EXPERIENCE OF VIDEOTHORACOSCOPY (VTS) IN THORACIC ONCOLOGY DIAGNOSIS AND TREATMENT OF SMALL LUNG NEOPLASMS
https://doi.org/10.18027/2224-5057-2014-3-18-21
Abstract
Hyperdiagnosis of lung cancer in recent years is of concern because of the emergence of new screening methods that detect small nodules, which clinical significance is unknown. The incidence of lung cancer ranged from 0.4% to 2.7% according to the results of screening studies, depending on the size of the population surveyed. The large number of false-positive diagnoses is unsolved problem yet. At the initial stage of the examination in the groups with high risk the number of false diagnoses is in the range of 10-20%, but can reach 50%, with positive predictive values of 2.8% to 11.6%. It is found that pathological nodules less than5 mmare unlikely malignant, and nodules from 5 to10 mmin diameter are undefined, 25-40% of which contain calcifications. Management of patients with such nodules, as a rule, is to perform repeated CT scans over time and if the growth of nodules is detected then fine-needle aspiration biopsy or surgical resection must be performed. Videothoracoscopy with biopsy provides a high efficiency in differential diagnosis of single tumors located in the cortical and subcortical regions of the lung or near the interlobar fissure. Presented here results indicate that the current VTS in peripheral tumors and metastatic lesions of the lung is the only minimally invasive method to verify the process with 100% accuracy.
About the Authors
Pavel A. Anistratov
Ростовский научно-исследовательский онкологический институт, г. Ростов-на-Дону
Russian Federation
Russian Federation
Yuriy N. Lazutin
Ростовский научно-исследовательский онкологический институт, г. Ростов-на-Дону
Russian Federation
Russian Federation
Gennadiy Z. Sergostyantz
Ростовский научно-исследовательский онкологический институт, г. Ростов-на-Дону
Russian Federation
Russian Federation
Tamara G. Ayrapetova
Ростовский научно-исследовательский онкологический институт, г. Ростов-на-Дону
Russian Federation
Russian Federation
Sergei P. Pyltsin
Ростовский научно-исследовательский онкологический институт, г. Ростов-на-Дону
Russian Federation
Russian Federation
References
1. Афанасьев С. Г., Августинович А. В., Волков М. Ю. Видеоторакоскопия как метод дифференциальной диагностики внутригрудных новообразований // Сибирский онкологический журнал. – 2010. – Прил. № 2 – С. 9–10.
2. Волобуев А. В. Видеоторакоскопия в диагностике опухолевых заболеваний легких и плевры. Автореф. дис. … к-та мед. наук. Москва, 2006. – 23 с.
3. Клименко В. Н., Барчук А. С., Лемехов В. Г. Видеоторакоскопия в диагностике и лечении одиночных округлых образований легкого // Вопросы онкологии. – 2006. – Т. 52. – № 3. – С. 349–352.
4. Котив Б. Н., Чуприна А. П. и соавт. Видеоторакоскопия в дифференциальной диагностике и лечении периферических образований легких // Вестник национального медико-хирургического центра им. Н. И. Пирогова. – 2012. – Т. 7. – № 2. – С. 18–21.
5. Мироненко Д. Е. Видеоторакоскопия в диагностике и лечении метастатического поражения легких и плевры. Автореф. дис. … к-та мед. наук. Москва, 2010. – 24 с.
6. Трахтенберг А. Х., Соколов В. В., Пикин О. В. и соавт. Возможности видеоторакоскопии в онкологической клинике. // Российский онкологический журнал. – 2007.– № 4.– С. 7–12.
7. Трахтенберг А. Х., Соколов В. В., Филоненко Е. В., Сухин Д. Г., Пикин О. В. и др. Торакоскопическая флюоресцентная диагностика и внутриплевральная фотодинамическая терапия у онкологических больных с первичным и метастатическим плевритом // Российский онкологический журнал – 2009 г.– № 2.– С. 8–13.
