• Journal of Chest Surgery
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• v.42 no.5
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• pp.662-665
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• 2009

A 65-year-old-male had a mass in the oral cavity, and this was ultimately determined to be squamous cell carcinoma and he underwent wide excision for it. Postoperatively, he underwent the staging work up; this showed that he had other cancers in the esophagus, stomach and lung. We performed a curative resection of all the lesions simultaneously. We report here on a case of synchronous multiple cancers of the esophagus, stomach, lung and oral cavity.

• Journal of Chest Surgery
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• v.27 no.5
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• pp.364-373
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• 1994

Alpha 1-Proteinase inhibitor[PI] was known as a major protective enzyme against to excessive hydrolytic and proteolytic reaction. So, it was suggested that Alpha 1-PI may implicated in growth of bronchogenic cancer. This study was undertaken to investigate the role of Alpha 1-PI in local invasion of bronchogenic cancer. Three groups of patients were studied; Preliminary research group of 15 bronchogenic cancer patients, Main research group of 13 bronchogenic cancer patients and Normal control group of 10 nephrectomy donor. Serum Alpha 1-PI level was observed in each group of patients during pre-and postoperative days. Pre-operative serum Alpha 1-PI level in preliminary research group [329.2$\pm$14.21mg/dl]and main research group[406.2$\pm$39.30mg/dl] were higher than in normal control group[236.2$\pm$19.55mg/dl] significantly[p<0.005]. Serial Alpha 1-PI level in each group during pre-and postoperative days shows peaked at 3rd. postoperative day in preliminary and main research group, thereafter decreased gradually. Immunohistochemical study for Alpha 1-antitrypsin[A1AT] was carried out by ABC[avidin-biotin peroxidase complex] method using Alpha-1 antitrypsin DAKOR to tumor tissues of 13 lung cancer patients in main research group. 6 cases[46.2%, squamous cell ca.;5, adenocarcinoma;1] of above 13 cases show positive immunoreactivity for A1AT. In conclusion, alpha 1-PI and elastase are disclosed that have defined actions for lung cancer growing or spreading.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.385-390
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• 2014

Background: Lung cancer is the most frequent malignancy of men worldwide. In Ninawa in Iraq, lung cancer ranks first among cancers diagnosed in men. Since no prior studies have been conducted on incidence trends in our population the present investigation of rates during 2000-2010 was therefore performed. Materials and Methods: Registy data for lung cancer cases were collected from the Directorate of Health in Ninawa-Mosul Continuing Medical Education Center. We restricted our analyses to men categorized according to the age groups of 0- 39, 40-49, 50-59, 60-69 and 70+ years. The significance of incidence rate trends during 2000-2010 was tested using Poisson regression. Age-standardized rates (ASR), and age-specific rates per 100,000 population were calculated. Results: A total of 1,206 incident lung cancer were registered among males, accounting for 15.5% of all male cancers registered during 2000-2010. It ranked first throughout the period. Median age at diagnosis was 69 (mean $66.8{\pm}11.0$) years. The incidence rate of all male lung cancers in Ninawa (all ages) decreased from 26.4 per 100,000 in 2000 to 12.7 in 2010 (APC=-6.55%, p<.0001). The incidences in age groups 40-49, 50-59, 60-69 and 70+ decreased in earlier years and recently appeared (2007-2010) stable. The incidence in age group (0-39) remained stable between 2000-2010. Squamous cell carcinoma (SCC)was the most common type of lung cancer, while adenocarcinoma was relatively rare. Conclusions: With the data from Directorate of Health in Ninawa during the period 2000-2010, lung cancer is the most common cancer but generally declining. Among all age groups, the recent incidence of lung cancer remained stable. The SCC predominance suggests change in tobacco habits as an important factor in the trends observed.

