To determine survival of patients with stage IIIA/B non-small cell lung cancer considering diseas... more To determine survival of patients with stage IIIA/B non-small cell lung cancer considering disease stage and treatment methods. A total of 304 patients with non-small cell lung cancer were treated at the Department of Thoracic Surgery and Oncology, Institute of Oncology, Vilnius University, in 2000-2004. Stage IIIA (T3N1-2M0) cancer was diagnosed for 193 (63.5%) patients and stage IIIB (T4N0-1M0) cancer was diagnosed for 111 (36.5%) patients. There were 277 (91.1%) males and 27 (8.9%) females. According to morphology, there were 219 (72%) patients with squamous cell lung cancer, 80 (26.3%) with adenocarcinoma, and 5 (1.7%) patients with large cell carcinoma. Surgery was performed in 145 patients: 84 (57.9%) patients underwent lung resection (T3-4N0-1M0), 51 (35.2%) patients - thoracotomy, and 10 (6.7%) patients - other palliative thoracic procedures (mediastinotomy, pleurectomy, mediastinoscopy). Forty-eight (30.2%) patients were treated with radiation therapy with total doses of >40 Gy and 58 (36.5%) patients were treated with radiation therapy with total doses of <40 Gy. Fifty-four (33.9%) patients were treated with Gemzar and cisplatin and 19 (11.9%) patients were treated with etoposide and cisplatin. Overall median and mean survival was 7.8 months (95% CI, 6.8 to 8.8) and 9.9 months (95% CI, 9.0 to 10.9), respectively. The median and mean survival of patients with stage IIIA cancer was 8.3 months and 10.4 months, respectively, and that of patients with stage IIIB cancer - 6.4 months and 9.0 months, respectively (P < or =0.05). The median survival of the patients with stage IIIA cancer who received a combination of operation, chemotherapy, and radiation therapy with a total dose of >40 Gy was 14.4 months (mean, 14.7 months), and the median survival of those who received operation, chemotherapy, and radiation therapy with a total dose of < or =40 Gy was 9.7 months (mean, 14.1 months); the median survival of the patients who underwent surgery alone was 4.9 months (mean, 6.7 months) (P=0.004 and P=0.007), respectively. There was a significant difference in the median survival comparing the patients with stage IIIB cancer who underwent surgery alone and those who received a combination of radiation therapy and chemotherapy (median survival of 5.0 months [mean, 8.1 months] versus 16.8 months [mean, 17.6 months], respectively; P < or =0.05). Disease stage had an influence on the survival of patients with non-small cell lung cancer: patients with stage IIIA (T3N0-1M0) cancer without metastases to mediastinal lymph nodes (N factor) survived longer than patients with stage IIIB (T4N1-2M0) cancer, where not only N factor had an impact but T factor as well. Better treatment outcomes, i.e. longer survival, can be achieved when a combination of three treatment types - surgery, chemotherapy, and radiation therapy - is applied to patients with stage IIIA or IIIB non-small cell lung cancer. The patients with stage IIIA disease who received surgery and radiation therapy (total dose, >40 Gy), and combinations of surgery, chemotherapy, and radiation therapy and second-line chemotherapy showed a significantly longer survival than those who received surgery alone.
To determine survival of patients with stage IIIA/B non-small cell lung cancer considering diseas... more To determine survival of patients with stage IIIA/B non-small cell lung cancer considering disease stage and treatment methods. A total of 304 patients with non-small cell lung cancer were treated at the Department of Thoracic Surgery and Oncology, Institute of Oncology, Vilnius University, in 2000-2004. Stage IIIA (T3N1-2M0) cancer was diagnosed for 193 (63.5%) patients and stage IIIB (T4N0-1M0) cancer was diagnosed for 111 (36.5%) patients. There were 277 (91.1%) males and 27 (8.9%) females. According to morphology, there were 219 (72%) patients with squamous cell lung cancer, 80 (26.3%) with adenocarcinoma, and 5 (1.7%) patients with large cell carcinoma. Surgery was performed in 145 patients: 84 (57.9%) patients underwent lung resection (T3-4N0-1M0), 51 (35.2%) patients - thoracotomy, and 10 (6.7%) patients - other palliative thoracic procedures (mediastinotomy, pleurectomy, mediastinoscopy). Forty-eight (30.2%) patients were treated with radiation therapy with total doses of &g...
