• Journal of Chest Surgery
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• v.51 no.5
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• pp.312-321
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• 2018

Background: Treatment strategies for octogenarians with lung cancer remain controversial. The purpose of this study was to compare surgical outcomes and survival between octogenarians and younger patients with stage IA and IB lung cancer. Methods: We reviewed the medical records of 34 consecutive octogenarians and 457 younger patients (<70 years) with stage I lung cancer who underwent surgical resection from January 2007 to December 2015. We analyzed the survival and surgical outcomes of the 2 groups according to the lung cancer stage (IA and IB). Results: The only significant differences in the clinicopathological features between the groups were the higher proportion of sublobar resection (56.3% vs. 18.9%) and the smaller number of dissected lymph nodes (LNs) in octogenarians. There was no significant difference in hospital stay (11 days vs. 9 days), pneumonia (5.8% vs 1.9%), or operative mortality (0% vs 0.6%) between the 2 groups. Among patients with stage IA lung cancer, 5-year recurrence-free survival was not significantly different between the octogenarians (n=16) and younger patients (n=318) (86.2% vs. 89.1%, p=0.548). However, 5-year overall survival was significantly lower in octogenarians than in younger patients (79.4% vs. 93.4%, p=0.009). Among patients with stage IB lung cancer, there was no significant difference in 5-year recurrence-free survival (62.1% vs. 73.5%, p=0.55) or overall survival (77.0% vs 85.0%, p=0.75) between octogenarians (n=18) and younger patients (n=139). In multivariable analysis, male sex, the number of dissected LNs, and tumor size were factors related to survival (hazard ratio [HR], 5.795; p=0.017; HR, 0.346, p=0.025; and HR, 1.699; p=0.035, respectively). Conclusion: Surgical outcomes and survival after pulmonary resection for stage I lung cancer were comparable in octogenarians and younger patients. Continued careful selection of octogenarians for pulmonary resection is important to achieve good results.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7825-7829
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• 2014

Objective: To investigate the effect of high expression of XAF1 in vivo or in vitro on lung cancer cell growth and apoptosis. Methods: 1. The A549 human lung cancer cell line was transfected with Ad5/F35 - XAF1, or Ad5/F35 - Null at the same multiplicity of infection (MOI); (hereinafter referred to as transient transfected cell strain); XAF1 gene mRNA and protein expression was detected by reverse transcription polymerase chain reaction (RT-PCR) and Western blotting respectively. 2. Methyl thiazolyl tetrazolium (MTT) and annexin V-FITC/PI double staining were used to detect cell proliferation and apoptosis before and after infection of Ad5/F35 - XAF1 with Western blotting for apoptosis related proteins, caspase 3, caspase - 8 and PARP. 3. After the XAF1 gene was transfected into lung cancer A549 cells by lentiviral vectors, and selected by screening with Blasticidin, reverse transcription polymerase chain reaction (RT-PCR) and Western blotting were applied to detect mRNA and protein expression, to establish a line with a stable high expression of XAF1 (hereinafter referred to as stable expression cell strain). Twenty nude mice were randomly divided into groups A and B, 10 in each group: A549/XAF1 stable expression cell strain was subcutaneously injected in group A, and A549/Ctrl stable cell line stable expression cell strain in group B (control group), to observe transplanted tumor growth in nude mice. Results: The mRNA and protein expression of XAF1 in A549 cells transfected by Ad5/F35 - XAF1 was significantly higher than in the control group. XAF1 mediated by adenovirus vector demonstrated a dose dependent inhibition of lung cancer cell proliferation and induction of apoptosis. This was accompanied by cleavage of caspase -3, -8, -9 and PARP, suggesting activation of intrinsic or extrinsic apoptotic pathways. A cell strain of lung cancer highly expressing XAF1 was established, and this demonstrated delayed tumor growth after transplantation in vivo. Conclusion: Adenovirus mediated XAF1 gene expression could inhibit proliferation and induce apoptosis in lung cancer cells in vitro; highly stable expression of XAF1 could also significantly inhibit the growth of transplanted tumors in nude mouse, with no obvious adverse reactions observed. Therefore, the XAF1 gene could become a new target for lung cancer treatment.

