166 Abstracts/Lung Cancer 14 (19%) 149-I 79

increased. PO, and PaCO, changed not significantly, however, they showed a tendency for increase. Authors observed a decrease on the maximum flow volume loop parameters: FVC (41 %), FEVI (38 %), MEF 50 % (29 %) and MEF 25 % (14 %). They discuss the meanings of some authors about the cardiopulmonary tests before pneumonec- tomy. Authors recommend to make firstly a spirometric examination andadiffusioncapacityofthehmgsforCO.Then,insteadofbronchospiro metry, to make an examination of quantitative ventilation-perfusion scan of the lungs and finally, physical exercise with measuring of oxygen consumption.

Surgical treatment of non-small cell lung carcinoma in TNM stage IDA Pekarek Z, Kosatova K, Kalina P, Mare1 M, Stasmy B. Pneumologickn Kfinika. I tekarska Fakxlta, Univertita Karlova, Veiesiavinska 1. 162 00 Pruha 6. Stud Pneumol Phtiseol 1995;55:200-6.

Authors present a literature review on surgical therapy of non-small cell carcinomaofthe lungs in stage IIIA. After considering ofthe extent of the disease, age, accompanied diseases, the whole and psychical condition of the patient, it is suitable to recommend surgical treatment for stage IIIA in patients who are able to undergo surgical therapy, and for whom complete resection is possible. More careful access in stage T3N2 and in cases of N2, however, is necessary. Neoadjuvant therapy - chemotherapy alone or combined with actinotherapy before surgical treatment - is of increasing importance in borderline operable, advanced cases in stage IIIA.

Risk analysis and long-term survival in patients undergoing extended resection of locally advanced lung cancer Izbicki JR, Knoefel WT, Passlick B, Habekost M, Karg 0, Thetter 0. Department of Surgery, University of Hamburg, Martinistr. 52, D- 20251 Hamburg. J Thorac Cardiovasc Surg 1995;110:386-95.

Although locally advanced lung cancer frequently necessitates extended resections to preserve a chance for cure, a higher morbidity is associated with extended resections, It is not known whether the increased morbidity is of relevance for the long-term outcome. It also remains unclear whether exclusion of certain patients according to their risk factorscandiminishmortalityinthesepatients. Thisstudythereforr investigated whether certain risk factors predispose patients undergomg extended puImonary resections to increased morbidity or mortality. It also assessed the long- term survival. The cases of 126 consecutive patients with locally advanced lung cancer (stage T3 or T4) were prospectively documented. Seventy-tivepercentofthepatientsrequired an extended resection and 25% a nonextended resection. Extended resectionswereassociatedwithasignificantlyincreasedoverallmorbidity (p < 0.002). However, mortality, severe complications, or multiple complications were not significantly increased afterextendedresections. No risk factor predisposed to an increased mortality. Risk factors that were associated with particular postoperative complications were pathologicergonomet~~@<0.002~,apositivecardiacscore@~0.003), coronary artery disease (p = 0.021) and an increased pulmonary risk score (p < 0.05). Overall 3-year survival was 3 1%. Patients undergoing extended resections for stage T3 or T4 tumors with no residual tumor (70%ofthepatients)showeda3-yearsurvivalof33%. Weconclude that postoperative mortality cannot be reduced by excluding patients on the basis of particular risk factors from operations that require extended resections. Ifapatient is considered tobe eligible to undergo pulmonary resection, he or she can be considered to be eligible to undergo extended pulmonary resection, Because prognosis is dismal in nonresected locally advanced lung cancer, we recommend an aggressive surgical approach.

Surgical treatment of lung cancer in patients with human immunodeficiency virus Thurer RJ, Jacobs JP, Holland FW II, Cintron J.R. Div. of Cardiothoracic Surgery, Univ. of Miami School of Medicine, PO Box 016960, Miami, FL 33101. Ann Thorac Surg 1995;60:599-602.

Background: Since January 1986, more than 20 patients have been seen at the University of Miami/Jackson Memorial Medical Center and the Miami Veterans Administration Medical Center with concurrent human immunodeficiency virus infection andbronchogenic carcinoma. Four of these patients were treated surgically with curative intent. Methods: The histories, records, operative reports, and pathology reports ofthe 4 patients were reviewed. Results: The 4 surgically treated patients had stage I Tl NO MO lung cancer. Three patients had T4 cell counts of less than 200/L and were managed by lobectomy. These patients died 5, 3%. and 5 months postoperatively. More recently, a fourth patient had aT4 ceil count of 963/L and was treated with wedge resection. He is currently alive 12 months postoperatively. Conclusions: It is concluded that surgically treated patients with lung cancer, human immunodeficiency virus infection, and T4 cell counts lower than 200/ L have high mortality and morbidity. Although it may be best to base surgical intervention on the stage of the patient’s human immuno- deficiency virus infection, further analysis is essential to determine which subgroup of human immunodeficiency virus-positive patients, if any, would benefit from surgical treatment of lung cancer.

The surgery of lung cancer Morgan WE. City Hospital. HucknallRoad, Nottingham NG5 IPB. Ann Oncol 1995;6:SuppI I:S33-6.

Surgery remains the best chance of cure in lung cancer, and should be offered to between 10% and 20% of patients. The success of surgery depends on accurate assessment of patient fitness and tumour stage. Surgery has an established role in stages I and II and some subtypes of stage III non-small cell carcinoma of the lung. The combination of surgery with radiotherapy and/or chemotherapy may have survival benefit. A multidisciplinary approach is essential for optimum patient care and the promotion of further research into this terrible disease.

Chemotherapy

Docetaxel in stage 111 and IV non-small cell lung cancer Rigas JR. Memorial Sloan-Kettering Cancer Ctr., 1275 York Avenue, New York, NY 10021. Eur J Cancer Part A Gen Top 1995;31:SuppI 4:s I8-S20.

Phase II studies have been conducted to evaluate the efficacy and tolerability of docetaxel in the treatment of patients with advanced non- small cell lung cancer (NSCLC). Docetaxel was administered to patients with stage III and IV NSCLC at a dose of 100 mg/m’ intravenously over 1 h every 3 weeks. Patients included in these four phase II studies had received either no prior chemotherapy (n = 114) or treatment with cisplatin- or carboplatin-containing regimens (n = 57). Major objective response rates were reportedin33-38%ofpreviouslyuntreatedevaluable patients and in 21-27% of previously treated evaluable patients, Neutropenia was the most common adverse event. Non-haematological adverse events included hypersensitivity reactions, skin rash, alopecia and fluid retention. Docetaxel demonstrates significant antitumour activity in patients with advancedNSCLC. Further investigationsofthis agent with corticosteroidpremedication, colony-stimulating factors and other agents active in NSCLC are indicated.