Adenocarcinoma of the lung in men.A clinicopathologic study of 100 cases

Abstract

One hendred adenocarcinomas of the lung were studied. Adenocarcinoma accounted for 9% of primary pulmonary malignancies in men examined for this study. Clinical features included peripheral location (65%), frequent lack of symptoms (28%), and difficulty in making a diagnosis prior to thoracotomy. Seventy‐one per cent of the adenocarcionmas were resected with only 9% 5‐year cures. Vascular invasion, pleural invasion, and degree of tumor differentiation were of no prognostic significance, but metastasis to lymph nodes and large tumor size were adverse factors. Almost half of the adenocarcinomas were associated with pre‐existent pulmonary scars, with transition from atypical metaplasia to carcinoma. Scar‐associated carcinomas seemed to have a more favorable prognosis. Reasons for the low cure rate are unclear. The incidence of lymph node and vasular nvasion is comparable to other bronchogenic and “recurrences” or “pulmojnary metastasis” may represent second primaries arising in such foci.

Pathological Factors in Survival of Lung Tumours: Local Extent, Size, and Nodal Involvement

“…In the present series 37 out of 45 patients included in P3 category had a 5 year follow-up; of 5 survivors, 4 had been included in P3 category as the tumours had involved the thoracic wall; none had lymph node metastasis. Moreover, Bennet et al (1969) (Table Vll). In any case, in N+ tumours there was no statistically significant difference in survival at 5 years amongst the 4 P categories (Fig.…”

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(Collier et al, 1958;Spjut et al, 1961;Maamies, 1966;Schottenfield, 1968;Jackman et al, 1969;Bennet et al, 1969; Slack, 1970) has been emphasized by some authors and denied by others.Higgins and Beebe (1967) found that only 4 or 5 out of 40 both clinical and pathological factors examined carried independent information predictive of cancer-free survival at 36 or 60 months. Midorikawa et al (1968) found that it was difficult to predict the prognosis of resected lung tumours on the basis of pathological examination.

This disagreement can be in part explained by the limitations of routine pathological examination (Sherwin, 1966) and more generally with the rather rough definition of some of the studied factors.

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“…ATTEMPTS to find clinical as well as pathological factors bearing on the prognosis of lung tumours have been for the most part unrewarding (Watson, 1968;Bennet et al, 1969). General agreement has been reached on the predictive value of nodal involvement, which lowers significantly the survival rate (Nohl, 1960;Hukfll and Stern, 1962;Bergh and Sherste'n, 1965;Nagaishi and Okada, 1968;Goldberg et al, 1970).…”

“…General agreement has been reached on the predictive value of nodal involvement, which lowers significantly the survival rate (Nohl, 1960;Hukfll and Stern, 1962;Bergh and Sherste'n, 1965;Nagaishi and Okada, 1968;Goldberg et al, 1970). The value of other pathological factors like size of the tumour, pleural and/or vascular involvement, histological type, site and/or location of the tumour (Collier et al, 1958;Spjut et al, 1961;Maamies, 1966; Schottenfield, 1968;Jackman et al, 1969;Bennet et al, 1969;Slack, 1970) has been emphasized by some authors and denied by others.…”

A 2-year retrospective review of the effect of cigarette smoking status on the histological cell types of lung carcinoma in the Western Cape

“…Owing to further research performed in the 1940s, there was a subsequent evolution in the understanding of SC and the following clinical features were then thought to make the diagnosis of SC more likely: the tumour is peripherally located with a size of less than 3 cm in diameter, upper-lobe predominance, more commonly found in males, and usually of ADC histological subtype. [20][21][22] A large cohort analysis of the prostate, lung, colorectal and ovarian cancer screening trial demonstrated a clear correlation between scar presence and the development of a carcinoma. [23] Cigarette smoking has long been known to be associated with chronic lung destruction and the development of lung cancer.…”