Lung Cancer Risk in Men and Compliance with the 2018 WCRF/AICR Cancer Prevention Recommendations.

Lung cancer is the most common and deadly form of cancer worldwide, especially in men. The 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) updated cancer prevention recommendations, and a standard scoring system (2018 WCRF/AICR Score) was published. The purpose of this study was to develop the adapted version of the 2018 WCRF/AICR Score with respect to lung cancer prevention recommendation (Ad-LC WCRF/AICR Score) and to examine the association between lung cancer risk in men and the Ad-LC WCRF/AICR Score as well as its single components. A case-control study was conducted among 439 men aged 45-80 years (187 controls, 252 primary lung cancer cases). Lifestyle and dietary data were collected with a questionnaire including the 62-item food frequency questionnaire (FFQ-6®). The Ad-LC WCRF/AICR Score was used as a categorized and continuous variable. Odds ratios (ORs) and 95% confidence intervals (95% CIs) for lung cancer risk were calculated with the partly and fully adjusted model. One component of the score was independently associated with a lower risk of lung cancer in men, regardless of the set of confounders used. In the fully adjusted model following the recommendation "Limit smoking" was associated with a lower risk of lung cancer-in the never smokers by 87% (OR: 0.13; 95% CI: 0.04-0.37; p = 0.0002) and in the moderate smokers by 45% (OR: 0.55; 95% CI: 0.33-0.91; p = 0.0189) compared with the heavy smokers as a reference. By adding the single components making up the Ad-LC WCRF/AICR Score, the combination of three components or more, reducing the risk of lung cancer compared to lower compliance as a reference by 45% to 78% and by 39% to 66% for intermediate compliance (except two models out of seven) and higher compliance, respectively. In the fully adjusted model, the risk of lung cancer for the total Ad-LC WCRF/AICR Score was lower by 47% (OR: 0.53; 95% CI: 0.32-0.88; p = 0.0129) in higher compliance with the score compared to those with the lower compliance. Each one-point increase in the Ad-LC WCRF/AICR Score reduced lung cancer risk by 34% (OR: 0.66; 95% CI: 0.45-0.95; p = 0.0267). The results support previous evidence that limiting smoking reduces the risk of lung cancer in men. It also provides an insight into cancer research by showing that following the combined 2018 cancer prevention recommendations related to diet, lifestyle and body fatness was associated with a lower risk of lung cancer in men.

Adherence to Prudent and Mediterranean Dietary Patterns Is Inversely Associated with Lung Cancer in Moderate But Not Heavy Male Polish Smokers: A Case-Control Study.

Lung cancer is the most commonly diagnosed cancer in men worldwide. Studies regarding dietary patterns (DPs) and lung cancer are limited, with results remaining inconclusive, and the association of DPs with lung cancer in smokers is unclear. This study analyzed the associations between DPs, including the Polish-adapted Mediterranean diet (Polish-aMED) score, and lung cancer risk in Polish adult male smokers. This case-control study involved 439 men aged 45-80 years from northeastern Poland, including 187 newly diagnosed lung cancer cases. Dietary data was collected with a 62-item food frequency questionnaire (FFQ-6). Two approaches were applied to identify dietary patterns. The Polish-aMED score was calculated (hypothesis-driven approach) and a principal component analysis (PCA) was used to identify PCA-driven DPs (data-driven approach). A logistic regression analysis was performed to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of the lung cancer risk associated with the adherence to DPs overall as well as for moderate (2.5-11 pack-years) and heavy (>11 pack-years) smokers. Among moderate smokers, the risk of lung cancer was lower by 41% (OR: 0.59; 95% CI: 0.39-0.90; p < 0.05; adjusted model) in the higher adherence to the prudent DP when compared to the lower adherence, and by 66% (OR: 0.34; 95% CI: 0.15-0.76; p < 0.05; adjusted model) in the high adherence (7-9 points) to the Polish-aMED score when compared to the low adherence (0-3 points). No significant association between the westernized traditional DP or the sweet dairy DP and lung cancer was revealed. In conclusion, the current study suggests that pro-healthy dietary patterns, including the Mediterranean pattern, may favour lower risk of lung cancer in moderate smokers, although it was not confirmed in heavy smokers.

Primary pulmonary sarcoma - treatment outcomes depending on the different types of radical operation.