8. Яблонский П. К., Пищик В. Г. и соавт. Торакоскопические операции при новообразованиях средостения // Вестник Санкт-Петербургского университета. – 2008. – Сер. 11. – Вып. 2 – С. 119–127.
9. Christensen JA, Nathan MA, Mullan BP, et al Characterization of the solitary pulmonary nodule:18F-FDG PET versus nodule-enhancement CT.AJR Am J Roentgenol 2006;187 (5):1361–7.
10. Chrysanthidis MG, Janssen JP. Autofluorescence videothoracoscopy in exudative pleural effusions: preliminary results. Eur. Respir J.– 2005 – V.26.– № 6.– P.989–92.
11. Gould MK, Maclean CC, Kuschner WG, et al. Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions a meta-analysis. JAMA 2001;285 (7):914–24.
12. Henschke CI, McCauley DI, Yankelevitz DF, et al. Early lung cancer action project: a summary of the findings on baseline screening. Oncologist. 2001;6 (2):147–52.
13. Henschke CI, Yankelevitz DF, Libby DM, et al. Survival of patients with stage I lung cancer detected on CT screening. N Engl J Med 2006;355 (17):1763–71.
14. Fernando HC, Schuchert M, Landreneau R, Daly BT. Approaching the high-risk patient: sublobar resection, stereotactic body radiation therapy, or radiofrequency ablation. Ann. Thorac. Surg. 2010; 89 (6): S2123–7.
15. Jett JR. Limitations of screening for lung cancer with low-dose spiral computed tomography. Clin Cancer Res 2005;11 (13 Pt 2):4988s–92s.
16. Kelly RF, Tran T, Holmstrom A, et al. Accuracy and cost-effectiveness of [18F] –2-fluoro-deoxy-D-glucose-positron emission tomography scan in potentially resectable non-small cell lung cancer. Chest 2004;125 (4):1413–23.
17. Kozower BD, Sheng S, O’Brien SM, et al. STS database risk models: predictors of mortality and major morbidity for lung cancer resection. Ann. Thorac. Surg. 2010; 90 (3):875–81.
18. Mulshine JL, Sullivan DC. Clinical practice.Lung cancer screening. N Engl J Med 2005; 352 (26):2714–20.
19. Obuchowski NA1, Graham RJ, et al. Ten criteria for effective screening: their application to multislice CT screening for pulmonary and colorectal cancers. AJR Am J Roentgenol. 2001 Jun;176 (6):1357–62.
20. Pastorino U, Bellomi M, Landoni C, et al. Early lung-cancer detection with spiral CT and positronemission tomography in heavy smokers: 2-year results. Lancet 2003;362 (9384):593–7.
21. Schuchert MJ, Pettiford BL, Keeley S, et al. Anatomic segmentectomy in the treatment of stage Inon-small cell lung cancer. Ann. Thorac. Surg. 2007;84 (3):926–32.
22. Sobue T, Moriyama N, Kaneko M, et al. Screening for lung cancer with low-dose helical computed tomography: anti-lung cancer association project. J Clin Oncol 2002; 20 (4):911–20.
23. Swensen SJ, Jett JR, Hartman TE, et al. Lung cancer screening with CT: Mayo Clinic experience. Radiology 2003;226 (3):756–61.
24. Von Meyenfeldt EM, Wouters MW et al. Local treatment of pulmonary metastases: from open resection to minimally invasive approach? Less morbidity, comparable local control. Surg Endosc. 2012 – V. 26 № 8. – P. 2312–21.
Review
For citations:
Anistratov P.A., Lazutin Yu.N., Sergostyantz G.Z., Ayrapetova T.G., Pyltsin S.P. EXPERIENCE OF VIDEOTHORACOSCOPY (VTS) IN THORACIC ONCOLOGY DIAGNOSIS AND TREATMENT OF SMALL LUNG NEOPLASMS. Malignant tumours. 2014;(3):18-21. (In Russ.) https://doi.org/10.18027/2224-5057-2014-3-18-21
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