International journal of occupational medicine and environmental health, 2004
The aim of the present study was to assess the incidence of larynx cancer in Lithuania in the yea... more The aim of the present study was to assess the incidence of larynx cancer in Lithuania in the years 1978-2001 and to outline possible future trends. The number of new laryngeal cancer cases in 1978-2001 was obtained from the Lithuanian Cancer Registry. The Lithuanian Department of Statistics provided data on the population being at the same age in the same years. The data were adjusted for age, using the direct method in accordance with the European standard; a linear regression analysis of trends in the larynx cancer incidence was performed. After standardization of data for the period of 1978-2001, an upward trend was registered for both men and women: in 1978 the incidence was 10.73 for men and 0.26 for women per 100000 population, in 2001 the corresponding data were 11.6 and 0.7. Throughout the study period the incidence was higher in men than in women and the mean age of male and female larynx cancer patients was increasing: mean age for men was annually increasing by 0.1566 ye...
Lithuania remains one of the highest tuberculosis burden countries in Europe. Epidemiological stu... more Lithuania remains one of the highest tuberculosis burden countries in Europe. Epidemiological studies have long pointed to infections as important factors of cancer aetiology, but the association between tuberculosis and the risk of non-pulmonary cancers has rarely been tested and results have been inconsistent. The aim of this population-based cohort study was to examine the risk of cancer among patients diagnosed with tuberculosis using data from Lithuanian Tuberculosis, Cancer and Resident's Registries. The study cohort included 21,986 tuberculosis patients yielding 1583 cancers diagnosed during follow-up (1998-2012). Standardized incidence ratios (SIRs) and 95% confidence intervals (95% CIs) were calculated to compare the incidence of cancer among cohort participants with the general population for overall, non-pulmonary, site-specific cancers, as well as for subgroups of smoking-related, alcohol-related, hormone-related and haematological cancers. The SIRs of all cancers co...
Objective of our work was to evaluate: incidence, ethiology, diagnostic and treatment methods of ... more Objective of our work was to evaluate: incidence, ethiology, diagnostic and treatment methods of malignant pleural mesothelioma. During period 1992-2001 125 cases of pleural mesothelioma were diagnosed in Lithuania. Conventional X-rays and ultrasound were used in 125 cases (100%), chest CT scans in 57 (45.6%), and chest X-rays and CT scans in 38 (30.4%) cases. In 5 cases (4.0%) we performed chest CT scans and MRI. Various surgical diagnostic methods were used: videothoracoscopy in 35 (28.0%) cases, pleural biopsies 72 (57.6%) cases, diagnostic "mini" thoracotomies - 18 (14.4%) cases. Malignant pleural mesothelioma in all cases was proved morphologically. These operations were performed: pleuropulmonectomies - 62 (60.1%), extended pleuropulmonectomies with resections of pericardium and subtotal diaphragm - 10 (9.7%), parietal pleurectomies without resection of lung and pericardium - 17 (16.5%), partial pleurectomies with resection of pericardium - 4 (3.8%), debulking of tumor (partial resections) - 10 (9.7%). Totally 103 patients were operated (82.4%). Twenty two patients were treated conservatively when diagnosis was confirmed. There were such main postoperative complications: fistulas of bronchial stump - 6 cases (5.8%), chylothorax - 5 cases (4.8%), injury of sympatic ganglion - 2 cases (1.9%), and hemothorax - 10 cases (9.7%); 3 patients (2.91%) died after operation. Mean survival time after combined treatment was 12+/-2 months. After conservative treatment alone - 6.0+/-2 months. In combined treatment group 22 patients (17.6%) had recurrence of disease during 3 years. In conservative treatment group no one survived 3 years. Combined surgical treatment of malignant pleural mesothelioma is still the most effective. Most of diagnosed cases were found in delayed stage. Mean survival time after combined treatment is 12.0+/-2 months, after conservative - 6.0+/-2 months, and recurrence of the disease during 3 years - 17.6% and 100% respectively.
