Long-term survivors of small-cell lung cancer (SCLC): a French multicenter study. Groupe d'Oncologie de Langue Française.

Background: The aim of this study was to analyze SCLC patients beyond 30 months, particularly their outcome, their way of life, and factors which could influence relapses, second-primary cancers and death.

Patients And Methods: Between January 1986 and May 1995, 263 SCLC patients who survived longer than 30 months were included from 52 French institutions. The analysis was performed on the 155 cases confirmed by a pathologic review.

Superior vena cava stent placement: results with the Wallstent endoprosthesis.

Purpose: To assess the clinical success and short-term patency of the Wallstent endoprosthesis in the treatment of superior vena cava (SVC) syndrome.

Materials And Methods: Twenty-one 14-mm-diameter endoprostheses were implanted in 15 patients (mean age, 60 years) treated for SVC syndrome due to malignant compression (n = 14) or postirradiation fibrotic stenosis (n = 1) of the SVC.

Results: Immediate technical success was achieved in all patients.

[Treatment of respiratory insufficiency in mucoviscidosis].

Cystic fibrosis respiratory disease leads to chronic respiratory insufficiency, pulmonary hypertension and cor pulmonale. Clinical evaluation must be helped by diurnal artérial gasometry and nocturnal saturation measure, especially in acute phase and during the weeks after respiratory infections. Treatment of hypoxemia is based on oxygenotherapy, but also on nasal nocturnal ventilation for patients waiting for a pulmonary transplantation.

Cardiac angiosarcoma revealed by lung metastases.

Cardiac angiosarcoma is a rare tumour with very poor prognosis especially in patients with metastatic disease. We present the case of a 43 year old patient with angiosarcoma revealed by open lung biopsy for multiple pulmonary metastases. Cardiac symptoms were limited to a moderate pericarditis and no echocardiographic sign of heart tumour was observed.

[Radon and primary bronchial cancer].

Radon is a natural radioactive gas, with worldwide distribution, deriving from uranium decay products, which can be inhaled, weather in mining condition (extraction and management of uranium ores) or in domestic condition (in some high risk homes or geographic areas). The main epidemiologic studies on uranium mining workers have all confirmed an excess in relative risk of primary lung cancer. Epidemiologic studies on indoor exposure suggest a role of radon in the genesis of a certain number of primary lung cancer, although these results remain controversial and need to be confirmed.

[Diseases of the diaphragmatic area. Difficulties of the radiological diagnosis].

Following a reminder of anatomy, the semiology of standard radiology and modern imaging methods is described. The authors then deal with the phrenic-supraphrenic thoracic pathologies (air and liquid effusions, neighbourhood atelectasis, etc.) and with the phrenic-infraphrenic pathologies (transdiaphragmatic hernias, hepatic pathology, subphrenic abscess and pleural effusions).

[Significance of the level of carcinoembryonic antigen in the alveolar lavage fluid in cancerous and non-cancerous bronchopulmonary pathology].

In a prospective study the level of carcinoembryonic antigen (ACE) were simultaneously measured in plasma and bronchoalveolar lavage liquid (LBA), in fifteen patients suffering from bronchopulmonary cancer and fifteen patients suffering from non-malignant pulmonary disease. In these two groups the level of ACE in LBA liquid (cancer 8,990 +/- 4,050 ng/ml; controls 2,510 +/- 1,060 ng/ml) were clearly more elevated than the corresponding plasma levels (cancer 1,931 +/- 1,760 ng/ml; controls 8.2 +/- 2 ng/ml) and the plasma levels of ACE were more elevated in the cancer group; in the same group the ACE levels in the LBA liquid were more elevated in the tumour group (4,770 +/- 2,180 ng/ml versus 808 +/- 300 ng/ml).

[Chemoprophylaxis of tuberculosis].

Chemoprophylaxis of tuberculosis may be primary or secondary. Primary chemoprophylaxis is intended for infants and children with negative tuberculin tests and exposed to contagion, in order to avoid primary tuberculosis. It lasts for three months and consists of oral isoniazide in one single daily dose of 5 to 10 mg/kg.