INTRODUCTION: Primary pulmonary sarcomas (PPS) are rare types of non-epithelial malignant tumors of the lungs (0.013-1.1% of all malignant lung tumors). The PPS can originate from mesenchymal elements of the bronchial wall, vessels or pulmonary stroma. Since the introduction of immunohistochemical and molecular diagnosis, a significant improvement in description and classification of sarcomas has been achieved. Nonetheless, sarcomas still remain a diagnostic and clinical problem. AIM: To estimate factors which could have an influence on the overall survival (OS) and progression-free survival (PFS) of different types of radical operations (R0) for PPS. MATERIAL AND METHODS: Fourteen patients who underwent surgical radical treatment between 1994 and 2009 with a final diagnosis of PPS were analyzed. RESULTS: A group of 14 patients, treated with R0 operations (pneumonectomies, lobectomies, non-anatomical resections), were included in the analysis. Median OS of patients undergoing R0 operations was respectively: for pneumonectomy 7 months, lobectomy 20 months, non-anatomic resections 213 months. Patients subjected to non-anatomical resections had better prognosis than the others treated radically (p < 0.05); however, this group of patients had the most local recurrences (3 patients - 50%). Statistical analysis did not show the influence of prognostic factors characteristic of PPS and soft tissue sarcoma (STS) on OS in the types of surgery performed. CONCLUSIONS: There are no unambiguous factors affecting OS and PFS of patients who have undergone anatomical and non-anatomical resections. A large number of local recurrences in non-anatomical operations may indicate that PPS spread like lung cancer.

Primary pulmonary sarcoma - long-term treatment outcomes and prognostic factors.

INTRODUCTION: Primary pulmonary sarcoma (PPS) is a rare type of non-epithelial malignant tumour of the lungs. Lung sarcomas are usually of metastatic character, originating from the primary tumour located in another organ. Pathomorphological diagnosis is difficult and therefore definitive diagnosis is usually determined after surgical treatment. Five-year survival of radical operated patients is 42-69%. AIM: To evaluate prognostic factors in PPS. MATERIAL AND METHODS: Twenty-two patients who underwent surgical treatment between 1994 and 2009 were analysed. RESULTS: Ten types of sarcomas were identified. All 22 analysed patients underwent operations and in 14 (63.6%) cases it was R0 resection (pneumonectomies, lobectomies, non-anatomical resections). In 8 out of 22 patients a locally advanced form was identified. Median overall survival (OS) in the group of all patients was 22 months, 5- and 10-year OS was 27% and 18% respectively, whereas in patients who underwent non-anatomical lung resections it was 80% and 60% respectively with median OS of 213 months. Overall survival was dependent on gender, completeness of treatment and size of tumour. Haemoptysis was a poor prognostic factor. Primitive neuroectodermal tumour was a type of sarcoma with a negative effect on progression-free survival. No impact of age, type of sarcoma, degree of histological malignancy, stage or adjuvant treatment on OS was noted. CONCLUSIONS: Primary radical surgical resection prolongs patient survival. Patients with tumours larger than 5 cm and men have worse prognoses. Future studies conducted on larger groups of patients diagnosed with PPS are necessary.

Associations of Mediterranean Diet and a Posteriori Derived Dietary Patterns with Breast and Lung Cancer Risk: A Case-Control Study.

Lung cancer in men and breast cancer in women are the most commonly diagnosed cancers in Poland and worldwide. Results of studies involving dietary patterns (DPs) and breast or lung cancer risk in European countries outside the Mediterranean Sea region are limited and inconclusive. This study aimed to develop a 'Polish-adapted Mediterranean Diet' ('Polish-aMED') score, and then study the associations between the 'Polish-aMED' score and a posteriori-derived dietary patterns with breast or lung cancer risk in adult Poles. This pooled analysis of two case-control studies involved 560 subjects (280 men, 280 women) aged 40-75 years from Northeastern Poland. Diagnoses of breast cancer in 140 women and lung cancer in 140 men were found. The food frequency consumption of 21 selected food groups was collected using a 62-item Food Frequency Questionnaire (FFQ)-6. The 'Polish-adapted Mediterranean Diet' score which included eight items-vegetables, fruit, whole grain, fish, legumes, nuts and seeds-as well as the ratio of vegetable oils to animal fat and red and processed meat was developed (range: 0-8 points). Three DPs were identified in a Principal Component Analysis: 'Prudent', 'Non-healthy', 'Dressings and sweetened-low-fat dairy'. In a multiple logistic regression analysis, two models were created: crude, and adjusted for age, sex, type of cancer, Body Mass Index (BMI), socioeconomic status (SES) index, overall physical activity, smoking status and alcohol abuse. The risk of breast or lung cancer was lower in the average (3-5 points) and high (6-8 points) levels of the 'Polish-aMED' score compared to the low (0-2 points) level by 51% (odds ratio (OR): 0.49; 95% confidence interval (Cl): 0.30-0.80; p < 0.01; adjusted) and 63% (OR: 0.37; 95% Cl: 0.21-0.64; p < 0.001; adjusted), respectively. In the middle and upper tertiles compared to the bottom tertile of the 'Prudent' DP, the risk of cancer was lower by 38-43% (crude) but was not significant after adjustment for confounders. In the upper compared to the bottom tertile of the 'Non-healthy' DP, the risk of cancer was higher by 65% (OR: 1.65; 95% Cl: 1.05-2.59; p < 0.05; adjusted). In conclusion, the Polish adaptation of the Mediterranean diet could be considered for adults living in non-Mediterranean countries for the prevention of the breast or lung cancers. Future studies should explore the role of a traditional Mediterranean diet fitted to local dietary patterns of non-Mediterranean Europeans in cancer prevention.