• Journal of Chest Surgery
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• v.26 no.9
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• pp.722-725
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• 1993

Multiple primary lung cancer is a rare disease entity and its clinical characteristics, treatment, and prognosis are poorly described. But the multiple primary lung cancer have a more favorable prognosis than locally recurrent or metastastic disease. Therefore, appropriate identification of multiple primary lung cancer will be very important. We have experienced a case of stage I multiple primary lung cancer in a 76-year-old male with two large mass in the right lower lobe without metastasis in the mediastinal lymph nodes with right mid and lower lobectomy. The microscopic pictures revealed adenocarcinoma in the one & small cell carcinoma in another. The post-operative courses were in uneventful for 4 months & but he was treated with chemotherapies, 2 times for complete remission of small cell carcinoma to now after discharge.

• Journal of Chest Surgery
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• v.27 no.3
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• pp.238-240
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• 1994

We performed post-operative hemodynamic evaluation and lung perfusion scan after left lung transplantation in dog. The heart & lungs were extracted from donor dog while the both lungs were flushed with 4oC Euro-Collin`s solution after heparinization & infusion of prostaglandin E1.In the recipient dog, anastomosis of the left atrial cuff was performed by continuous 4-0 Prolene everted suture, and bronchial anastomosis by telescope method with 4-0 Prolene continuous suture. The end-to-end anastomosis of left main pulmonary arteries was performed with continuous 6-0 Prolene suture. After closure of left thoracotomy incision, the lung perfusion scan was performed post operative 2 days for evaluation of the function of the transplanted lung which showed good perfusion. The dog was sacrificed in the post-operative 5 days for autopsy.

• Journal of Chest Surgery
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• v.55 no.4
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• pp.338-356
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• 2022

Lung transplantation (LT) is now considered as an effective treatment option for end-stage lung diseases that improves the short and long-term survival rates and quality of life. As increasingly many LT procedures are being performed, the medical complications of LT are also increasing in frequency and emerging as a very important issue for transplant clinicians. Although chronic lung allograft dysfunction and infection are major causes of death after LT, many medical complications, several of which result from immunosuppressive treatment, contribute to increased mortality and morbidity. This article reviews the most frequent and important medical complications of LT, accompanied by a review of the literature and studies from South Korea, including lung allograft rejection, infection, and non-allograft organ systemic complications.

• Journal of Chest Surgery
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• v.43 no.2
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• pp.228-231
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• 2010

An 80 year-old male with a medical history of angiosarcoma of the scalp visited the Emergency Department complaining of dyspnea, and the chest X-ray revealed pneumothorax. He has undergone scalp resection and radiotherapy three years ago due to angiosarcoma. Due to a persistent air leak, he underwent wedge resection of the lung and was pathologically diagnosed with metastatic angiosarcoma to the lung. He underwent radiotherapy following the lung resection, but he died from his disease at 15 month following surgery due to further aggravation of the lung metastasis. Angiosarcoma is a highly malignant tumor and it frequently occurs on the scalp and face in elderly patients. Angiosarcoma frequently metastasizes to the lung and it may cause pneumothorax as a consequence of a ruptured cavitary lesion. We report here on a case of pneumothorax that was caused by lung metastasis in an elderly patient with a history of angiosarcoma of the scalp.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.73-80
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• 1990

A total of 129 patients with a confirmed diagnosis of primary lung cancer were treated at Dep. of Thoracic k Cardiovascular Surgery, National Medical Center, Seoul, Korea, between July, 1981 and Dec., 1988. Particular emphasis was given in this review to the 72 patients that underwent surgical resection of their primary lung lesion. Factors such as histology, type of resection, sex, age, staging, and degree of dissemination were considered possible influences on survival. The age group of fifty k sixty decade occupied 55.8 %, and the youngest being 24 years and oldest 78 years. The incidence ratio of male to female was 3,2:1. The subjective symptoms of the patients were coughing [72.6%], chest pain [48.2%] and hemoptysis [35.6%], which were due to primary local influence. The confirmed diagnostic procedures were bronchoscopic biopsy, sputum cytology needle aspiration biopsy, open lung biopsy, anterior mediastinotomy & lymph node biopsy. By pathologic classifications, the squamous cell carcinoma was the most prevalent, 67 cases [51.9 %], and the adenocarcinoma in 36 cases [27.9%], undifferentiated small cell carcinoma in 13 cases [10.1 %], undifferentiated large cell carcinoma in 9 cases [6.9%], bronchioloalveolar carcinoma was 4 cases [3.1%]. The lymph node dissection with pneumonectomy [42 cases], lobectomy [14 cases] and pneumonectomy [6 cases], lobectomy [9 cases] without lymph node dissection were performed. The post operative TNM Staging[AJC] in 72 cases were Stage I in 24 cases, Stage II in 27 cases, and Stage III in 21 cases. Overall resectable was possible in 72 cases [55.8 %], and the operation mortality was 5.6 % [4 cases].

