Free-circulating DNA concentration in plasma was significantly higher in NSCLC patients versus healthy controls. Its drastic increase following radical NSCLC treatment was most likely due to the surgical trauma. Importantly, the kinetics of plasma free-circulating DNA seems to be a promising marker of long-term effects of radical surgery in NSCLC.

According to the literature patient's age, nutrition and smoking status, cardiopulmonary comorbidity and surgeon's experience are the main factors associated with perioperative complications after pulmonary resection. The purpose of the study was to identify the correlation between pre- and intraoperative risk factors and complications after pneumonectomy for primary carcinoma of the lung. Between Sept. 11th 1999 and Dec. 20th 2003 121 standard pneumonectomies were performed in patients with non small-cell lung cancer. Sixteen risk factors noted in the patients before surgery were correlated with complications occurred after pneumonectomy. Overall mortality and morbidity rates were 3.3% and 30.6%, respectively. Twenty patients (16.5%) experienced cardiac rhythm disturbances, six (4.9%)--pleural haematomas, five (4.1%)--main bronchus stump fistulas, four (3.3%)--acute respiratory failure. Chronic obstructive pulmonary disease was correlated with broncho-pleural fistulas and acute respiratory failure after surgery. Chronic coronary disease was associated with postoperative cardiac arrhythmias, whereas postoperative bleeding was correlated with the overweight of the patients. Chronic obstructive pulmonary disease, chronic coronary disease and overweight are the risk factors associated with complications after pneumonectomy.

Even when patients with nonsmall cell lung cancer undergo surgical resection at an early stage, recurrent disease often impairs the clinical outcome. There are numerous causes potentially responsible for a relapse of the disease, one of them being extensive angiogenesis. The balance of at least two systems, VEGF VEGFR and Ang Tie, regulates vessel formation. The aim of this study was to determine the impact of surgery on the plasma levels of the main angiogenic factors during the first month after surgery in nonsmall cell lung cancer patients. The study group consisted of 37 patients with stage I nonsmall cell lung cancer. Plasma concentrations of Ang1, Ang2, sTie2, VEGF, and sVEGF R1 were evaluated by ELISA three times: before surgical resection and on postoperative days 7 and 30. The median of Ang2 and VEGF concentrations increased on postoperative day 7 and decreased on day 30. On the other hand, the concentration of sTie2 decreased on the 7th day after resection and did not change statistically later on. The concentrations of Ang1 and sVEGF R1 did not change after the surgery. Lung cancer resection results in proangiogenic plasma protein changes that may stimulate tumor recurrences and metastases after early resection.