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Povzetek: Background. The aim of the study was to establish eventual progress in routine management of lung cancer patients over a ten-year period at University Clinic for Respiratory and Allergic Diseases Golnik, Slovenia, comparing the results of analysis of 345 patients, diagnosed in 1996 (with analysis performed in 2002), and 405 patients, diagnosed in 2006 (with analysis performed in 2008).Patients and methods. The patients of both analysed groups were of comparable age and number of patients in stage I and II, but there were relatively more females, patients with better performance status, more precise clinical staging and tumour histology in the 2006 group. The parameters used for assessing the progress of management were as follows: time period from admittance to diagnosis and to surgery; precision of staging; accordance of clinical and pathological staging in resected patients; percentage of exploratory thoracotomy; and use of new treatment modalities. The proportion of patients in selected/actual primary treatment modality and survival rate could also be used for assessing the progress. Results. Althoughunessential longer time from admittance to microscopic confirmed diagnosis increased from a mean 7.4 to 8.6 days in 2006 progress was established by the following: more precise clinical staging (stage I and II also A and B stage, TNM staging also in small-cell lung cancer patients); improved accordance with clinical and pathological staging in resected patients (46% against 58%); decreased percentage of exploratory thoracotomy (13% against 4%); increased use of multimodality therapy as primary treatment modality (radiotherapy/chemotherapy, neoadjuvant chemotherapy); newly performed radio frequency tumour ablation. The proportion in selected/actual surgery increased from 76% to 93% and median survival rate of all patients from 6.2 to 10.6 months. (Abstract truncated at 2000 characters)
Objavljeno v DiRROS: 08.03.2024; Ogledov: 138; Prenosov: 35
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Povzetek: Background. In a patient with suspicious synchronous multiple tumours, there are limited possibilities for effective therapy. Therefore, the decision for invasive diagnostics and precise staging of tumours is questionable, especially in elderly patients suitable only for symptomatic therapy. Case report. A 78-year-old man with hypertension and angina pectoris was admitted to the hospital due to syncope. Two primary lung tumours and a kidney tumour were detected by imaging investigation. The patient refused invasive diagnostics and left the hospital. After 19 months he was readmitted in an impaired clinical condition and subsequently died of bronchopneumonia. The autopsy revealed squamous cell carcinoma of the right upper lobe with metastases to regional lymph nodes and to the brain, small-cell carcinoma of the left upper lobe with metastases to regional lymph nodes and to the spleen,and clear-cell kidney carcinoma with multiple metastases to the lungs. All tumours were necrotizing, and therefore we assumed that any attempt at specific therapy would have been ineffective. Conclusions. In an elderly patient with advanced lung tumors and suspicious synchronous triple cancers, the "wait and see" option can be suitable.
Objavljeno v DiRROS: 22.02.2024; Ogledov: 204; Prenosov: 41
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