Dietary patterns and breast or lung cancer risk: A pooled analysis of 2 case-control studies in north-eastern Poland.

BACKGROUND: Breast cancer in women and lung cancer in men are the most prevalent cancers in Poland and worldwide. Evidence of the impact of food groups and nutrients on the risk of breast and lung cancer is limited and lacking conclusions. Studies on food consumption and breast or lung cancer are limited. OBJECTIVES: Assessment of the association between dietary patterns and the prevalence of breast and lung cancers in adult Poles. MATERIAL AND METHODS: The study involved a pooled analysis of 2 case-control studies on 320 subjects aged 50-70 years from north-eastern Poland (160 women, 160 men). Breast cancer cases in 80 women and lung cancer cases in 80 men were diagnosed. The food consumption frequency for 21 selected foods was collected using the Questionnaire of Eating Behaviors (QEB). Principal component analysis and multiple logistic regression analysis were used. The odds ratio (OR) and 95% confidence interval (95% CI) were calculated. RESULTS: Three dietary patterns (DPs) were identified: 'Prudent', 'Processed & fast food', and 'Traditional Polish'. In the pooled analysis for both cancers, the ORs were from 0.35 (95% CI: 0.20-0.61; p < 0.05 with adjustment for age) to 0.48 (95% CI: 0.26-0.88; p < 0.05 with adjustment for age, socioeconomic status index, physical activity, smoking, and abuse of alcohol) in the upper tertile of the 'Prudent' DP in comparison to the absence of cancers (OR = 1.00). The ORs of both cancers were 1.83 (95% CI: 1.06-3.16; p < 0.05 with adjustment for age) in the upper tertile of the 'Processed & fast food' DP. The ORs of both cancers for the 'Traditional Polish' DP were insignificant. CONCLUSIONS: In the pooled analysis, a strong inverse relation was found between the 'Prudent' dietary pattern, characterized by higher frequency of dairy, fruit, vegetables, wholemeal bread, fish and juices consumption, and breast or lung cancer prevalence, irrespective of age, socioeconomic status, physical activity, smoking, alcohol abuse, and type of cancer in Polish adults from north-eastern Poland.

Air tamponade of the heart.

Pneumopericardium is a rare disease defined as the presence of air or gas in the pericardial sac. Among the etiological factors, the following stand out: chest trauma, barotrauma, air-containing fistulas between the pericardium and the surrounding structures, secondary gas production by microorganisms growing in the pericardial sac, and iatrogenic factors. Until now, spontaneous pneumopericardium has been considered a harmless and temporary state, but a review of clinical cases indicates that the presence of air in the pericardium can lead to cardiac tamponade and life-threatening hemodynamic disturbances. We present the case of an 80-year-old patient with a chronic bronchopericardial fistula, who suffered from a cardiac arrest due to air tamponade of the heart.

Pulmonary Artery Perforation as a Complication of Pleural Drainage - Case Report.

The case presented is a drainage of empyema of the left pleural cavity complicated with the penetration of the lung parenchyma and perforation of the left pulmonary artery with drain displacement to the right pulmonary artery. The cause of complications has been shown along with the possible ways of conduct. Drainage of the pleural cavity is a primary surgery in the chest. The presence of pleural air or fluid is an indication for its implementation. This procedure usually has no complications. Time pressure, anatomical anomalies, changes of the topography in the course of co-morbidities are the factors allowing for the creation of many complications. The aim of the work is to remind about the technical performance of this simple surgical procedure and to note that its complications may directly threaten the life of the patient. This is the first case reported in Polish literature.