Peritoneoscopy in the staging of 190 patients with small-cell anaplastic carcinoma of the lung with special reference to subtyping

Dombernowsky, P; Hirsch, Fred R.; Hansen, Heine H.; Hainau, Bo

doi:10.1002/1097-0142(197805)41:5<2008::aid-cncr2820410548>3.0.co;2-i

Cited by 42 publications

(4 citation statements)

References 14 publications

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“…Prior to initiation of therapy all patients were evaluated with a routine history and physical examination, chest X-ray, bilateral bone marrow examinations (Hirsch et al, 1979) and peritoneoscopy with liver biopsy (Dombernowsky et al, 1978). Aspirates or biopsies were obtained when pleural fluid, enlarged lymph nodes or cutaneous metastases were observed.…”

Section: Methodsmentioning

confidence: 99%

Chemotherapy versus chemotherapy plus irradiation in limited small cell lung cancer. Results of a controlled trial with 5 years follow-up

Østerlind¹,

Hansen²,

Hh³

et al. 1986

Br J Cancer

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Summary One hundred and forty-five patients with limited stage small cell lung cancer were included in a randomized trial to evaluate the effect of chemotherapy with or without chest irradiation. Seventy-six patients were allotted chemotherapy alone while 69 patients received the same chemotherapy plus radiotherapy, 40 Gy in split-course, administered in weeks 6 and 10 after the initiation of chemotherapy. The chemotherapy consisted of lomustine, cyclophosphamide, vincristine and methotrexate. Patients treated with chemotherapy alone survived for a median of 52 weeks compared to 44 weeks in patients receiving the combined regimen (P=0.055). After exclusion of five early deaths and one patient refusing the irradiation plus 14 completely resected patients, the remaining 65 patients receiving chemotherapy alone and the 60 patients treated with chemotherapy plus radiotherapy were included in a new analysis. The difference in survival duration which could be ascribed to treatment with or without chest irradiation thereby diminished (P=0.24). Eighteen months' disease-free survival was obtained in 9.2% of the 65 patients and in 9.8% of the 60 patients. The complete remission rates were 37% and 46%, respectively, (P=0.33) and the median durations of complete remission were 40 weeks and 52 weeks (P=0.67). Treatment failure of the primary tumour occurred in 85% of patients treated with chemotherapy alone in contrast to 61% of patients receiving the combined regimen (P=0.005). Seventy-nine of these patients underwent autopsy at which no residual chest disease was observed in 17% and 37%, respectively (P=0.045). The combined regimen was more toxic than chemotherapy alone resulting in significantly greater dose reductions and more pronounced thrombocytopenia. Lung and pericardial fibrosis was responsible for four deaths among the complete responders in the radiotherapy group.The combined regimen thus tended to be more efficacious with respect to tumour control at the expense, however, of increased toxicity which per se, eliminated a potential improvement of the overall therapeutical results.

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Section: Methodsmentioning

confidence: 99%

Chemotherapy versus chemotherapy plus irradiation in limited small cell lung cancer. Results of a controlled trial with 5 years follow-up

Østerlind¹,

Hansen²,

Hh³

et al. 1986

Br J Cancer

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“…6 The CAT scan is complementary to the other noninvasive studies and has been shown to be superior to the isotope scan when a patchy uptake is seen.:'." Abdominal lymph node enlargement was not often found.…”

Section: Discussionmentioning

confidence: 99%

Computerized axial tomography in the pretreatment assessment of small-cell carcinoma of the bronchus

Harper

Souhami

Houang

et al. 1981

Cancer

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Computerized axial tomographic scans (CAT scans) of thorax and abdomen were used as part of the initial staging procedure of 50 consecutive patients with small-cell bronchogenic carcinoma (SCBC). The aims were to define the extent of the primary tumor and metastatic spread, and to compare the information obtained from CAT scans with conventional staging procedures. With CAT scanning, spread of the primary tumor was found to be far more extensive than originally believed when defined by conventional assessment. Of 35 patients conventionally staged as localized T1 or T2 tumors, 27 (77%) had their stage increased to extensive T3 disease. similarly, subcarinal lymph nodes were found in one patient when conventional methods were used (2%), but 16 patients (32%) were found when CAT scan was used. Unsuspected adrenal metastases were found in eight patients (16%) and retrocrural nodes in four patients (8%). Thirty-seven patients (74%) were found to have Stage III tumors when conventional staging was used; 47 patients (94%) were found to be Stage III following CAT scanning, demonstrating that, within the thorax, localized tumors are very uncommon. CAT scanning demonstrates the degree of intrathoracic spread very clearly, and has a valuable role in the initial investigation of patients with SCBC if the planned treatment includes radiotherapy.

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“…In most cancers, assessment of liver metastasis is usually by clinical examination, biochemistry, and isotope scans.23 These methods have been validated in SCBC by comparison with laparoscopic biopsies. 6 The CAT scan is complementary to the other noninvasive studies and has been shown to be superior to the isotope scan when a patchy uptake is seen.:'." In the study reported here seven of 50 cases were considered to have metastatic disease after conventional staging compared which six (12%)) following CAT scanning.…”

Section: Discussionmentioning

confidence: 99%

Computerized Axial Tomography in the Pretreatment Assessment of Small-Cell Carcinoma of the Bronchus

Harper¹,

Houang²,

Spiro³

et al. 1981

Journal of Computer Assisted Tomography

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Computerized axial tomographic scans (CAT scans) of thorax and abdomen were used as part of the initial staging procedure of 50 consecutive patients with small-cell bronchogenic carcinoma (SCBC). The aims were to define the extent of the primary tumor and metastatic spread, and to compare the information obtained from CAT scans with conventional staging procedures. With CAT scanning, spread of the primary tumor was found to be far more extensive than originally believed when defined by conventional assessment. Of 35 patients conventionally staged as localized T, or T, tumors, 27 (77%) had their stage increased to extensive TS disease. Similarly, subcarinal lymph lymph nodes were found in one patient when conventional methods were used (2%), but 16 patients (32%) were found when CAT scan was used. Unsuspected adrenal metastases were found in eight patients (16%) and retrocrural nodes in four patients (8%). Thirty-seven patients (74%) were found to have Stage 111 tumors when conventional staging was used; 47 patients (94%) were found to be Stage 111 following CAT scanning, demonstrating that, within the thorax, localized tumors are very uncommon. CAT scanning demonstrates the degree of intrathoracic spread very clearly, and has a valuable role in the initial investigation of patients with SCBC if the planned treatment includes radiotherapy.

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Peritoneoscopy in the staging of 190 patients with small-cell anaplastic carcinoma of the lung with special reference to subtyping

Cited by 42 publications

References 14 publications

Chemotherapy versus chemotherapy plus irradiation in limited small cell lung cancer. Results of a controlled trial with 5 years follow-up

Chemotherapy versus chemotherapy plus irradiation in limited small cell lung cancer. Results of a controlled trial with 5 years follow-up

Computerized axial tomography in the pretreatment assessment of small-cell carcinoma of the bronchus

Computerized Axial Tomography in the Pretreatment Assessment of Small-Cell Carcinoma of the Bronchus

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