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3143-3147
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• 2012

Background: Previous studies investigating the association of physical activity with risk of lung cancer reported conflicting results. In order to update and improve available evidence on any link, a meta-analysis was performed. Method: We searched the PubMed database for prospective cohort studies investigating the relation of physical activity with risk of lung cancer. The pooled relative risk (RR) with its 95% confidence intervals (95%CI) was used to assess the association. Results: We included 14 prospective studies with a total of 1,644,305 participants, with 14,074 incident lung cancer cases documented during follow-up. Meta-analysis of all 14 studies suggested both high and medium levels of physical activity to be associated with decreased risk of lung cancer compared to the reference group with low level of physical activity (for high level, RR = 0.77, 95%CI 0.73-0.81, P < 0.001; for medium level, RR = 0.87, 95%CI 0.83-0.90, P < 0.001). Subgroup analyses by gender found obvious associations in both men and women. No publication bias was observed. Conclusion: Our findings suggest that high and medium levels of physical activity have a beneficial effect on lung cancer by reducing the overall risk of tumour development among both men and women.

• Journal of Chest Surgery
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• v.48 no.5
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• pp.335-344
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• 2015

Background: A raised carcinoembryonic antigen (CEA) may be associated with significant pathology during the postoperative follow-up of lung adenocarcinoma. Methods: We reviewed the medical records of 305 patients who underwent surgical resections for primary lung adenocarcinoma at a single institution between April 2006 and February 2013. Results: Preoperative CEA levels were significantly associated with age, smoking history, pathologic stage including pT (pathologic tumor stge), pN (pathologic nodal stage) and overall pathological stage, tumor size and differentiation, pathologically positive total lymph node, N1 and N2 lymph node, N2 nodal station (0/1/2=1.83/2.94/7.21 ng/mL, p=0.019), and 5-year disease-free survival (0.591 in group with normal preoperative CEA levels vs. 0.40 in group with high preoperative CEA levels, p=0.001). Preoperative CEA levels were significantly higher than postoperative CEA levels (p<0.001, Wilcoxon signed-rank test). Postoperative CEA level was also significantly associated with disease-free survival (p<0.001). A follow-up serum CEA value of >2.57 ng/mL was found to be the appropriate cutoff value for the prediction of cancer recurrence with sensitivity and specificity of 71.4% and 72.3%, respectively. Twenty percent of patients who had recurrence of disease had a CEA level elevated above this cutoff value prior to radiographic evidence of recurrence. Postoperative CEA, pathologic stage, differentiation, vascular invasion, and neoadjuvant therapy were identified as independent predictors of 5-year disease-free survival in a multivariate analysis. Conclusion: The follow-up CEA level can be a useful tool for detecting early recurrence undetected by postoperative imaging studies. The perioperative follow-up CEA levels may be helpful for providing personalized evaluation of lung adenocarcinoma.

• Journal of Chest Surgery
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• v.50 no.2
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• pp.126-129
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• 2017

The identification of circulating tumor cells (CTCs) is clinically important for diagnosing cancer. We have previously developed a size-based filtration platform followed by epithelial cell adhesion molecule immunofluorescence staining for detecting CTCs. To characterize CTCs independently of cell surface protein expression, we incorporated a chromosomal fluorescence in situ hybridization (FISH) assay to detect abnormal copy numbers of chromosomes in cells collected from peripheral blood samples by the size-based filtration platform. Aneuploid cells were detected in the peripheral blood of patients with lung cancer. Unexpectedly, aneuploid cells were also detected in the control group, which consisted of peripheral blood samples from patients with benign lung diseases, such as empyema necessitatis and non-tuberculous mycobacterial lung disease. These findings suggest that chromosomal abnormalities are observed not only in tumor cells, but also in benign infectious diseases. Thus, our findings present new considerations and bring into light the possibility of false positives when using FISH for cancer diagnosis.