Nodal involvement at the time of pulmonary metastasectomy: experiences in 245 patients.

Background: Although routine systematic mediastinal and hilar lymph node dissection contemporary with pulmonary metastasectomy has not been uniformly performed in many thoracic surgical centers, the value of this procedure needs to be investigated.

Methods: Between 1996 and 2001, 245 patients (157 men, 88 women) underwent pulmonary resection of metastatic colorectal carcinoma, sarcoma, and renal cell carcinoma. Generally, systematic mediastinal and hilar lymph node dissection was performed concurrently with pulmonary metastasectomy.

[Clinical and prognostic significance of tumor markers cytokeratin 19 fragment, carcinoembryonic antigen, and neuron-specific enolase in lung cancer].

Objective: To evaluate the clinical and prognostic significance of the tumor markers cytokeratin 19 fragment, carcinoembryonic antigen and neuron-specific enolase in lung cancer patients.

Materials And Methods: Serum levels of cytokeratin 19 fragment, carcinoembryonic antigen and neuron-specific enolase were measured using electrochemical luminescence immunoassay in 46 lung cancer patients. Serum levels of cytokeratin 19 fragment, carcinoembryonic antigen, and neuron-specific enolase higher than 3.

Surgical resection of secondary chest wall tumors.

Objective: The objective of this study was to evaluate which factors influence survival following surgical resection of secondary tumors of the chest wall (non-bronchial carcinoma).

Methods: Between 1990 and 2001, 69 patients (23 men, 46 women) underwent chest wall resection with curative intent. All of the patients were retrospectively analyzed for sex and age, presenting symptoms, tumor location, disease-free interval, histology, radiation therapy or chemotherapy, surgical techniques and extent of resection, 30-day mortality and long-term survival.

Adrenalectomy for solitary adrenal metastases from non-small cell lung cancer.

Background: The treatment of patients with adrenal metastases from lung cancer (non-small cell lung cancer, NSCLC) remains controversial. Several studies of adrenalectomy in cases of isolated adrenal metastases from NSCLC suggest that these patients could have improved survival. Our aim is to define the history of patients after resection of solitary metastases to the adrenal gland and to identify characteristics of patients who achieved prolonged survival.

Comparison of bone scintigraphy with bone markers in the diagnosis of bone metastasis in lung carcinoma patients.

This study was designed to evaluate the utility of the bone markers total alkaline phosphatase (TAP), bone-specific alkaline phosphatase (BAP), aminoterminal propeptide of type I collagen (PINP), carboxyterminal propeptide of type I collagen (PICP), pyridinoline crosslinks (PYD), deoxypyridinoline crosslinks (DPD), cross-linked carboxyterminal telopeptide of type I collagen (ICTP), cross-linked carboxyterminal telopeptide of type I collagen (CTx, beta-CrossLaps) and tartrate-resistant acid phosphatase 5b (TRAP 5b) in comparison with bone scintigraphy for the diagnosis of bone metastasis in lung carcinoma patients. The study population consisted of 49 patients with bone metastasis confirmed by plain radiography and/or computed tomography, 89 patients without bone metastasis, 12 patients with benign lung diseases and 18 healthy persons. All patients were of male gender.

[Surgery in non-small cell lung cancer of the superior sulcus: results of a combined preoperative and postoperative irradiation regime].

Unlabelled: Due to local invasion of the chest wall, patients with non small cell carcinoma (NSCLC) of the superior sulcus have been treated mainly by the Paulson regime with radiotherapy followed by surgical resection. Recent published data on the use of concurrent irradiation and chemotherapy followed by surgical resection seemed very promising. The aim of the present study was to determine the value and benefit of a combined preoperative and postoperative radiotherapy regime (Sandwich irradiation), and which factors predict prognosis following resection.

CYFRA 21-1 and CEA are independent prognostic factors in 153 operated stage I NSCLC patients.

Currently, no further therapy in addition to surgery is recommended in completely resected NSCLC stage I patients. However, the 5-year survival rate at this stage has been reported to be approximately 60%, i.e.

CYFRA 21-1 is a prognostic determinant in non-small-cell lung cancer: results of a meta-analysis in 2063 patients.

The purpose of this study was to determine the prognostic significance of a high pretreatment serum CYFRA 21-1 level (a cytokeratin 19 fragment) adjusted for the effects of well-known co-variables in non-small-cell lung cancer (NSCLC). This meta-analysis based on individual updated data gathered comprehensive databases from published or unpublished controlled studies dealing with the prognostic effect of serum CYFRA 21-1 level at presentation in NSCLC of any stage (nine institutions, 2063 patients). Multivariate regression was carried out with the Cox model.

Non-small-cell superior sulcus tumor: results of en bloc resection in fifty-six patients - non-small-cell pancoast.

Background: Various multidisciplinary approaches are taken in the treatment of superior sulcus tumors. The purpose of this study was to determine the outcome, long-term results, and factors associated with prolonged survival after administering different combined radiosurgical regimens in a single institution.

Methods: Between 1986 and 2000, 56 patients (43 men, 13 women) with superior sulcus tumor and histology of non-small-cell lung cancer underwent surgical resection.

Increased CYFRA 21-1 and CEA levels are negative predictors of outcome in p-stage I NSCLC.

Besides established factors, we assessed the prognostic impact of tumor markers CYFRA 21-1, CEA and NSE on survival probability in a series of 515 NSCLC patients who were treated by surgery. In addition, we studied the prognostic significance of CYFRA 21-1 and CEA with reference to the individual postoperative (p-) stages. It was found that p-stages correlated inversely with survival probability.

Prognostic factors and survival after complete resection of pulmonary metastases from colorectal carcinoma: experiences in 167 patients.

