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C Deschamps

Publications and source records attributed to C Deschamps.

At least 55 records · Page 3Linked to original sources
PubMed1999

Early and long-term results of prosthetic chest wall reconstruction.

OBJECTIVE: The purpose of this report is to evaluate our results in patients who underwent prosthetic bony reconstruction after chest wall resection. METHODS: We retrospectively reviewed all patients who underwent chest wall resection and reconstruction with prosthetic material at the Mayo Clinic. RESULTS: From January 1, 1977, to December 31, 1992, 197 patients (109 male patients and 88 female patients) underwent chest wall resection and reconstruction with prosthetic material. Median age was 59 years (range, 11-86 years). The indication for resection was recurrent chest wall malignancy in 65 patients (33.0%), primary chest wall malignancy in 62 patients (31.5%), contiguous lung or breast carcinoma in 58 patients (29.4%), and other reasons in 12 patients (6.1%). Three patients (1.5%) each had an open draining wound. This review covers 2 time periods. Sixty-four patients (32.5%) underwent reconstruction with polypropylene mesh during the period from 1977 to 1986. One hundred thirty-three patients (67.5%) underwent reconstruction with polytetrafluoroethylene from 1984 to 1992. Soft tissue coverage was achieved with transposed muscle in 116 patients (58.9%), local tissue in 81 patients (41.1%), and omentum in 3 patients (1.5%). There were 8 deaths (operative mortality rate, 4.1%). Ninety-one patients (46.2%) experienced complications. Seromas occurred in 14 patients (7.1%). Wound infections occurred in 9 patients (4.6%; 5 patients with polypropylene mesh and 4 patients with polytetrafluoroethylene). The prosthesis was removed in all 5 patients with polypropylene mesh and in none of the patients with polytetrafluoroethylene. Follow-up was complete in 179 operative survivors (94.7%) and ranged from 1 to 204 months (median, 26 months). A well-healed asymptomatic wound was present in 127 patients (70.9%). CONCLUSIONS: Chest wall resection and reconstruction with prosthetic material will yield satisfactory results in most patients. Little difference exists between polypropylene mesh and polytetrafluoroethylene.

Adolescent↗
PubMed1999

Large cell carcinoma of the lung: results of resection for a cure.

OBJECTIVE: The effectiveness of surgical resection of large cell undifferentiated carcinoma of the lung remains poorly defined because of the histology's relatively low frequency, the tendency for presentation with high-stage disease, and the failure in most published series to separate large cell carcinomas from the other variants of non-small cell lung carcinoma. To define the effectiveness of surgical treatment of large cell carcinoma, we reviewed the Mayo Clinic experience over a 5-year period. METHODS: We have retrospectively reviewed the Mayo Clinic experience with 61 patients with large cell carcinoma and 17 patients with adenocarcinoma with focal mucin production who came to surgical resection during the 5-year period of January 1, 1982, through December 31, 1986. RESULTS: One-hundred percent 5-year follow-up was obtained. For the 61 patients with large cell carcinoma, the overall 5-year survival was 37%. Five-year survival for those with stage I tumors was 58% (n = 31), stage II 33% (n = 6), stage IIIA 15% (n = 20), stage IIIB 0% (n = 2), and stage IV 0% (n = 2). No significant differences in survival were detected between the 61 patients with large cell carcinoma and the 17 patients with solid adenocarcinoma with mucin production. CONCLUSIONS: Our results suggest that there is a subset of patients with large cell carcinoma of the lung who can undergo resection with a reasonable expectation of long-term survival and that this survival is, stage for stage, comparable to or only slightly less than that achieved with other non-small cell lung carcinomas.

Adenocarcinoma↗
PubMed1999

Results of reoperation on the upper esophageal sphincter.

