Assuntos
Carcinoma Pulmonar de Células não Pequenas/cirurgia , Neoplasias do Mediastino/cirurgia , Mediastinoscopia/métodos , Cirurgia Torácica Vídeoassistida , Carcinoma Pulmonar de Células não Pequenas/patologia , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Neoplasias do Mediastino/patologia , Oncologia , Estadiamento de NeoplasiasRESUMO
BACKGROUND: The aims of the present study were: 1) to study the type and extent of resection in patients with pathological stage I lung cancer; 2) to evaluate the results of surgical treatment; 3) to assess prognostic factors. SETTING: a tertiary referral general hospital. METHODS: Retrospective review of clinical records of 296 patients operated on for pathologic stage I lung cancer between 1989 and 1998. Mean follow-up period was 33.1+/-28.1 months. Survivals were calculated by the actuarial method and compared by the long-rank test. Age, sex, tumor size, type and extent of resection and histologic type were evaluated by univariate and multivariate analisis. RESULTS: Two hundred and forty-five lobectomies, 39 pneumonectomies, 5 segmental resections and 7 wedge resections were performed. Overall actuarial 5- and 10-year survivals were 62 and 49%, respectively. Stage Ia patients showed significantly better 5- and 10-year survivals (76 and 54%, respectively) as compared to Stage Ib patients (57 and 46%, p=0.007). Univariate analysis showed no significant difference in survival according to the age, the sex or the extent of resection. The histological type influenced the outcome (p=0.05): 5-year survival rate were 57, 67, 75% in squamous cell carcinoma, adenocarcinoma and bronchoalveolar carcinoma, respectively. At multivariate analysis stage and histology were identified as independent prognostic factors. CONCLUSIONS: Satisfactory results in terms of suvival can be achieved following surgery for stage I lung cancer. The T status and the histologic type significantly influence survival.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/cirurgia , Pneumonectomia , Adenocarcinoma/mortalidade , Adenocarcinoma/cirurgia , Adenocarcinoma Bronquioloalveolar/mortalidade , Adenocarcinoma Bronquioloalveolar/cirurgia , Idoso , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Análise de SobrevidaRESUMO
We report the case of a 15-year-old boy with primary high grade angiosarcoma of the 6th rib. The patient underwent chest wall resection (3 ribs) and reconstruction by using a sandwich of Marlex mesh with strips of methyl methacrylate. No adjuvant treatment was administered. A favourable outcome was observed, with no recurrence at 6-year follow-up. Functional results were excellent as well, with complete return of the patient to normal activities.
Assuntos
Hemangiossarcoma/cirurgia , Costelas/cirurgia , Neoplasias Torácicas/cirurgia , Adolescente , Hemangiossarcoma/diagnóstico por imagem , Humanos , Masculino , Radiografia , Costelas/diagnóstico por imagem , Neoplasias Torácicas/diagnóstico por imagemRESUMO
Inflammatory pseudotumor is a rare clinical entity. We report here the case of a 14-year-old boy who underwent lung resection en bloc with the lower esophagus, the mediastinal pleura and the diaphragm for an inflammatory pseudotumor of the left lower lobe. Postoperative radiotherapy was administered. The patient is well at 9-year follow-up. Inflammatory pseudotumor may present a particularly aggressive behavior. Multimodality approach, including extensive surgical resection, may be necessary in dealing with this disease.