OBJECTIVE: To evaluate efficacy of diagnostic procedures, results of surgery, and complications i... more OBJECTIVE: To evaluate efficacy of diagnostic procedures, results of surgery, and complications in malignant pleural diseases.MATERIAL AND METHODS: From 1999 to 2006, 169 patients underwent treatment in the Department of Thoracic Surgery and Oncology, Institute of Oncology, Vilnius University. Patients were divided into two groups: group I, patients with primary pleural malignant diseases (93 patients, 55.0%), and group II, secondary pleural tumors (76 patients, 45%). Of the 76 patients, 40 patients (52.6%) were diagnosed with metastatic pleural tumors and 36 patients (47.4%) with tumors invading parietal pleura. We used noninvasive and invasive methods for diagnosis. Noninvasive methods included chest x-ray, chest computed tomography, magnetic resonance imaging, chest ultrasound, positron emission tomography/computed tomography (performed in Germany), and invasive methods included puncture of pleural effusions, transthoracic pleural puncture, drainage, pleural biopsy and video-assisted thoracoscopic pleural biopsy, pleural resection, and ultrasound-guided needle biopsy of the pleura. The following procedures were performed in group I: pleurectomy in 15 patients (16.1%), pleural pneumonectomy in 42 patients (45.2%), pleural decortication in 12 patients (12.9%), extended pleuropneumonectomy with diaphragm and pericardium resections and plastic surgery in 14 patients (15.0%), pleurectomy with costal resections in 10 patients (10.1%). Procedures performed in group II included video-assisted thoracoscopic pleurectomy in 15 patients (19.7%), pleural biopsy in 10 patients (13.2%), pleurectomy in 15 patients (19.7%), pleural drainage and fenestration in 5 patients (6.5%), lung and pleura resection in 12 patients (15.8%), chest wall and pleura resection in 10 patients (13.2%), diaphragm and pleura resections in 9 patients (11.8%).RESULTS: Early stage primary pleural tumors were found in 24 patients (25.8%). Metastatic pleural disease was found in 32 patients with early primary tumors (80.0%). In all 36 patients (100.0%) with chest wall tumors, disease of advanced stage was determined. Main surgical complications of the group I were observed in 26 patients (27.9%). Six patients (6.5%) died after surgery. In group II, 23 patients (30.2%) had postoperative complications; 3 patients (3.9%) died.CONCLUSIONS: In noninvasive methods, the highest sensitivity was achieved for chest computed tomography and magnetic resonance imaging (97%); the specificity of chest magnetic resonance imaging was 100%, and the specificity chest computed tomography and magnetic resonance imaging--98%. The accuracy of chest x-ray plus computed tomography was 98%. In invasive methods, accuracies of pleural biopsy, video-assisted thoracoscopic pleural biopsy, and pleurectomy were 100%, 90%, and 100%, respectively. In case of primary pleural tumors, the main surgery was extended pleuropulmonectomy (45.2%) with or without mediastinal resection. Mortality rate was 6.5%. In case of metastatic pleural disease, the main surgery was video-assisted thoracoscopic pleurectomy (19.7%). Mortality was rate 5%. In cases of pleural invasion by other thoracic malignancies, the main surgeries were chest wall and pleural resection (13.2%) and lung and pleural resection (15.8%). Mortality rate was 2.8%. After 169 operations due to malignant pleural diseases, the rate of postoperative complications ranged from 1.3% to 7.8%.
