286 Abstracts/Lung Cancer I2 (1995) 265-329

Mehstasls in tongue from carcinoma of broochus: A case report Shehab Z. Desousa S, Pahor AL. Ciry Hospitol, Dudley Road, Birmingham BIS 7Q,? J Laiyngol tXo1 1994;108:1099-1101.

A case of ewcinoma of the lung with a metastasis on the tongue is presented. The ease is of interest because, although primaly carcinomas of the tongue are fairly common accounting for 50 per cent of all oral carcinomas, mctastatic turnour represents only one per cent of all malignant turnours of the oral cavity and of these only 0.2 per cent metastesize to the tongue.

~omcmp~y~dedfiwo~pllmoaorybiopsy~~ROTEX needle: Results from 890 patients with focal lung lesions Szolar DHM, Preidlcr KW, Kugln C, Hausegger K, Klein GE, Popper H et al. UniversitaIsklinik/ur Radiologie. Auenbruggerplatz 9, A-8036 Graz. Rofo Fortschr. Geb RontgCnstr Neucn Bildgcbendm Verfahren 1994;161:505-11.

Fluoroscopically guided transthoracic line needle biopsies were performed in 890 patients (380 female, 582 male, mean age: 56 years). In 795 patients (89.4%) the first biopsy was successful. The success rate of biopsy correlated closely with the size of the lesion and increased with larger size. Sensitivity in the diagnosis of malignant lesions was 94.6%, specificity 99.5%. Due to cytological, histological, and clinical confirmation of benign lung lesions in 300 patients (33.7% of all patients), the number of unnecessary diagnostic thoracotomics for benign disease could be reduced significantly. In 9 of 113 cases (8%) histological reclassitication of the cytologic results was necessary. Reclassification was not necessary in the differentiation between benign and malignant lesions and between small cell and non-small cell carcinomas. The overall complication rate was 24.7% (220 patients). Only 36 patients (4% of all patients) required chest-tube insertion. There were no fatal complications. Pcrcutancous tluoroscopicelly guided transthoracic tine needle biopsy of the lung, performed with the Rotex needle, is a time-effective, safe. and ellicient method for diagnosing focal pulmonary lesions.

Videotboracoscopy and video-assisted smail tboracotomy for tbe treatment of pulmoaary maligoancies Casadio C, Giobbe R, Cianci R, Molinatti M, Oliaro A, Maggi G. Department of Thoracic Surgery, University of ‘lirrin. via Genovo 3. 10126 Turin. J Cardiovesc Swg 1994;35:44S-8.

Video-assisted thoracic surgical procedures continue to be performed with increased frequency, the role of this new technique in the treatment of pulmonary malignancies or metastetic mediastinal adenopathics is not yet defined. Out of a series of 100 consecutive video-assisted thoracic operations, 22 patients resulted affected by a malignancy in the lung or in the subearinal lymphnodes: six patients had a primary lung cancer and were operated with a video-assisted small thorawtomy of 5 cm (three lobectomy and three segmcntcotomy) because of a vcty poor respiratory reserve. Nine patients received a video-assisted wedge resection of a nodule resulted et the frozen section a metastasis of a carcinoma: a smell thoracotomy of 8 cm was made and a hand entered the thoracic cage to obtain 8 careful palpation ofthc entire lung; five patients had enlarged lymphnodes only in posterior and inferior mcdiastinum, inaccessible by cervical mediestinoscopy or anterior mediastinotomy: thoracoscopic exploration obtained a useful mediastinal nodal sampling for these adenopathies. In selected cases video-assisted thoracic surgery can be used for resection or assessment of thorn&c malignancies.

Aeascdadcnocarciooataoftbchmg sxtmddIy treated by combiiation cl~~mothcrapy with cisplatbt and viadesii resulting ia a long swvival without recurreoceaod synch-s thyroidcancer Haiti S, Kimum Y, Oke2aki M. Division of IntemolMedicine. Chugoku Chuoh Hospital, Muhad Aid Association, Fukuyamo. Jpn J Chest Dis 1994;53:925- 30.

A combined chemotherapy with cisplatin (20 mgim’, day 1-S) and vindcsine (3 mp”m’, day 1 and 8) was administered for a 68-yearaId male patient with a low differentiated adenocarcinoma of the lung (T3NOMI) and pulmonary hypofimction. A&r completion of 3 courses, the lesion on chest radiographs became unnoticeable. Afler completion of 3 courses, the chest CT showed only a scar like shadow, Then a thyroid cancer was found and was resected Non- recurrent non small cell lung caneer following chemotherapy for a long time is uncommon. This patient has been well without recurrence of either tumor for 4 years and 7 months afler the initiation of chemotherapy.