• Journal of Chest Surgery
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• v.7 no.1
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• pp.31-36
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• 1974

The clinical observations on the bronchogenic cancer of one hundred sixty cases treated in the Department of Thoracic Surgery, Seoul National University Hospital are as follows: 1] Most of them,. 90 percent of the cases were over 40 years of age and male was predominated over female with sex ratio of 6 to 1. 2] The average duration of symptoms before the first examination was about 5 months arid the most common complaints were cough, chest pain, breathing difficulty and blood-tinged sputum. 3] In ninety-four cases[59%] thoracotomy was undertaken with resection of the lesion in 52 cases[33% ]. 4] Histopathological diagnoses made in 141 cases were squamous cell carcinoma in 47.5%, undifferentiated cell carcinoma in 33.3%, adenocarcinoma in 9.2,% and alveolar cell carcinoma in a single case.

• Journal of Chest Surgery
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• v.26 no.5
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• pp.373-379
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• 1993

Primary lung cancer has increased markedly in its incidence and prevalence rate recently in Korea. In frequency, it occupies the second rank cancer preceded by stomach cancer in korean male. From February 1986 to December 1992, we have operated on 55 cases of primary lung cancer in Korea Veterans Hospital and followed them. The results are as follows; 1. The peak incidence of age of primary lung cancer was 6th decade and 5th decade and those were 87.3% of study group, mainly in male. 2. Symptoms were cough [63.6%], dyspnea [41.8%], chest pain and discomfort [38.2%], blood tinged sputum and hemoptysis [21.8%]. Symptoms were frequently encountered before hospitalization and asymptomatic cases were 9.1% of study group. 3. Methods of diagnostic confirmation were bronchoscopic biopsy [52.7%], percutaneous needle aspiration[PCNA][21.8%], sputum cytolgy [12.7%], open biopsy [12.7%]. 4. Histopathologically, squamous cell carcinoma [76.4%] was the most frequent cancer and adenocarcinoma [10.9%], giant cell cancer [7.3%], and the others in order. 5. Methods of operation were pneumonectomy [32.7%], bilobectomy [18.2%], lobectomy [27.3%], lobectomy and segmenectomy [1.8%], exploration [20%], and overall resectability was 80%. 6. Operative mortality was 5.5% [3 cases] and there were 5 cases of complication. 7. Postoperative long-term follow up reveals that the cumulative survival rates in 6 months, 12 months, 26 months, 34 months, 43 months, 64 months were 89.5%, 71.7%, 66.7%, 57.2%, 50.8%, 42.3% respecively.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.536-542
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• 1999

Background: The purpose of this study is to improve the quality of the diagnostic procedures in the preoperative evaluation so as to reduce the unnecessary thoracotomy and to ensure resectability in non-small cell lung cancer. Material and Method: Of 616 patients who underwent thoracotomy for primary lung cancer from January 1990 to December 1996, 59 patients(9.6%) turned out to have inoperable lesions after the thoracotomy. We reprospectively reviewed the bronchoscopic findings, methods of tissue diagnosis, CT scans, pulmonary function test and lung perfusion scan, reasons for nonresectability, and adjuvant therapy, and then followed up on the survival rate after exploratory thoracotomy. Result: The cell types were squamous cell carcinoma in 38, adenocarcinoma in 15, large cell carcinoma in 3 and others in 3. Primary loci were RUL in 20, RML in 6, RLL in 8, LUL in 13, LLL in 4 and others in 8. The reasons for non-resectability were various; direct tumor invaison to mediastinal structures(n=41), seeding on pleural cavity(n=8), poor pulmonary function(n=2), invasions to extranodal mediastinal lymph node(n=2), technical non- resectability due to extensive chest wall invasion (n=3), small cell carcinoma (n=1), malignant lymphoma(n=1), and multiple rib metastases(n=1). In the follow-up of 58 patients, 1-year survival rate was 55.2% and 2-year survival rate was 17.2% and the mean survival time was 14 months. When compared according to cell types or postoperative adjuvant therapeutic modalities, no significant difference in the survival rates were found. The squamous cell carcinoma was frequently accompanied by local extension to contiguous structures and was the main cause of non-resectability. In adenocarcinoma, pleural seeding with malignant effusion was frequently encountered, and was the major reason for non-resectability. Conclusion: These data revealed that if appropriate preoperative diagnostic tools had been available, many unnecessary thoracotomies could have been avoided. Both the use of thoracoscopy in selected cases of adenocarcinoma and the more aggressive surgical approach to the locally advanced tumor could reduce the incidence of unnecessary thoracotomies for non-small cell lung cancers.

