Abstracts/Lung Cheer 14 (19%) 377-408 397

We treated 14 patients with multiple squamous cell carcinoma of the tracheobronchial tree and lung, which corresponded to 2.3% of all squamous cell carcinoma patients undergoing resection. Results. Two patients had peripheral secondary tumors and underwent segmentectomy or partial resection of the lung with good results. The secondary lesions were superficial and minute (leas than 5 mm) in 3 patients, and treated with neodymium-yttrium aluminum garnet laser ablation. Five patients had endobronchial tumors of the nodular or polypoid type with suspected deep invasion or invasion extending beyond the bronchial wall based on the bronchoscopic findings. They underwent parenchymal- sparing limited bronchoplasty with excellent results. Three patients had more advanced tumor with massive invasion outside the bronchial wall without lymph node me&stases, I patient underwent sleeve lobectomy with long survival, and the other 2 patients without operation died of bleeding or had recurrence. One patient with stage IIIA (T2 N2) secondary cancer who underwent lobectomy died 14 months after the second operation. ConcJu.rionr. The surgical treatment of multiple squamous cell carcinoma is justified and limited operation using bronchoplaatic techniques provides superior results.

Surgical treatment of primary lung cancer: A multivariate analysis of prognostic factors Lee Y-c, Luh S-p, Lee C-j, Chu S-h. Department of Surgery, National Taiwan University Hospital, No 7 Chung-Shari South Road. Taipei 10016. Asian J Surg 199.5; 18294-300.

From 1981 to 1990, 312 consecutive patients with primary lung cancer were treated surgically in this department. There were 224 males and 88 females, aged between 18 and 84 years (mean, 56.0 years). Of these, 260 had complete resection of the tumour and 52 had incomplete resectionorexploratory thoracotomy. Thelive-year survival for patients receiving complete resection was 39.5 96. This was significantly better than that for patients with incomplete resection or exploration (live-year survival,O%,p < O.oooOl). Multivariateanalysisofpossibleprognostic factors for survival, including age, sex, history of smoking, performance status, type ofoperation, status of immunotherapy and histological type, location, pathological stage and nuclear DNA content of the himour, showed that the pathological stageof themmour was theonly significant prognostic factor @ < 0.005).

Evaluation of cases with combined bronchoplasty and pulmonary arterioplasty for the treatment of lung cancer Wada H, Okubo K-I, Himta T, Hitomi S. Depaflment of lhoracic Surgery. Chest Disease Research Institute. Kyoto University, Kawaharacho53, Shogo-in, Sakyo-ku. Kyoto 606. Lung Cancer(Ireland) 1995;13:113-20.

Bronchoplasty and pulmonary angioplasty(PA-plasty) have been performed in recent years for lung cancer invading the bronchus and pulmonary artery. We evaluated the results and complications in patients who underwent such operations. There were 23 cases of bronchoplasty performed between 1988 and October 1993. Of these 23 cases, 9 underwent PA-plasty with bronchoplasty. There were 8 males and I female (mean 65.6 year-old). There were 8 patients with primary lung cancer(sq 5, ad 1, la 1, and sm I) and 1 with metastatic lung tumor of colon cancer. One patient was in p-stage II, 6 in p-stage III, and I in p-stage IV. Seven patients underwent right upper lobectomy, 1 did the right upper and middle bilobectomy, and I did a left upper lobectomy. Bronchoplasty wss performed using sleeve resection in 8 patients, and a wedge resection in 1 patient. PA-plasty was performed using sleeve resection and end to end anastomosis in 2 cases, and using side wall resection and plasty in 7 patients alter clamp. Of9 patients in whom both broncho- and PA-plaaty were performed, there was one with the resected bronchial stump of cancer-positive. Total resection of the cancer was

possible in the remaining 8 patients. Postoperative complications included 2 pneumonia, 2 empyema, and 1 each, acute cardiac failure, pulmonary thrombus, and chylothorax. The patients with empyema required re-operation using omentopexy or thoracoplasty. Long-term results showed that 2 patients died because of recurrence. Another patient died of respiratory failure. The remaining 6 patients were alive without any evidence of cancer. Pneumonectomy was avoided and the combination of PA-plasty and bronchoplasty was performed instead. However, the incidence of postoperative complications was high, indicating that utmost care must be exercised in the postoperative management of these patients.

Stent implantation in the palliative treatment of obstruction of the upper inflow veins in patients with bronchial carcinoma Wilhelm K, Schild H, Textor J, Mildenberger P, Strunk H, Terjung B et al. Radiologische Umiversii~sklia~k, Vniversitat Bonn, Sigmund- Freud-Srr. 25, 53105 Bonn. Dtsch Med Wochenschr 1995;120: 1419- 25.

Aim of study: To analyse results obtained in the upper palliative treatment of obstruction of the upper inflow veins by stent implantation in patients with bronchial carcinoma. Patients andmethods: Stems were implanted in 14 patients with upper venous obstruction due to bronchial carcinoma (three women, eleven men; mean age 64 [48-741 years), 4 of the superior vena cava (SVC), 6 of the SVC and brachiocephalic vein, 4oftheSVCandsubclavianvein. TopreventthrombcemboIicphenomena all patients received heparin in therapeutic doses for l-3 days from the timeofstentsimplantation. Resulrs: Treatment wassuccessful (regression of the clinical signs) in 12 of the 14 patients. Six patients died, without recurrence of the clinical signs, an average of 141 (10-420) days after the procedure. Mean survival time of the six patients who remained without symptoms was 3 months (longest interval 9 months). In one patient thrombotic occlusion of the SVC occurred 6 days after stent implantation. However, local thrombolysis successfully reopened the vessel. Renewed upper vein obstruction occurred in two patients during follow-up. None of the stent filaments fractured and there was no stent dislocation. Conclasion: With a success rate of 86% stent implantation proved to be a sparing procedure in the palliative treatment of upper inflow vein obstruction, especially in patients with extensive malignant disease.

Chemotherapy

Combination chemoimmunotherapy with interferon-alpha and cisplatin in patients with advanced non-small cell lung cancer Chao T-Y, Hwang W-S, Yang M-J, Chang J-Y, Wang C-C, Hseuh E- J et al. Department of Medicine, Tri-Service General Hospital, 8, Section 3, Ding-Chow Road, Taipei. Chin Med J Taipei 1995;56:232- 8.

Background. Non-small cell lung cancer (NSCLC) has a relatively low response rate to systemic chemotherapy. Recently, several invest- igations have shown that interferon may augment the cytotoxic effect of chemotherapeutic agents and may improve the result of chemotherapy in treating cancers. Methods. An open-label non-comparative phase II study investigated the efficacy and safety of combined chemoimmuno- therapy for NSCLC using IFN-alpha, given by intramuscular injection with 9 million units thrice a week for a maximum of 26 weeks, and cisplatin by intravenous infusion, 100 mglm’, every 4 weeks for a maximum of 6 cycles. Ten patients, with histology-confirmed NSCLC at stage IV of their diseases were enrolled. They included 5 men and 5 women, with an average age of 53.7 year. Five of them had adeno-