Small cell long cancer presenting as a metastatic conjonctival tumor Gotoh T, Tsujimoto S, Hashimoto S, Arimoto T, Iwasaki Y, Hiramori N et al. Second Deparbnenf ofMpdicine, Kyofo Pr&~ural Yosanoumi Hospital, Kyoto. Jpn J Thorec Dis 1994;32:1120-4.

A 65-year-old man complaining of a let? medial ocular angle mass and hcmoptysis was admitted to our hospital. Chest radiography revealed a right hilar mess and bronchoscopy revealed widespread cancerous invasion of the carinn, both main bronchi, right upper lobe bmnchus, truncus intermedius, and middle lobe bronchus. Histological examination of 8 biopsied specimen revealed small cell carcinoma. Brain CT scan, abdominal CT scan, and bone scintigmm showed solitary brain, multiple liver, and multiple bone metestases. Partial response was obtained with three courses of combined chemotherapy with carboplatin and ctoposidc, and the ocular tomor until it was almost invisible to the unaided eye. However, complete response could not be obtained with additional hvo courses of combined chemotherapy, and the patient was discharged. Seven months after the first admission, he was readmitted with dyspnca and en enlarged (6 mm in diameter) lefi ocular mass. Histological examination of the resected mass revealed a small cell carcinoma that had metastasized to the conjunctival substantia prop&. He died of respiratory failure one month after readmission. Metastasis to the eye from primary lung cancer is uncommon and patients such as this we extremely rare. Although some cases of weal or orbital metastasis from lung cancer have been reported, we can find no other report of conjunctival metastasis from lung cancer.

Meawrable or assessable disease in luhg caocer trials: Does it matter? ktt JR, Su JQ, Krook IE, Goldberg RM, Kuglcr JW. NCCTWU. Plummer C- 402. 200 Firsf St SW Rocheste,: MN 55905. J Clin Oncol 1994,12:2677-g 1.

Purpose: The goals of this study were to analyze and compare the major clinical response rates and survival of patients with either measurable or assessable disease status to treatment with systemic chemotherapy. Pafienfs and Melhods: All patients had stage IIIB or IV non-small-cell lung cancer (NSCLC) and were enrolled onto three consecutive phase Ill clinical trials. Patients were stretitied by disease status (measurable or usesable) before randomization to systemic chemotherapy. The three trials were conducted in the setting of a multicenter cooperative oncology group. Composite data were obtained for the three trials. Major clinical responses, time to progression, and survival were analyzed and compared in patients with measurable or assessable disease using standard statistical methods. Resulrr: Four hundred hventy-six patients were enrolled onto the three trials from June 1981 through August 1990. Measurable disease was present in 236 patients (55%) and assessable disease in 190 (45%). Each study was well balanced for the number of patients with measurable or assessable disease on either treatment regimen. A major clinical response was observed in 71 patients with measurable disease (30%; 95% confidence interval [Cr], 24 to 36). Forty p&ems with assessable disease responded to treatment (21%; 95% CI, 16 to 28) (P = .04). The time to progression for all patients (P = .23) and for responders only (P = .lO) was not significantly different based on disease statlls. Overall survival and survival of responders only was not significantly different, but patients with assessable disease tended to do better. Using multivariate analysis, sex and disease status had a borderline influence on the major response rate (P = .05). Performance score (PS) was the only factor that was significantly correlated with survival. Conclusion: NSCLC patients with assessable disease have major clinical response rates, time to progression, and survival that are similar to those ofNSCLC patients with measurable discax. This study suppats the inclusion of patients with assessabledisease lung cancer in both phase II and III trials conducted in the cooperative group setting.

Preoperative evaluation of stage I and stage II wn-small cell hog cancer Hatter J, Kohman LJ, Mosca RS, Graziano SL, Veit LJ, Coleman M. Deparbnenf of Surgery. SUNY Health Science Cenfe,: 750 E Adorns Street. Syracuse, NY 13210. Ann Thorac Surg 1994;58:1738-41.

The appropriate preoperative evaluation for occult metastasis m patients with potentially resectable lung cancer remains controversial. The records of 265 patients with stage I and II non-small cell lung cancers who underwent resection with curative intent were reviewed to determine if there was a survival benefit of negative preoperative scanning to detect metestases. A minimum of 5 years of follow-up was possible for all long-term survivors. Patients having preoperative bone scans, brain imaging, and abdominal imaging had no increased survival over those without such evaluation (using Kaplan-Meier survivsl curves).