Prediction of the effect of neoadjuvant chemotherapy in patients with non-small cell lung cancer of stage III at phases of combined treatment.

We examined 100 patients with non-small cell lung cancer (NSCLC). In addition to surgery there was performed neoadjuvant chemotherapy (2-3 cycles) EP (cisplatin at a dose of 80 mg/m2 on first day + etoposide at a dose of 120 mg/ m2 on days 1,3,5). There were studied the levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) as prognostic factors in the use of neoadjuvant chemotherapy in patients with NSCLC. The control group consisted of 30 healthy volunteers. The baseline level of bFGF was necessary for the prediction of combined treatment in patients with NSCLC stage III. The threshold value bFGF>10,2 ng/ml allowed predicting a good effect from chemotherapy with a sensitivity of 71,4% and specificity of 80,6%, while the sensitivity of VEGF in terms of forecasting bicycles reached 42,9 %. The resulting algorithm for predicting of the effect of neoadjuvant chemotherapy of patients with NSCLC provided perspectives to improve the outcomes of such patients.

[The immediate results of bronchoplastic surgical operations in surgery for lung malignant tumors].

Bronchoplastic surgical operations by means of invaginated method on 1 semicircle in lung malignant tumors were performed in 124 patients. Of them 116 patients (93,5%) had primary and 8 patients (6,5%) metastatic tumors. There were 94 men (75,8%) and 30 women (24,2%). The average age of patients was 56,4. The lesion of the right lung was observed in 78 patients (62,9%), of the left one in 46 patients (37,1%). Bronchoplastic lobectomies were performed in 98 patients (79%), bilobectomies - 17 patients (13,7%), segmentectomy - 4 patients (3.3%), isolated resections of bronchi - 5 patients (4,0%). All operations were radical. In all cases of lung cancer there was carried out extended inpsilateral lymph node dissection. Complications of different severity were observed in 24 patients (19,4%): pneumonia (4,8%), atelectasis (0,8%), insufficiency of bronchial sutures (3.2%), granulation stenosis of the bronchial anastomosis (1,6 %), chylothorax (0,8%), recurrent nerve palsy (2,4%), heart rhythm disorders (2,4%). Postoperative lethality was 4.8%.

[Optimization of treatment methods of surgical complications in lung cancer].

The present report analyses the immediate and long-term results of treatment of surgical complications in 998 patients with lung cancer. There were complications in 37,5% of the cases, with a fatality rate of 14,7%. The most frequent complications were as follows: postoperative empyema with bronchopleural fistula (41,3%), bleeding (12,0%), pneumonia (9,8%), pulmonary arteries embolism (8,1%) and heart rhythm disorders (8,1%). Adjuvant and neoadjuvant treatment does not increase the rate of surgical complications as compared to just surgery alone (p = 0,1). Postoperative empyema with bronchopleural fistula requires intensive therapy, affects the quality of life of patients but does not decrease survival rates as compared to patients at the same stages of disease with uncomplicated course (p = 0,001). Timely drainage of pleural cavity accompanied by its adequate sanation does not differ (p = 0,1) from usage thoracoplasty (MS 29,9 months to 33,2 months).

[Bronchopleural fistula--risk factors, prophylactics and treatment in oncopulmanology].

The problem in question is actual because of great incidence of postoperative complications and considerable problems with treatment of them. The authors made an analysis of surgical treatment of 506 patients with primary cancer and carcinoid tumors of the lung. The authors have developed a system of individual prognosis of risk of the development of bronchopleural fistulas (BPF), introduced an original technique of bronchomyoplasty with the help of m.serratus anterior and m.lattissimus dorsi. It resulted in 1.2% less frequency of the development of BPF. Current methods and highly informative techniques were used in examining the patients. The total number of the examined patients, program and research methods allowed reliable conclusions to be obtained.