is indicated. The purpose of this prospective study is to determine whether EGFR mutation status could be identified with reference to preoperative factors. Materials and Methods: One hundred-forty eight patients with lung cancer (111 adenocarcinomas, 25 squamous cell carcinomas and 12 other cell types) were enrolled in this study. The EGFR mutation status of each lung cancer was analyzed postoperatively. Results: There were 58 patients with mutant EGFR lung cancers (mutant LC) and 90 patients with wild-type EGFR lung cancers (wild-type LC). There were significant differences in gender, smoking status, maximum tumor diameter in chest CT, type of tumor shadow, clinical stage between mutant LC and wild-type LC. EGFR mutations were detected only in adenocarcinomas. Maximum standardized uptake value (SUVmax:$3.66{\pm}4.53$) in positron emission tomography-computed tomography of mutant LC was significantly lower than that ($8.26{\pm}6.11$) of wild-type LC (p<0.0001). Concerning type of tumor shadow, the percentage of mutant LC was 85.7% (6/7) in lung cancers with pure ground glass opacity (GGO), 65.3%(32/49) in lung cancers with mixed GGO and 21.7%(20/92) in lung cancers with solid shadow (p<0.0001). For the results of discriminant analysis, type of tumor shadow (p=0.00036) was most significantly associated with mutant EGFR. Tumor histology (p=0.0028), smoking status (p=0.0051) and maximum diameter of tumor shadow in chest CT (p=0.047) were also significantly associated with mutant EGFR. The accuracy for evaluating EGFR mutation status by discriminant analysis was 77.0% (114/148). Conclusions: Mutant EGFR is significantly associated with lung cancer with pure or mixed GGO, adenocarcinoma, never-smoker, smaller tumor diameter in chest CT. Preoperatively, EGFR mutation status can be identified correctly in about 77 % of lung cancers.

Lentivirus-mediated shRNA Interference Targeting SLUG Inhibits Lung Cancer Growth and Metastasis

  • Wang, Yao-Peng;Wang, Ming-Zhao;Luo, Yi-Ren;Shen, Yi;Wei, Zhao-Xia
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.4947-4951
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    • 2012
  • Objective: Lung cancer is a deadly cancer, whose kills more people worldwide than any other malignancy. SLUG (SNAI2, Snail2) is involved in the epithelial mesenchymal transition in physiological and in pathological contexts and is implicated in the development and progression of lung cancer. Methods: We constructed a lentivirus vector with SLUG shRNA (LV-shSLUG). LV-shSLUG and a control lentivirus were infected into the non-small cell lung cancer cell A549 and real-time PCR, Western blot and IHC were applied to assess expression of the SLUG gene. Cell proliferation and migration were detected using MTT and clony formation methods. Results: Real-time PCR, Western Blot and IHC results confirmed down-regulation of SLUG expression by its shRNA by about 80%~90% at both the mRNA and protein levels. Knockdown of SLUG significantly suppressed lung cancer cell proliferation. Furthermore, knockdown of SLUG significantly inhibited lung cancer cell invasion and metastasis. Finally, knockdown of SLUG induced the down-regulation of Bcl-2 and up-regulation of E-cadherin. Conclusion: These results indicate that SLUG is a newly identified gene associated with lung cancer growth and metastasis. SLUG may serve as a new therapeutic target for the treatment of lung cancer in the future.

Surgical Lung Biopsy for Diffuse Infiltrative Lung Disease (미만성 침윤성 폐질환의 외과적 폐생검)

  • Lee, Jang-Hoon;Kwon, Jin-Tae;Lee, Jung-Cheul
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.844-849
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    • 2006
  • Background: The diffuse infiltrative lung disease requires surgical lung biopsy for its final diagnosis. We evaluated the effect of surgical lung biopsy for final diagnosis of duffuse interstitial lung disease and compared video assisted thoracoscopic lung biopsy(TLB) with open lung biopsy(OLB). Material and Method: We evaluated the patients who underwent surgical lung biopsy from March 2000 from December 2005, retrospectively, We divide to two groups(OLB and TLB group) and compared them. Result: There were 36 patients and cough was the most common pre- operative symptom. Surgery time, anesthetic time, hospital stay, duration of chest tube indwelling, specimen volume and the rate of post-operative complication were not significantly different between two groups. Histologic diagnosis was confirmed in all cases. There was one post-operative death who had suffered from respiratory failure since pre-operative period. Conclusion: Surgical lung biopsy is effective method in final diagnosis for diffuse infiltrative lung disease. Video assisted thoracoscopic lung biopsy is lesser invasive method than open lung biopsy and provide similar results, so it is basic diagnostic method of surgical lung biopsy.