Entries Tagged as 'Lung Cancer'
Predictors of talc pleurodesis outcome in patients with malignant pleural effusions.
Lung Cancer. 2008 Oct;62(1):139-44
Authors: Yildirim H, Metintas M, Ak G, Metintas S, Erginel S
OBJECTIVE: Chemical pleurodesis is an accepted palliative therapy for patients with recurrent, symptomatic, malignant pleural effusions (MPE). The purpose of the study was to determine the factors that have an effect on successful pleurodesis for MPE. PATIENTS AND INTERVENTIONS: Eighty-four consecutive patients with biopsy-proven malignant pleural disease and recurrent, symptomatic MPE were eligible to participate in this study. Five grams of talc mixed in 150ml of normal saline were administered via tube thoracostomy or small-bore catheters after complete drainage of the pleural effusion. RESULTS: Seven patients did not return for their 30-day follow-up visit and were excluded from further analysis. Successful pleurodesis was achieved in 63 of 77 eligible patients (81.8%) with MPE. In the univariate analysis, female gender, Karnofsky performance status, pleural fluid pH, cholesterol, and adenosine deaminase level showed a significant association with the probability of success. Multivariate logistic regression analysis showed that pleural fluid pH and ADA levels were independent predictors of talc pleurodesis outcome. CONCLUSION: Our results show that pleurodesis using talc as the sclerosing agent is a simple and acceptable procedure with high efficacy for controlling MPE, especially when used in appropriate patients.
PMID: 18403045 [PubMed - indexed for MEDLINE]
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Tags: Lung Cancer
How to deal with incidentally detected pulmonary nodules less than 10mm in size on CT in a healthy person.
Lung Cancer. 2008 May;60(2):151-9
Authors: van’t Westeinde SC, de Koning HJ, Xu DM, Hoogsteden HC, van Klaveren RJ
The high frequency of non-calcified pulmonary nodules (NCN) <10mm incidentally detected on a multi-detector CT (MDCT) of the chest raises the question of how clinicians and radiologists should deal with these nodules. Management algorithms for solitary pulmonary nodules >10mm do not carry across to sub-centimeter lesions. Purpose of this review is to provide a 10-step approach for routinely detected sub-centimeter NCN on a MDCT in healthy persons in order to be able to make an optimal discrimination between benign and malignant NCNs. Recommendations are primarily based on individual cancer risk, the presence or absence of calcifications and nodule size. In nodules >4-5mm nodule consistency, margin and shape should be taken into account. Next steps in the nodule evaluation are the assessment of localization, nodule number, presence or absence of growth and volume doubling time. Growth is defined as a volume doubling time of 400 days or less, based on volumetry. For nodules <4mm, a follow-up CT at 12 months is recommended in high risk persons, whilst for low-risk persons no follow-up is needed. If no growth is observed at 12 months, no further follow-up is required. For solid, smooth or attached indeterminate NCN between 5 and 10mm we recommend an annual repeat scan, whilst for purely intra-parenchymal nodules a 3-month repeat scan should be made to assess growth. Growing lesions with a volume doubling time <400 days require further work-up and diagnosis, otherwise an annual repeat scan to assess growth is recommended.
PMID: 18359124 [PubMed - indexed for MEDLINE]
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Tags: Lung Cancer
Prognostic significance of pleural lavage cytology in patients with lung cancer: a meta-analysis.
Lung Cancer. 2008 May;60(2):183-92
Authors: Li YN, Shi HZ, Liang QL, Yang HB, Huang GM
OBJECTIVE: Cytologic approaches such as pleural lavage cytology (PLC) are considered as possible aids to assessing prognosis of lung cancer patients. We aimed to comprehensively review the evidence for use of PLC to predict prognosis of lung cancer. METHODS: Fifteen studies, including 6391 patients, were found to be eligible for the present meta-analysis. A meta-analysis was done on the log hazard ratios and their variances in these studies. RESULTS: Four studies dealt with pleural lavage before lung resection, six studies dealt with pleural lavage after lung resection, and five studies had PLC data from both before and after lung resection examination. For before lung resection studies, combined hazard ratios showed that positive PLC results had an unfavorable impact on survival: 3.96 (95% confidence interval 2.48-6.33), 4.55 (2.95-7.04), 5.00 (3.39-7.36), 5.67 (3.81-8.43), and 7.06 (5.04-9.90), for 1-, 2-, 3-, 4- and 5-year, respectively. For after lung resection studies, combined hazard ratios showed that positive PLC results had an unfavorable impact on survival: 6.02 (3.74-9.71), 6.64 (4.53-9.72), 7.06 (4.93-10.12), 7.29 (5.18-10.25), and 8.47 (6.12-11.73), for 1-, 2-, 3-, 4- and 5-year, respectively. Totally, the combined hazard ratio was 5.61 (3.98-7.90), showing a worse survival when PLC was positive. These findings could be overestimated because of publication and reporting bias. CONCLUSIONS: PLC is a strong prognostic factor for survival in patients with lung cancer.
PMID: 17996976 [PubMed - indexed for MEDLINE]
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Tags: Lung Cancer