Objective: Surgical resection is an important form of treatment for pulmonary metastases from colorectal carcinoma. We analyzed the clinical course, outcome, and prognostic factors after surgery.

Methods: Between 1985 and 2000, 167 patients (103 men, 64 women) underwent complete pulmonary resection of metastatic colorectal carcinoma.

Technical performance and diagnostic utility of the new Elecsys neuron-specific enolase enzyme immunoassay.

This international multicenter study was designed to evaluate the technical performance of the new double-monoclonal, single-step Elecsys neuron-specific enolase (NSE) enzyme immunoassay (EIA) and to assess its utility as a sensitive and specific test for the diagnosis of small-cell lung cancer (SCLC). Intra- and interassay coefficients of variation, determined in five control or serum specimens in six laboratories, ranged from 0.7 to 5.

Prognostic factors for survival after pulmonary resection of metastatic renal cell carcinoma.

Background: Pulmonary resection in metastatic renal cell carcinoma is an accepted method of treatment. The purpose of this study was to determine the clinical course, outcome, and prognostic factors after surgery.

Methods: Between 1985 and 1999, 191 patients (145 men, 46 women) with pulmonary metastases from a renal cell carcinoma underwent surgical resection.

Prognostic significance of cytokine modulation in non-small cell lung cancer.

Increased production of immunosuppressive interleukin-10 (IL-10) by non-small cell lung cancer (NSCLC) and increased serum IL-10 concentrations in NSCLC-patients have recently been correlated to reduced survival. We earlier demonstrated suppression of IL-2 secretion in whole blood cell cultures of NSCLC-patients. We now analyzed the influence of IL-2 secretion on survival in NSCLC-patients and the influence of IL-10 on IL-2 secretion.

Comparison of changes in the NSE levels with clinical assessment in the therapy monitoring of patients with SCLC.

In a series of 130 consecutive patients suffering from small cell lung cancer (SCLC), we compared response evaluations according to standard criteria of the WHO with response evaluations according to changes in the neuron-specific enolase (NSE) levels during systemic therapy. For assessment by changes in the marker levels, the difference between two consecutive levels must exceed 30%. This value is based on the formula: Dc = 2(square root 2) x CV (CV: inter-assay coefficient of variation of the NSE test, set at 10 %).

Cytokine secretion: clinical relevance of immunosuppression in non-small cell lung cancer.

Increased production of immunosuppressive IL-10 by non-small cell lung cancer (NSCLC) and increased plasma IL-10 concentrations in NSCLC-patients have recently been correlated to reduced survival. We earlier demonstrated suppression of IL-2 secretion in NSCLC-patients. We now analyzed the influence of IL-2 suppression on survival in NSCLC-patients and influence of IL-10 on IL-2 secretion.

Primary tracheal tumors: experience with 14 resected patients.

Objective: Primary tracheal tumors are rare. Management includes interventional endoscopy, surgery and radiotherapy.

Methods: Between 1987 and 1996, 14 patients treated by resection and reconstruction of the trachea and bifurcation for primary tracheal tumors were retrospectively analyzed.

CYFRA 21-1 in the follow-up of inoperable non-small cell lung cancer patients treated with chemotherapy.

The introduction of new regimens in the chemotherapy of inoperable non-small cell lung cancer (NSCLC) patients provides a useful extension of survival probability that may now justify the application of tumor markers for the disease monitoring. In a prospective study of 48 consecutive NSCLC patients with TNM stages IIIB/IV we compared changes in the serum levels of the cytokeratin 19 fragment CYFRA 21-1 with the clinical evaluations of response to therapy. CYFRA 21-1 levels were measured using the enzyme immunoassay of Boehringer, Mannheim (Germany).

[Resection of the trachea and bifurcation in newborn infants and children].

From 1973 to 1994, 38 tracheal and/or bifurcation resections were performed in 37 children aged 1 month to 18 years. Twenty-four children had an acquired stenosis, 8 a congenital and 5 a combined stenosis. In 16 children, the stenosis was located in the lower trachea or bifurcation.

[Treatment strategy in pleural mesothelioma].

The development of diffuse malignant pleural mesothelioma is associated with exposure to asbestos. The surgical treatment comprises a radical pleuropneumonectomy with resection of the pericardium and diaphragm (P3D) or palliative pleurectomy/decortication of the tumor. The prognosis in general is poor.

[Lung metastases: tumor reduction as an oncologic concept].

The principle of surgery for lung metastases is the removal of all lesions in the lung that are either visible or detectable by palpation. This may be combined with complete dissection of all ipsilateral lymph nodes. Therefore, "tumor reduction" rather than "complete" or "radical resection" may be an adequate description of this surgical approach.

[Incomplete resections in bronchial carcinoma: morbidity and prognosis].

Residual tumor (R1) was proven at the proximal bronchial resection margin in 88 (3.6%) of 2464 cases of lung cancer following lung resection and standard lymph node dissection. Postoperative complications (8%) were: fistula of the bronchial suture line (n = 7), bleeding (n = 2) and heart luxation (n = 1).

Monitoring of therapy in inoperable lung cancer patients by measurement of CYFRA 21-1, TPA- TP CEA, and NSE.

In a series of 381 consecutive patients with lung tumors and benign pulmonary diseases, we examined whether tumor markers CYFRA 21-1 (EIA, Boehringer, Mannheim), TPA-M (IRMA AB Sangtec Medical, Bromma, Sweden), TPS (IRMA, Beki Diagnostics AB, Bromma, Sweden), CEA and NSE (EIA, Roche, Basel) have the potential to contribute to clinical decision-making processes with respect to diagnosis and assessment of response to therapy. The sensitivity values of the marker tests in NSCLC (CYFRA 21-1: 44.4% > 3.