To determine survival of patients with stage IIIA/B non-small cell lung cancer considering diseas... more To determine survival of patients with stage IIIA/B non-small cell lung cancer considering disease stage and treatment methods. A total of 304 patients with non-small cell lung cancer were treated at the Department of Thoracic Surgery and Oncology, Institute of Oncology, Vilnius University, in 2000-2004. Stage IIIA (T3N1-2M0) cancer was diagnosed for 193 (63.5%) patients and stage IIIB (T4N0-1M0) cancer was diagnosed for 111 (36.5%) patients. There were 277 (91.1%) males and 27 (8.9%) females. According to morphology, there were 219 (72%) patients with squamous cell lung cancer, 80 (26.3%) with adenocarcinoma, and 5 (1.7%) patients with large cell carcinoma. Surgery was performed in 145 patients: 84 (57.9%) patients underwent lung resection (T3-4N0-1M0), 51 (35.2%) patients - thoracotomy, and 10 (6.7%) patients - other palliative thoracic procedures (mediastinotomy, pleurectomy, mediastinoscopy). Forty-eight (30.2%) patients were treated with radiation therapy with total doses of >40 Gy and 58 (36.5%) patients were treated with radiation therapy with total doses of <40 Gy. Fifty-four (33.9%) patients were treated with Gemzar and cisplatin and 19 (11.9%) patients were treated with etoposide and cisplatin. Overall median and mean survival was 7.8 months (95% CI, 6.8 to 8.8) and 9.9 months (95% CI, 9.0 to 10.9), respectively. The median and mean survival of patients with stage IIIA cancer was 8.3 months and 10.4 months, respectively, and that of patients with stage IIIB cancer - 6.4 months and 9.0 months, respectively (P < or =0.05). The median survival of the patients with stage IIIA cancer who received a combination of operation, chemotherapy, and radiation therapy with a total dose of >40 Gy was 14.4 months (mean, 14.7 months), and the median survival of those who received operation, chemotherapy, and radiation therapy with a total dose of < or =40 Gy was 9.7 months (mean, 14.1 months); the median survival of the patients who underwent surgery alone was 4.9 months (mean, 6.7 months) (P=0.004 and P=0.007), respectively. There was a significant difference in the median survival comparing the patients with stage IIIB cancer who underwent surgery alone and those who received a combination of radiation therapy and chemotherapy (median survival of 5.0 months [mean, 8.1 months] versus 16.8 months [mean, 17.6 months], respectively; P < or =0.05). Disease stage had an influence on the survival of patients with non-small cell lung cancer: patients with stage IIIA (T3N0-1M0) cancer without metastases to mediastinal lymph nodes (N factor) survived longer than patients with stage IIIB (T4N1-2M0) cancer, where not only N factor had an impact but T factor as well. Better treatment outcomes, i.e. longer survival, can be achieved when a combination of three treatment types - surgery, chemotherapy, and radiation therapy - is applied to patients with stage IIIA or IIIB non-small cell lung cancer. The patients with stage IIIA disease who received surgery and radiation therapy (total dose, >40 Gy), and combinations of surgery, chemotherapy, and radiation therapy and second-line chemotherapy showed a significantly longer survival than those who received surgery alone.
To determine survival of patients with stage IIIA/B non-small cell lung cancer considering diseas... more To determine survival of patients with stage IIIA/B non-small cell lung cancer considering disease stage and treatment methods. A total of 304 patients with non-small cell lung cancer were treated at the Department of Thoracic Surgery and Oncology, Institute of Oncology, Vilnius University, in 2000-2004. Stage IIIA (T3N1-2M0) cancer was diagnosed for 193 (63.5%) patients and stage IIIB (T4N0-1M0) cancer was diagnosed for 111 (36.5%) patients. There were 277 (91.1%) males and 27 (8.9%) females. According to morphology, there were 219 (72%) patients with squamous cell lung cancer, 80 (26.3%) with adenocarcinoma, and 5 (1.7%) patients with large cell carcinoma. Surgery was performed in 145 patients: 84 (57.9%) patients underwent lung resection (T3-4N0-1M0), 51 (35.2%) patients - thoracotomy, and 10 (6.7%) patients - other palliative thoracic procedures (mediastinotomy, pleurectomy, mediastinoscopy). Forty-eight (30.2%) patients were treated with radiation therapy with total doses of &g...
