Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
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Comparative Study
Spontaneous smoking cessation before lung cancer diagnosis.
We have observed that many patients with lung cancer stop smoking before diagnosis, usually before clinical symptoms, and often without difficulty. This led us to speculate that spontaneous smoking cessation may be a presenting symptom of lung cancer. ⋯ These results challenge the notion that patients with lung cancer usually quit smoking because of disease symptoms. The hypothesis that spontaneous smoking cessation may be a presenting symptom of lung cancer warrants further investigation.
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Clinical Trial
Management of thymic tumors: a survey of current practice among members of the European Society of Thoracic Surgeons.
Management of thymoma has largely been based on single-institution retrospective, observational studies. The European Society of Thoracic Surgeons (ESTS) Thymic Working Group has investigated the current practice among ESTS members. ⋯ The survey provides a large, multiinstitutional overview of the clinical practice in the management of thymic tumors by ESTS members. Responses show some areas of agreement along with several areas of controversy. It is conceivable that a consequent step forward will be the creation of a collaborative effort within the ESTS and with other organizations for the creation of standard recommendations and guidelines for the management of thymic malignancies.
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Adenocarcinoma is the most common histologic type of lung cancer. To address advances in oncology, molecular biology, pathology, radiology, and surgery of lung adenocarcinoma, an international multidisciplinary classification was sponsored by the International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society. This new adenocarcinoma classification is needed to provide uniform terminology and diagnostic criteria, especially for bronchioloalveolar carcinoma (BAC), the overall approach to small nonresection cancer specimens, and for multidisciplinary strategic management of tissue for molecular and immunohistochemical studies. ⋯ This new classification strategy is based on a multidisciplinary approach to diagnosis of lung adenocarcinoma that incorporates clinical, molecular, radiologic, and surgical issues, but it is primarily based on histology. This classification is intended to support clinical practice, and research investigation and clinical trials. As EGFR mutation is a validated predictive marker for response and progression-free survival with EGFR tyrosine kinase inhibitors in advanced lung adenocarcinoma, we recommend that patients with advanced adenocarcinomas be tested for EGFR mutation. This has implications for strategic management of tissue, particularly for small biopsies and cytology samples, to maximize high-quality tissue available for molecular studies. Potential impact for tumor, node, and metastasis staging include adjustment of the size T factor according to only the invasive component (1) pathologically in invasive tumors with lepidic areas or (2) radiologically by measuring the solid component of part-solid nodules.
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Multicenter Study
Increased lung cancer risk among patients with pulmonary tuberculosis: a population cohort study.
Given one third of the human population have been infected with tuberculosis, it is important to delineate the relationship between tuberculosis and lung cancer. This study explored whether contracting pulmonary tuberculosis is associated with an increased risk of developing lung cancers. ⋯ This study provides a compelling evidence of increased lung cancer risk among individuals with tuberculosis. The risk may increase further with coexisting COPD or other smoking-related cancers.