• Journal of Chest Surgery
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• v.20 no.3
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• pp.473-482
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• 1987

The records of 65 patients with a confirmed diagnosis of primary lung cancer who underwent surgical therapy at the Department of Thoracic and Cardiovascular Surgery of the Keimyung University Hospital were analyzed during the period of 8 years and 4 months, from August, 1978 to December, 1986. The peak incidence was observed in the 5th decade of life and the mean age was 52.9 years old. Male versus female ratio was 8.3:1 Cough was the most frequent presenting symptom, 76.9% then chest discomfort, hemoptysis and dyspnea followed in order. 44.6% of the patient had 2 months of prediagnostic symptomatic period, 72.3% had 5 months, and the mean was 5.7 months. As for preoperative diagnosis, 62 of total 65 patients revealed the mass lesion on simple chest x-ray, and 56 of 65 patients on bronchoscopic biopsy, 10 of 37 patients on sputum cytology and 15 of 15 patients on computerized tomography of the chest were positive. Of the 65 patients, 35 [53.9%] had squamous cell carcinoma, 18 [27.7%] adenocarcinoma, 3 [4.6%] large cell carcinoma, and 3 [4.6%] small cell carcinoma all which was oat cell carcinoma. 83.1% of the total patient was resectable, and 34 underwent pneumonectomy and 20 lobectomy. Of these 65 operations, 29 was radical resection, 25 palliative, and 11 exploratory thoracotomy. As for clinical stagings, 23 patients were in Stage, I, another 23 in Stage II and 19 in Stage III, while 16 was in stage, I, 14 in stage ll and 35 in stage III in postoperative staging evaluation. In correlation of postoperative TNM classification and radical resection, those patients who had lung cancer of stage I [14/16] and stage II [9/13] had more radical resection. As postoperative complications, one patient had massive bleeding, two empyema, one empyema with bronchopulmonary fistula, and one cardiac herniation. Operative mortality rate was 1.5% [1 patient]. Mean duration between 1st operation and discovering recurrence in 18 patients was 12.7 months.

• Radiation Oncology Journal
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• v.13 no.1
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• pp.19-26
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• 1995

Purpose : Surgery is the treatment of choice for resectable non-small cell lung cancer. For patients who are medically unable to tolerate a surgical resection or who refuse surgery, radiation therapy is an acceptable alternative. A retrospective analysis of Patients with stage I non-samll cell lung cancer treated with curative radiation therapy was performed to determine the results of curative radiation therapy and patterns of failure, and to identify factors that may influence survival. Materials and Methods : From 1986 through 1993, 39 Patients with T2N0M0 non-small cell lung cancer were treated with curative radiation therapy at department of radiation oncology, Kyungpook national university hospital. All Patients were not candidates for surgical resection because of either Patient refusal (16 patients), poor pulmonary function (12 patients), old age (7 patients), Poor Performance (2 patients) or coexisting medical disease (2 patients). Median age of patients was 67 years. Histologic cell type was squamous cell carcinoma in 36, adenocarcinoma in 1, large cell carcinoma in 1 and mucoepidermoid carcinoma in 1. All patients were treated with megavoltage irradiation and radiation dose ranged from 5000cgy to 6150cGy with a median dose of 6000cGy. The median follow-up was 17 months with a range of 4 to 82 months, Survival was measured from the date therapy initiated. Results : The overall survival rate for entire Patients was $40.6\%$ at 2 years and $27.7\%$ at 3 years, with a median survival time of 21 months. The disease-free survival at 2 and 3 years was $51.7\%$ and $25.8\%$, respectively. Of evaluable 20 patients with complete response, 15 patients were considered to have failed. Of these, 13 patients showed local failure and 2 patients failed distantly. Response to treatment (p=0.0001), tumor size (p=0.0019) and age (p=0.0247) were favorably associated with overall survival. Only age was predictive for disease-free survival (p = 0.0452). Conclusion : Radiation therapy is an effective treatment for small (less than 3cm) tumors, and should be offered as an alternative to surgery in elderly or infirm patients. Since local failure is the prominent Patterns of relapse, potential methods to improve local control with radiation therapy are discussed.