International journal of occupational medicine and environmental health, 2004
The aim of the present study was to assess the incidence of larynx cancer in Lithuania in the yea... more The aim of the present study was to assess the incidence of larynx cancer in Lithuania in the years 1978-2001 and to outline possible future trends. The number of new laryngeal cancer cases in 1978-2001 was obtained from the Lithuanian Cancer Registry. The Lithuanian Department of Statistics provided data on the population being at the same age in the same years. The data were adjusted for age, using the direct method in accordance with the European standard; a linear regression analysis of trends in the larynx cancer incidence was performed. After standardization of data for the period of 1978-2001, an upward trend was registered for both men and women: in 1978 the incidence was 10.73 for men and 0.26 for women per 100000 population, in 2001 the corresponding data were 11.6 and 0.7. Throughout the study period the incidence was higher in men than in women and the mean age of male and female larynx cancer patients was increasing: mean age for men was annually increasing by 0.1566 ye...
Lithuania remains one of the highest tuberculosis burden countries in Europe. Epidemiological stu... more Lithuania remains one of the highest tuberculosis burden countries in Europe. Epidemiological studies have long pointed to infections as important factors of cancer aetiology, but the association between tuberculosis and the risk of non-pulmonary cancers has rarely been tested and results have been inconsistent. The aim of this population-based cohort study was to examine the risk of cancer among patients diagnosed with tuberculosis using data from Lithuanian Tuberculosis, Cancer and Resident's Registries. The study cohort included 21,986 tuberculosis patients yielding 1583 cancers diagnosed during follow-up (1998-2012). Standardized incidence ratios (SIRs) and 95% confidence intervals (95% CIs) were calculated to compare the incidence of cancer among cohort participants with the general population for overall, non-pulmonary, site-specific cancers, as well as for subgroups of smoking-related, alcohol-related, hormone-related and haematological cancers. The SIRs of all cancers co...
Objective of our work was to evaluate: incidence, ethiology, diagnostic and treatment methods of ... more Objective of our work was to evaluate: incidence, ethiology, diagnostic and treatment methods of malignant pleural mesothelioma. During period 1992-2001 125 cases of pleural mesothelioma were diagnosed in Lithuania. Conventional X-rays and ultrasound were used in 125 cases (100%), chest CT scans in 57 (45.6%), and chest X-rays and CT scans in 38 (30.4%) cases. In 5 cases (4.0%) we performed chest CT scans and MRI. Various surgical diagnostic methods were used: videothoracoscopy in 35 (28.0%) cases, pleural biopsies 72 (57.6%) cases, diagnostic "mini" thoracotomies - 18 (14.4%) cases. Malignant pleural mesothelioma in all cases was proved morphologically. These operations were performed: pleuropulmonectomies - 62 (60.1%), extended pleuropulmonectomies with resections of pericardium and subtotal diaphragm - 10 (9.7%), parietal pleurectomies without resection of lung and pericardium - 17 (16.5%), partial pleurectomies with resection of pericardium - 4 (3.8%), debulking of tumor (partial resections) - 10 (9.7%). Totally 103 patients were operated (82.4%). Twenty two patients were treated conservatively when diagnosis was confirmed. There were such main postoperative complications: fistulas of bronchial stump - 6 cases (5.8%), chylothorax - 5 cases (4.8%), injury of sympatic ganglion - 2 cases (1.9%), and hemothorax - 10 cases (9.7%); 3 patients (2.91%) died after operation. Mean survival time after combined treatment was 12+/-2 months. After conservative treatment alone - 6.0+/-2 months. In combined treatment group 22 patients (17.6%) had recurrence of disease during 3 years. In conservative treatment group no one survived 3 years. Combined surgical treatment of malignant pleural mesothelioma is still the most effective. Most of diagnosed cases were found in delayed stage. Mean survival time after combined treatment is 12.0+/-2 months, after conservative - 6.0+/-2 months, and recurrence of the disease during 3 years - 17.6% and 100% respectively.
