[Factors affecting survival of radically operated nonsmall cell lung cancer patients of 70 years and older].

It is performed univariate and multivariate analysis of factors affecting the overall cancer survival of 613 patients of 70 years or older radically operated for non-small cell lung cancer. It is found that the main independent predictors of survival are T and N categories. These variables retain their importance in the overall multivariate model both types of survival, and the variable T - in separate multivariate models for samples stratified by category N. The presence of diabetes dramatically reduced both types of survival. Among patients without regional metastases women had a higher survival rate. The age of the operated patients older than 70 years had no significant independent effect on survival.

[Intelligent distributed system of population cancer screening].

This review summarizes data dedicated to improving the efficiency of screening of malignant tumors through the use of modern information and telecommunication technologies. It is showed that currently available software solutions in the field of medical imaging is not enough adapted for population screening. So far there is no single standard that defines checking algorithms of data processing at certain controlled conditions. The most expected result will be the organization of information centralized storage, sharing diagnostic data, providing broad access to them, automated analysis and selection of diagnostically significant results through the software. The basic requirements for the development of self-learning systems for intelligent processing array of heterogeneous data through the use of technologies of semantic networks are provided.

[Treatment of neoplastic lesions of the central bronchi and trachea using endotracheobronchial surgery, intraluminal brachytherapy, combined radiotherapy and chemoradiotherapy].

There are summarized the foreign and domestic references of recent years devoted to methodology and the efficiency of the use of intraluminal high-dose radiation brachytherapy in patients with lesions of the central bronchi and trachea caused by primary and metastatic malignant tumors. It is presented own experience of applying this method in 207 patients. It is showed that in some patients to ensure the delivery of the radiation source to the area of interest it is advisable to perform firstly endotraheobronhial surgery with recanalization of the lumen of the respiratory pathways. The best is the use of intraluminal brachytherapy with high dose radiation. Palliative intraluminal irradiation of inoperable patients allowed achieving a good immediate results (65-95%), a significant reduction of the main symptoms--hemoptoe (87-95%), dyspnea (75-90%), obstructive pneumonia phenomena (50-85%), and significantly increasing survival median from 1-3 to 9-14 months. Following performance of chemoradiotherapy permitted increasing the survival median up to 15-20 months. The number of complications of intraluminal high-dose radiation brachytherapy was small, usually--pulmonary hemorrhage (2-7%) more likely developing when using large fractions--more than 10 g for 1 session.

[Analysis of one-year mortality of radically operated patients over 70 years with nonsmall cell lung cancer].

One-year lethality was studied in 613 patients older than 70 years who underwent surgery for lung cancer for the period of 1970-2002. During the first year after surgery 166 patients died (27.1%) and besides from the generalization of the disease - 92.2%, from other causes - 7.8%. The highest rate of one-year lethality was observed after pneumonectomy (39.4%), the lowest one - after lung margins resection (16.5%). It was found that the most important factor in one-year lethality rate was N2 lymph node status. Risk of dying from the generalization of the disease during the first year sharply increased in group of patients underwent extended and combined pneumonectomy (one-year lethality of 52.6% and 57.1%, respectively), pneumonectomy with N2 (56,0%), lobectomy in peripheral cancer with metastases of N2 level (63,6%), especially when the amount of the tumor was more than 5 cm (83.3%).

[Rationale for surgical treatment of octogenarians with lung cancer].

Lung cancer was treated by surgery in 17 patients (males--13, females--4) aged more than 80 years, i.e. 2% of surgical patients older than 70 (n-870). The chief death-causing factors were cardiovascular insufficiency and thromboembolism of the pulmonary artery.

[Immediate results of pneumonectomies in lung cancer patients older than 70 years].

During 1970-2002 pneumonectomy for lung cancer was fulfilled on 155 patients older than 70 years of age. Immediate postoperative lethality took place in 19.3%. From 142 male patients after pneumonectomy 30 (21.1%) patients died, from 13 female patients - nobody died. The whole time was divided into 3 periods 10 years each. It was noted that postoperative lethality decreased from 21.4% in the first period to 13.8% - in the third one. Lethality was substantially decreased in patients aged 70-72 from 32.6% in 1970-1981 to 6.9% in 1992-2002. In patients older than 75 lethality failed to decrease. The main causes of lethal outcomes were acute cardio-vascular insufficiency and thromboembolism of the pulmonary artery.

[Immediate results of pulmonary resection carried out for lung cancer in patients older than 70 years].

Pulmonary resection was carried out for lung cancer in 155 patients aged more than 70 yrs (1970--2002). Operative mortality was 19.3%. Out of 142 male survivors, 30 (21.1%) died later, while none did out of 13 female survivors. Post-operative mortality fell from 21.4% within the first decade to 13.8% in the third one. Particularly marked decrease was registered in the 70-72 year bracket--from 32.6% (1970--1981) to 6.9% (1992--2002). However, no progress was reported in patients aged more than 75 yrs. Among the main causes of lethality were acute cardio-vascular insufficiency and lung artery thromboemboly.

[Diagnosis of central cancer of the lungs]. / O diagnostike tsentra'lnogo raka legkogo.

Data on 396 patients with central cancer of the lung admitted to the thoracal department of the Petrov Research Institute of Oncology and the City Oncological Dispensary in 1985-1986 are presented. In 94 of them (23.7%) the disease was diagnosed by prophylactic roentgenofluorography, in 302 (76.3%)--in consultation with a doctor. Operability of the patients of the first group was somewhat higher than in those of the second group. During the two years under analysis the roentgenofluorography detected central cancer of the lung in 266 patients (11%). Radical operations were performed in 48 patients (18%), while in patients consulted by doctors after the appearance of clinical symptoms of the disease, resectability made up 13.3%. Main efforts should be directed to the active detection of central cancer of the lung in patients who addressed the polyclinic for lung symptoms.

[Evaluation of diagnosis and treatment of various clinico-anatomical forms of lung cancer]. / Otsenka diagnostiki i lecheniia razlichnykh kliniko-anatomicheskikh form raka legkogo.

Among 3898 cases of primary lung cancer registered in Leningrad within 1985-1986, central cancer clearly predominated (61.9%). Central/peripheral cancer ratio was 1.6:1. The most common procedure used for treatment of central lung cancer was pneumonectomy (74.6% of cases) and lobectomy--for peripheral cancer management (85.7%). Significant differences in approach to diagnosis and surgical treatment of these pathologies were established. It seems unfeasible to increase resectability of central lung carcinoma by extending surgery. Such tumors should be diagnosed at the stage of segment involvement. However, prophylactic photo-roentgenography does not assure early detection of central lung cancer. Organization of lung cancer detection in Leningrad needs to be improved.