Aims.To study the life expectancy of patients with small cell lung cancer, depending on the method of treatment; to determine the efficacy of surgical component at the treatment stages of small cell lung cancer and preoperative chemotherapy Materials and methods.The study involved 852 patients with small cell lung cancer. All patients were subdivided into 3 groups. I.Untreated -155 (18.2%) patients who refused or who were denied treatment due to medical indications.II. Conservative treatment -558 (65.5%) patients who received chemoradiotherapy. III.Surgical treatment -139 (16.3%) patients, including: 1-1st subgroupsurgery (without mediastinal lymph node dissection) -in 31 (3.6%); 2-2nd subgroupsurgery (without mediastinal lymph node dissection), 4 courses of postoperative polychemotherapy and external beam radiotherapyin 81 (9.5%); 3-3rd subgroup -3-4 courses of preoperative polychemotherapy, surgery with mediastinal lymph node dissection, postoperative polychemotherapy 2-4 coursesin 27 (3.1%). Among the patients there were 809 (94.9%) men and 43 (5.1%) women. The predominating groups were patients aged: 50-59 years -249 persons (29.2%) and 60-69 years -314 patients (36.8%). The largest number of patients were in stage IIIA (299 persons, 35.1%), and a slightly smaller number of patients with stage IIIB (194 persons, 22.7%)Results.The use of surgical treatment of small cell lung cancer has a positive effect on the average life expectancy in patients of group III -26.4 months, which is longer than in group II by 19.6 and group Iby 24.2 months.The size of the primary lung tumour starts affecting the average life expectancy of patients with tumour process T1-2, and metastases to regional lymph nodeswith tumour process T2-3N1-2. Conclusions.Removal of primary malignant tumour with mediastinal lymph node dissection followed by adjuvant polychemotherapy with modern drugs has a positive effect on the survival of patients.
The result of treatment of primary Hodgkin's lymphoma lesion of the thymus gland of a 26-year-old patient is presented. At the preoperative stage of examination, tumor maligna cells were obtained during puncture of mediastinal formation. The diagnosis is malignant tumor of the mediastinum. Considering this, a surgical treatment was performed-radical removal of the mediastinal tumor. After the study of the postoperative drug, a clinical diagnosis was made: lymphogranulomatosis, a massive (bulky) tumor lesion of the mediastinum, stage IIХ, after surgical treatment. First course of ABVD chemotherapy was performed 28 days after the operation. When performing the second course of chemotherapy according to the same scheme, the patient developed complications in the form of moderate leukocytopenia (leukocytes, 0.9109/l) and stomatitis. Special treatment was discontinued, and the patient was observed by an oncologist in the polyclinic of an oncological dispensary. At the next examination, which was performed 11 months later, a relapse of the disease was identified. Considering the preservation of persistent leukopenia (leukocytes, 3.0109/l), it was decided to conduct six courses of ABVD polychemotherapy with prednisone, against the background of G-CSF. At this stage of oncology, the main method of treating Hodgkin's lymphoma is chemo-hormone therapy in combination with radiation therapy. The performed non-standard complex treatment is radical surgical removal of a mediastinal tumor followed by polychemotherapy. It allowed 4 years after the completion of treatment to know motherhood, which did not affect the patient's health. As indicated by the long relapse, free period of the disease is 16 years, and life expectancy is 18 years.
The study presents the results of the combined surgical treatment of a pinched, unrecoverable ventral hernia of the anterior abdominal cavity, resection of a non-viable pinched loop of the small intestine, and side-to-side anastomosis and removal of a large retroperitoneal tumor. The latter required an incision of the anterior abdominal wall along the white line of the abdomen, from the xiphoid process of the sternum, to the upper border of the pubis, with subsequent plastic surgery of the hernial gate with local tissues.
The result of radical treatment of locally advanced thyroid cancer with metastases to the regional lymph nodes of the neck on the left, with tissue breakdown and skin fistula formation, is presented. An 84-year-old female patient has severe concomitant pathology, such as ischemic heart disease, widespread atherosclerosis, cardiosclerosis, and permanent atrial fibrillation (tachy form, Grade 2A). A conglomerate of lymph nodes with disintegration in the projection of the external jugular vein and possible profuse bleeding was considered an absolute indication for surgery, which was performed on February 10, 2015. Considering the conglomeration of the lymph nodes of the neck, which displaced the trachea to the right, an endoscopist was called in, who performed tracheal intubation through the nose using a fiberoptic bronchoscope. The surgical treatment included combined thyroidectomy, a Criles operation on the left side, and the removal of the conglomerate of the lymph nodes of the neck as well as the adjacent area of the skin in a single block. The postoperative period was uneventful. On the second day after surgery, the patient was examined by an endocrinologist. The prescribed treatment was L-thyroxine 75 mg once a day in the morning. On the fifth day, the patient was discharged with recovery to be treated in the outpatient clinic by an oncologist and an endocrinologist.
The result of the radical treatment for multiple gastrointestinal stromal tumors of large size (GIST) coming from the anterior wall of the stomach has been represented. Conducted researches at the prehospital stage are not indicated on the GIST of the stomach. The GIST presence was confirmed by the immunohistochemical study.
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