[Diagnostic pitfalls, artefacts and difficulties of thoracic radiography].

The antero-posterior X-ray film of the chest is still a basic examination in everyday clinical practice. It supplies multiple data but reading of the image is difficult and requires much accuracy and method. In this review paper we examine all the artefacts, pitfalls and diagnostic problems we have encountered in many years of experience, irrespective of their cause (technical, iatrogenic) or origin (parietal, intrathoracic, pleural, vascular, gastrointestinal, mediastinal, pulmonary).

[Current indications for thoracic imaging].

The authors present all the chest imaging techniques that are currently available to pneumologists and detail their indications and advantages. They suggest that in each major chest disease clinicians should use the technique that is most useful to the diagnosis and least costly, thereby avoiding overlaps of expensive techniques.

[Applications of a simple system of aid to medical decision-making with various patients in internal medicine: SELF].

Many medical decision helping systems are very complex and require expensive computers, which restricts their diffusion and limits their use to specialized people. The idea was to find a simplified system that any practitioner--even unaccustomed to microcomputing--would be able to use. Moreover, this system had to work on widely available and inexpensive microcomputers.

[Surgery of microcellular bronchial cancer: retrospective multicenter study apropos of 110 cases].

The results of a multicentric retrospective study of 110 cases of small cell bronchial cancer are reported. In 57 of these patients the histological diagnosis was unknown before surgery. Among the remaining 53 patients, 22 were operated upon immediately and 31 after chemo-and/or radiotherapy (12 full responders, 10 partial responders, 5 no change and 4 in relapse).

[Double-blind study of Biostim in the prevention of superinfection in patients with chronic bronchopathy].

In a multicenter trial conducted with patients suffering from chronic bronchopathy, Biostim, an immunomodulating compound of biological origin has been studied using the double-blind placebo-controlled method for prevention of respiratory tract infections. One hundred and ten patients from 10 french pneumology health centers entered the study. The treatment was administered at random in three sequences of 8 days a month for 3 months (2 mg/day the first month, 1 mg/day the second and third months).

[Microcellular bronchial cancer. Current general and therapeutic problems].

Small cell carcinomas constitute about 15-20% of all primary lung tumours. They are divided into oat cell and intermediate cell carcinomas. Pathognomonic neurosecretory granules have been detected in the cytoplasm of these cells by electron microscopy.

["Plastic lung". Broncho-pulmonary pathology related to plastics (author's transl)].

Plastics can induce three main groups of respiratory accidents.--Acute and subacute intoxications related to the inhalation of volatil substances from decomposing plastics (mostly during burning and pyrolysis) or on the contrary during synthesis. They are accidental chemical broncho-pneumopathies (acute tracheo-bronchitis and pulmonary edema).

[Lung hematomas (author's transl)].

The peculiarity of lung hematomas is due to the association of two types of lesions: vascular ruptures and alveolar ruptures. Six original observations are associated to 68 others published by various authors in a detailed general review. The main characteristics are radiological, with the following stages: 1) diffuse confusion giving a widespread picture of a low density and imprecise outline, 2) constituted hematoma with a dense picture with clear cut outline of late diagnosis, 3) less frequently aero-hydric pictures.

[Diagnosis of diffuse pneumopathies (author's transl)].

The authors analyze their proceeding in the etiological diagnosis of 40 diffuse pneumopathies in patients admitted to hospital. In 31 cases, diagnosis was made 10 times at the radioclinical stage, 14 times at the endoscopical stage, 6 times at the surgical stage, and once at autopsy. After, they analyze the problems of interpreting the data obtained at each stage, particularly the limited contribution of the X-ray, the necessity of discussing the anatomo-pathological diagnosis (the problem of fibrosis, of sarcoidosis reactions and of pneumoconioses).

[Should the lung cancer of iron-miners in Lorraine be considered an occupational disease? (author's transl)].

The occupational group composed of the iron-miners working at the bottom of the mines in Lorraine makes up a high risk population for lung cancer (The carcinogenic index is 5 to 12 times as high as that of the population of non-miners). The authors report a new series of 270 cases in support of this assertion. The cancers have few particular characteristics.