• Journal of Chest Surgery
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• v.28 no.6
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• pp.591-595
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• 1995

Recently, primary lung cancer has increased markedly in incidence and prevalence in Korea. From January 1986 to June 1993, 86 patients were operated and evaluated at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. The results are as follows; 1. There were 79 males and 7 females with the peak incidence of 5th and 6th decades of life[75.6% . The age ranged from 13 to 76[mean 56.6$\pm$10.3 years. 2. Symptoms were cough[47.7% , sputum[25.6% , chest pain or dyspnea[18.6% , and hemoptysis or blood tinged sputum[20.9% in order. Symptoms were frequently encountered before hospitalization, but asymtomatic patients were 12.8% in this study. 3. Methods of diagnostic confirmatiom were bronchoscopic biopsy[55.8% , percutaneous needle aspiration[29.1% , suspicious sputum cytology[1.2% , and open biopsy[14.0% . 4. Histopathologically, squamous cell carcinoma[51.2% was the most frequent cell type and adenocarcinoma[26.7% , large cell carcinoma[8.1% , adenosquamous cell carcinoma[3.5% , and the others in order. And TNM stages were Stage I 40.5%, Stage II 15.5%, Stage IIIa 27.4%, and Stage IIIb 3.6%. 5. Methods of operation were pneumonectomy[25.6% , bilobectomy[5.8% , lobectomy[53.4% , segmentectomy[1.2% , and exploration[14.0% . The overall resectability was 86.0% 6. The operative mortality was 2.3% and postoperative complications developed in 7 cases[8.1% . 7. The postoperative follow-up reveals that the overall cumulative survival rates at 1 year, 2 year, 3 year, 4 year, 5 year were 76%, 62%, 43%, 36%, and 27%, respectively.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3851-3854
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• 2013

Objective: To explore changes in the serum tumor makers, hypoxia-inducible factor-$1{\alpha}$ (HIF-$1{\alpha}$) and vascular endothelial growth factor (VEGF) level and their relations in patients with non-small cell lung cancer (NSCLC) before and after intervention. Materials and Methods: Forty patients with NSCLC and 40 healthy individuals undergoing physical examination in our hospital provided the observation and control groups. HIF-$1{\alpha}$ and VEGF levels in serum were detected by enzyme-linked immuno-sorbent assay (ELISA) in the observation group before and after intervention and in control group on the day of physical examination, along with serum carcino-embryonic antigen (CEA), neuron-speci ic enolase (NSE) and squamous cell carcinoma antigen (SCC) levels in the observation group with a fully automatic biochemical analyzer. Clinical effects and improvement of life quality in the observation group were also evaluated. Results: The total effective rate and improvement of life quality after treatment in observation group were 30.0% and 32.5%, respectively. Serum HIF-$1{\alpha}$ and VEGF levels in the control group were lower than that in observation group (p<0.01), but remarkably elevatedafter intervention (p<0.01). In addition, serum CEA, NSE and SCC levels were apparently lowered by treatment (p<0.01). Serum HIF-$1{\alpha}$ demonstrated a positive relation with VEGF level (p<0.01) and was inversely related with CEA, NSE and SCC levels (p<0.01). Conclusions: Significant correlations exist between marked increase of serum HIF-$1{\alpha}$ and VEGF levels and decrease of indexes related to hematological tumor markers in NSCLC patients after intervention.