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In patients with lung cancer invading the left atrium, performing complete resection is difficult. In many cases of complete resection, pneumonectomy is performed. We herein report two techniques in which complete resection with negative margins at the intrapericardial pulmonary vein and left atrium was achieved without pneumonectomy. In the first technique, the groove of the pericardium between the right and left atrium was dissected and an atrial cuff was made in a manner that elongated the intrapericardial pulmonary vein. In the second technique, traction was applied to the atrial cuff, and only the middle lobe vein of the elongated pulmonary vein was resected, to perform atrial cuff plasty. The upper lobe vein and inferior pulmonary vein could be preserved. These techniques of PV elongation and atrial cuff plasty are suitable for both achieving complete resection and lung preservation for lung cancer patients with invasion of the left atrium. [ABSTRACT FROM AUTHOR]

Background: To define the factors associated with increased risk of isolated locoregional failure that may justify postmastectomy radiotherapy in patients with T1/2 breast cancer and 1-3 positive lymph nodes. Methods: Between 1990 and 2002, 248 patients who had pT1-2 breast cancer and 1-3 positive lymph nodes were treated with mastectomy without radiotherapy (age 32-84, median 54). Results: Median follow-up time was 82 months (range 2-189 months). For all patients, the 8-year isolated locoregional failure-free rate was 95 %. In univariate analysis, hormone receptor status and administration of hormone therapy were statistically significant factors, and vascular invasion was the borderline significant factor for isolated locoregional failure-free rates ( P = 0.0377, 0.0181, and 0.0555, respectively). The 8-year isolated locoregional failure-free rates were 98 % for patients with positive hormone receptor status and 90 % for patients with negative hormone receptor status, 97 % for patients who received hormone therapy and 89 % for patients who did not receive hormone therapy, 92 % for patients with vascular invasion and 97 % for patients without vascular invasion. In multivariate analysis for hormone receptor status and vascular invasion, the former was statistically significant ( P = 0.0491) and the latter was borderline significant ( P = 0.0664). When patients had both negative hormone receptor and positive vascular invasion status, the 8-year isolated locoregional failure-free rates decreased to 83 %. Conclusions: With regard to patients who had pT1/2 breast cancer and 1-3 positive lymph nodes, isolated locoregional failure was not common in general; however, patients who had both negative hormone receptor status and vascular invasion were comparatively high-risk patients for isolated locoregional failure. [ABSTRACT FROM AUTHOR]

Purpose: Follow-up by chest CT is often performed routinely after stereotactic body radiotherapy (SBRT) for primary lung cancer. We investigated how often periodical chest CT detected lung-cancer related chest events (failure in the chest, new primary lung cancer), and how often chest CT follow-ups led to curative intent salvage treatment.Materials and Methods: Between 2006 and 2009, 90 stage I primary lung cancers in 86 patients received SBRT. In principle, chest CT was scheduled every 2-3 months in the first two years, and every 3-4 months thereafter.Results: Median time to follow-up by chest CT was 26 months (1-61 months). Twenty-seven lung-cancer related chest events were detected by periodical chest CT after SBRT. The three-year lung-cancer related chest event free rate was 62 %. It was possible to apply curative-intent salvage treatment to 56 % of the lung-cancer related chest events. The two-year overall survival rate was 66 % among the 13 patients who received curative-intent salvage treatment (radiotherapy, 11; surgery, 2).Conclusion: Post-SBRT lung-cancer related chest events (as detected by periodical chest CT) were not uncommon (approximately 40 % at 3 years from SBRT), and it was possible to treat more than half of these lesions with curative-intent salvage treatment. [ABSTRACT FROM AUTHOR]

Purpose: To identify factors affecting local control of stereotactic body radiotherapy (SBRT) for lung tumors including primary lung cancer and metastatic lung tumors. Materials and methods: Between June 2006 and June 2009, 159 lung tumors in 144 patients (primary lung cancer, 128; metastatic lung tumor, 31) were treated with SBRT with 48-60 Gy (mean 50.1 Gy) in 4-5 fractions. Higher doses were given to larger tumors and metastatic tumors in principle. Assessed factors were age, gender, tumor origin (primary vs. metastatic), histological subtype, tumor size, tumor appearance (solid vs. ground glass opacity), maximum standardized uptake value of positron emission tomography using F-fluoro-2-deoxy- d-glucose, and SBRT doses. Results: Follow-up time was 1-60 months (median 18 months). The 1-, 2-, and 3-year local failure-free rates of all lesions were 90, 80, and 77 %, respectively. On univariate analysis, metastatic tumors ( p < 0.0001), solid tumors ( p = 0.0246), and higher SBRT doses ( p = 0.0334) were the statistically significant unfavorable factors for local control. On multivariate analysis, only tumor origin was statistically significant ( p = 0.0027). The 2-year local failure-free rates of primary lung cancer and metastatic lung tumors were 87 and 50 %, respectively. Conclusions: A metastatic tumor was the only independently significant unfavorable factor for local control after SBRT. [ABSTRACT FROM AUTHOR]

The article analyzes histopathological prognostic factors. One hundred and thirty patients with stage I-II uterine cervical cancer were treated with radical hysterectomy and postoperative radiotherapy at Ehime University Hospital between 1978 and 1997. All surgical specimens were reviewed, and the relationship between histopathological factors and the clinical outcome was analyzed. Significant differences in prognosis were observed for six factors: pT factor, venous infiltration, pelvic lymph node metastases, thickness of the residual muscular layer, tumor depth, and tumor growth pattern. The risk classification may make it possible to predict which patients are at risk of recurrence.