Roentgenographically occult lung cancer

Da, Cortese; Pc, Pairolero; Ej, Bergstralh; Lb, Woolner; Ma, Uhlenhopp; Jm, Piehler; Dr, Sanderson; Pe, Bernatz; De, Williams; Wf, Taylor; Ws, Payne; Rs, Fontana

doi:10.1016/s0022-5223(19)39149-4

Cited by 179 publications

(38 citation statements)

References 13 publications

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“…The importance of finding Stage 0 lung tumors is that a number of curative endobronchial treatment modalities are now available in addition to surgery. The 5‐year survival rate for patients with Stage 0 lung carcinoma after PDT,1, 12 electrocautery,3 or YAG laser therapy4 or surgery5, 6 is >90%. A number of promising chemopreventive agents also are under evaluation currently in high risk patients with bronchial dysplasia to reduce the risk of lung carcinoma 33.…”

Section: Resultsmentioning

confidence: 99%

“…The primary reason for such a dismal cure rate is that the great majority of lung tumors are found at a very late stage. Because the presence of symptoms usually indicates advanced disease, a potentially more effective way to improve the outcome is to detect tumors in the asymptomatic stage when curative treatment, such as photodynamic therapy (PDT),2 electrocautery,3 or YAG laser therapy4 or surgery,5, 6 can be applied.…”

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confidence: 99%

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Detection and localization of early lung cancer by fluorescence bronchoscopy

Lam¹,

MacAulay²,

LeRiche³

et al. 2000

Cancer

167

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BACKGROUND Curative therapy is available for patients with Stage 0 lung carcinoma, with a >90% 5‐year survival rate. Promising chemopreventive agents also are under investigation currently to reduce the risk of lung carcinoma in high risk populations. However, preinvasive bronchial lesions (moderate to severe dysplasia and carcinoma in situ) are very small and thin. They are difficult to localize by conventional white‐light bronchoscopy. Fluorescence bronchoscopy is a new diagnostic tool for the detection of these preinvasive lesions. METHODS The data on the use of fluorescence bronchoscopy to detect and localize preinvasive lesions in current heavy smokers and in former smokers at the British Columbia Cancer Agency as well as the worldwide experience cited in MEDLINE, Index Medicus, and Deutsches Institut fur Medizinische Dokumentation und Information (Cologne, Germany) comparing white‐light and fluorescence bronchoscopy using the lung imaging fluorescence endoscope (LIFE)‐Lung device (Xillix Technologies Corp., Richmond, British Columbia, Canada) were reviewed. RESULTS Among current heavy smokers and former smokers with sputum atypia, the prevalence of carcinoma in situ was 1.6%. Moderate or severe dysplasia was found in another 19%. The preinvasive lesions were found to be small: 55% measured ≤1.5 mm in greatest dimension. Over 1000 cases have been reported in the literature between 1994 and 1999. Overall, 40% of the preinvasive lesions were detected by white‐light bronchoscopy alone. The addition of fluorescence bronchoscopy increased the detection rate to an average of 80%. CONCLUSIONS Preinvasive lesions, especially dysplastic lesions, are small. They are difficult to detect and localize by white‐light bronchoscopy. Fluorescence bronchoscopy improves the detection rate. It is an important part of the armamentarium in the overall management of early lung cancer. Cancer 2000;89:2468–73. © 2000 American Cancer Society.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Detection and localization of early lung cancer by fluorescence bronchoscopy

Lam¹,

MacAulay²,

LeRiche³

et al. 2000

Cancer

167

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“…4,16 -18 However, limited resections, such as segmentectomy or sleeve resection, have never been evaluated in these lesions. The 5-year overall survival for surgery has ranged from 50 to 91%, 17,18 and was only about 10% at 10 years in one of these reports. 17 Moreover, several characteristics of this population with early stage lung cancers limit surgical efficacy: (1) at the time of diagnosis, these lesions are often multifocal (19% in our population); (2) later, the appearance of a second location in the follow-up is very frequent 17 and reached 23% in our population;…”

Section: Discussionmentioning

confidence: 97%

“…(3) functional impairment with severe COPD, common in such heavy smokers, as well as a history of bronchogenic or upper aerodigestive tract carcinoma (42% in our population) either contraindicate surgery or increase mortality. For example, in one surgical report, 18 operative mortality rate was 5 to 6%, which is quite high.…”

Section: Discussionmentioning

confidence: 97%

Cryotherapy in Early Superficial Bronchogenic Carcinoma

Deygas

Froudarakis

Ozenne

et al. 2001

Chest

127

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“…Therefore, the main application is in the treatment of carcinoma in situ or intramural invasive tumor. The likelihood of lymph node metastasis from these types of tumors is low (7,8). In our study, seven out of nine cancers with a complete response after laser hyperthermia were roentgenographically occult tumors less than 3 cm 2 in surface area and within the reach of the flexible fiberoptic bronchoscope.…”

Section: Discussionmentioning

confidence: 51%

Bronchoscopic Local Nd:YAG Laser Hyperthermia in the Treatment of Lung Cancer

Ono¹

1994

Diagnostic and Therapeutic Endoscopy

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Between March 1989 and July 1990, 13 patients with tracheobronchial cancer were treated by laser hyperthermia at the National Cancer Center Hospital. A complete response was achieved in 9 patients (with 9 carcinoma lesions), with no evidence of local recurrence on follow-up ranging from 4 to 29 months. Four patients had a partial response, requiring alternative therapy. The surface area of the lesions showing complete response was less than 3 cm2. These lesions had a superficial appearance by bronchoscopic observation. Our experience suggests that laser hyperthermia may be a useful alternative to surgical resection in patients with small localized tumors confined within the tracheobronchial wall.

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Roentgenographically occult lung cancer

Cited by 179 publications

References 13 publications

Detection and localization of early lung cancer by fluorescence bronchoscopy

Detection and localization of early lung cancer by fluorescence bronchoscopy

Cryotherapy in Early Superficial Bronchogenic Carcinoma

Bronchoscopic Local Nd:YAG Laser Hyperthermia in the Treatment of Lung Cancer

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