OBJECTIVE: To evaluate efficacy of diagnostic procedures, results of surgery, and complications i... more OBJECTIVE: To evaluate efficacy of diagnostic procedures, results of surgery, and complications in malignant pleural diseases.MATERIAL AND METHODS: From 1999 to 2006, 169 patients underwent treatment in the Department of Thoracic Surgery and Oncology, Institute of Oncology, Vilnius University. Patients were divided into two groups: group I, patients with primary pleural malignant diseases (93 patients, 55.0%), and group II, secondary pleural tumors (76 patients, 45%). Of the 76 patients, 40 patients (52.6%) were diagnosed with metastatic pleural tumors and 36 patients (47.4%) with tumors invading parietal pleura. We used noninvasive and invasive methods for diagnosis. Noninvasive methods included chest x-ray, chest computed tomography, magnetic resonance imaging, chest ultrasound, positron emission tomography/computed tomography (performed in Germany), and invasive methods included puncture of pleural effusions, transthoracic pleural puncture, drainage, pleural biopsy and video-assisted thoracoscopic pleural biopsy, pleural resection, and ultrasound-guided needle biopsy of the pleura. The following procedures were performed in group I: pleurectomy in 15 patients (16.1%), pleural pneumonectomy in 42 patients (45.2%), pleural decortication in 12 patients (12.9%), extended pleuropneumonectomy with diaphragm and pericardium resections and plastic surgery in 14 patients (15.0%), pleurectomy with costal resections in 10 patients (10.1%). Procedures performed in group II included video-assisted thoracoscopic pleurectomy in 15 patients (19.7%), pleural biopsy in 10 patients (13.2%), pleurectomy in 15 patients (19.7%), pleural drainage and fenestration in 5 patients (6.5%), lung and pleura resection in 12 patients (15.8%), chest wall and pleura resection in 10 patients (13.2%), diaphragm and pleura resections in 9 patients (11.8%).RESULTS: Early stage primary pleural tumors were found in 24 patients (25.8%). Metastatic pleural disease was found in 32 patients with early primary tumors (80.0%). In all 36 patients (100.0%) with chest wall tumors, disease of advanced stage was determined. Main surgical complications of the group I were observed in 26 patients (27.9%). Six patients (6.5%) died after surgery. In group II, 23 patients (30.2%) had postoperative complications; 3 patients (3.9%) died.CONCLUSIONS: In noninvasive methods, the highest sensitivity was achieved for chest computed tomography and magnetic resonance imaging (97%); the specificity of chest magnetic resonance imaging was 100%, and the specificity chest computed tomography and magnetic resonance imaging--98%. The accuracy of chest x-ray plus computed tomography was 98%. In invasive methods, accuracies of pleural biopsy, video-assisted thoracoscopic pleural biopsy, and pleurectomy were 100%, 90%, and 100%, respectively. In case of primary pleural tumors, the main surgery was extended pleuropulmonectomy (45.2%) with or without mediastinal resection. Mortality rate was 6.5%. In case of metastatic pleural disease, the main surgery was video-assisted thoracoscopic pleurectomy (19.7%). Mortality was rate 5%. In cases of pleural invasion by other thoracic malignancies, the main surgeries were chest wall and pleural resection (13.2%) and lung and pleural resection (15.8%). Mortality rate was 2.8%. After 169 operations due to malignant pleural diseases, the rate of postoperative complications ranged from 1.3% to 7.8%.
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