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Povzetek: Background. Currently primary treatment options for esophageal cancer are surgery only or concomitant chemoradiotherapy (CRT) and the long-term survivalof patients with locally advanced disease is rare. Preoperative concomitant CRT seems to be beneficial, mostly in patients who achieve a complete pathologic response (pCR) after CRT. In this retrospective analysis the efficiency and toxicity of preoperative CRT in patients with locally advanced esophageal cancer was analysed as well as the influence of pCR on thesuraival. Patients and metkods From 1996 to 2002 41 patients with locoregionally confined esophageal cancerwere treated with cisplatin 75 mgžm2 and 5-FU 1000 mgžm2 as 4 day contonuous infusion starting on days 1. and 22. with concorrtitant radiotherapy 4500 cGy, 200-300 cGyžday. Esophagectomy followed 4-5 weeks after radiotherapy. After the surgery patients were followed-up regularly at 3-6 months intervals. Results. The pCR was achieved in 26.8% of patients. The overall median survival time was 18 months for all patients, 21.2 months for patients who achieved pCR and 16 months in those with residual disease (p= 0,79). Postoperative mortality rate was 22%. The median dose intensity for cisplatin was 92% and for 5-FU 71.5 of the planned dose. Disease recurred most often locoregionally (31.7%) and the overall recurrence rate was 43.9. Conclusion. Modern radiation techniques and the adequate dose intensity could further improve the locoregional control. The selection of patients without comorbid conditions and without already present distant metastases is essential for this combined treatment approach.
Objavljeno v DiRROS: 15.02.2024; Ogledov: 696; Prenosov: 164
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Povzetek: Background. The aim of the study was to establish characteristics of lung cancer patients diagnosed at the University Clinic of Respiratory and AllergicDiseases Golnik in 1996, their selected and realized therapy, and survival. Methods. The retrospective study comprises 345 patients aged from 37to 90 years (mean 65), 285 males and 60 females. Performance status (Karnofsky): > 80 in 171 patients, 60-80 in 130 and < 60 in 44 patients. Mirroscopically confirmed tumour in 97%: by bronchoscopy 281, transthoracic needle biopsy 23, peripheral lymph nodes biopsy 12, sputum cytology 7, pleural(effusion) cytology 4, distant metastases biopsy 2, mediastinoscopy 1, autopsy 4 patients. Histology and/or cytology: squamous 131, adenocarcinoma 86, large cell 63, small cell 51, non-small cell 1, unclassified 2. Clinical staging of non-small cell lung cancer (NSCLC): stage I 63, stage ll 32, stage IIIA 48, stage IIIB 59, stage IV 77, undeterminable 2 patients. Staging in small cell lung cancer (SCLC): limited disease 24, extended disease 27 patients. Results. The selected primary oncological therapy was changed in 11%. Realized primary therapy: radiotherapy 102 (30%), surgery 77 (23%), chemotherapy 47 (14%), supportive treatment 111 (33%). In resected patients staging was correct in 46%, underestimated in 44%, overestimated in 10%. The overall five-year survival was 7.8% (median 6.2 months) and the five year survival of resected patients was 41.9% (median 33 months). The median survival of irradiated patients was 5.7 months, of supportively treated patients 2.5 months. The survival was significantly different according to theperformance status and stage. (Abstract truncated at 2000 characters)
Objavljeno v DiRROS: 14.02.2024; Ogledov: 738; Prenosov: 170
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Objavljeno v DiRROS: 11.01.2024; Ogledov: 757; Prenosov: 204
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Povzetek: Background. Overall bad progmpsis of lung is mostly due to too late detection of early lung cancer, which may be teated with good success. Therefore different diagnostic methods are developing for more efficient detection of early lung cancer: besides modern radiological, bronchoscopic methods with additional fluorescence techniques, quantitative cytological investigations, also histological and molecular investigations are included. History may reveal early preinvasive lung xcancer lesions, associated early during multistep lung carcinogemesis with molecular genetic changes. Patients and methods. Preinvasive epithelial lung cancer lesions we searched in two groups of patients. In the first group of 316 patients from the period March 2003 - August 2006, 498 bronchial and transbronchial biopsies were examined for squamous metaplasia and dysplasia, carcinoma in situ, and invasive tumours. Inthe second group of 238 patients from the period January 2004 - August 2006,resected primary lung tumours were analysed for preinvasive neuroendocrine tumours and atypical adenomatous hyperplasia. Resuots. The mostfrequent changes in bronchial and transbronchial biopsies were squamous metaplasia (46.5%), simple or goblet cell hyperplasia of the bronchial epithelium (44.3%), malignant tumours (20.66%) and squamous dysplasia (16.1%),but rare carcinoma in situ (0.63%). Diffuse idiopoathic pulmonary neuroendocrine cell hyperplasia was found in 15 (6.3%) cases in the vicinity of 238 resected lung cancer specimens, carcinoid in12 patients (5%), and mostly combined large neuroendocrine cancer in 21 patients (8.8%). Atypical denomatous hyperplasia was found in 2 patients. Conculsions. Classical histological analysis should be focused on detection of early preinvasive epithelial lung cancer lesions. (Abstract truncated at 2000 characters).
Objavljeno v DiRROS: 05.12.2023; Ogledov: 678; Prenosov: 174
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Objavljeno v DiRROS: 17.09.2019; Ogledov: 2438; Prenosov: 642
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