OBJECTIVE: Reoperation on the upper esophageal sphincter is infrequent. We reviewed our experience in patients who underwent reoperation on the upper esophageal sphincter. METHODS: This is a retrospective report of accumulative series from 2 separate institutions. RESULTS: From September 1, 1976, to February 28, 1997, 37 patients underwent reoperation on the upper esophageal sphincter for recurrent or persistent obstructive symptoms. There were 29 men and 8 women. The median age was 69 years (range, 38-87 years). The original indication for the operation was a pharyngoesophageal (Zenker's) diverticulum in 33 patients (89.2%), oculopharyngeal dystrophy in 3 patients (8.1%), and muscular dystrophy in 1 patient (2.7%). One prior upper esophageal sphincter operation had been performed in 26 patients (70.3%), two operations in 9 patients (24. 3%), and three operations in 2 patients (5.4%). All patients were symptomatic; 35 patients (94.6%) had dysphagia; 23 patients (62.2%) had regurgitation; and 12 patients (32.4%) had episodes of aspiration. Thirty of the patients (91.0%) with Zenker's diverticulum were found to have a recurrent or persistent diverticulum at reoperation. A diverticulectomy and cricopharyngeal myotomy were performed in 23 patients (62.2%); cricopharyngeal myotomy alone, in 7 patients (18.9%); diverticulopexy and cricopharyngeal myotomy, in 6 patients (16.2%); and diverticulectomy alone, in 1 patient (2.7%). There were no operative deaths. Complications developed in 10 patients (27.0%). Follow-up was complete in 34 patients (91.9%) and ranged from 2 to 149 months (median, 39 mo). Thirty-two patients (94.1%) were improved. Functional results were classified as excellent in 26 patients (76. 5%), good in 2 patients (5.9%), fair in 4 patients (11.7%), and poor in 2 patients (5.9%). CONCLUSIONS: Reoperation for patients who have persistent or recurrent symptoms after an operation on the upper esophageal sphincter is associated with acceptable morbidity and mortality rates. Resolution of symptoms occurs in most patients.

Adult↗
PubMed1999

Study of cardiac repolarization in healthy volunteers performed with mizolastine, a new H1-receptor antagonist.

AIMS: The occurrence of serious dysrhythmias, such as torsades de pointes, with terfenadine and astemizole had led to a reexamination of the potential effect of H1 antihistamines on cardiac repolarization. Mizolastine is a potent, selective, nonsedating peripherally acting H1-receptor antagonist which is registered for rhinitis and urticaria at a recommended dose of 10 mg once daily. The present study was carried out to investigate the effects of therapeutic and supratherapeutic doses of mizolastine, on ventricular repolarization in healthy volunteers. METHODS: Twenty-four healthy young volunteers participated in a double-blind, placebo-controlled, randomised study with three parallel groups. Each group consisted of 2 way cross-over 7 day treatment periods where mizolastine (10, 20 or 40 mg) and placebo were randomly administered. On day 1 and day 7, 12-lead ECG recordings were performed prior and 0.5, 1, 2, 3, 4, 6, 8, 12, 16, and 20 h after dosing and from day 2 to day 6, before dosing and 1, 2, 3, and 4 h after. RESULTS: Whatever the analysis used (raw data, changes from baseline, incidence of individual out-of-range values) no significant differences were observed at any dose level vs placebo, on any of ECG parameters (HR, PR, QRS, QT, and QTc). In particular, no effect of mizolastine vs placebo was shown on QT and QTc although 95% CIs were wide. The only subject who exhibited a QTc>/=450 ms received placebo for 7 days. CONCLUSIONS: This study found no evidence of an effect of mizolastine up to 40 mg (four times the therapeutic dose) on ventricular repolarization in healthy volunteers.

Adult↗
PubMed1998

Safety and pharmacokinetics of a single oral dose of amisulpride in healthy elderly volunteers.

OBJECTIVE: Amisulpride is a substituted benzamide neuroleptic, which binds selectively to dopamine D2 and D3 receptors, mainly in the limbic structures. States of delusion and agitation occur frequently in the population aged more than 65 years, especially in demented patients and this sometimes requires the use of neuroleptics. The objectives of this study were to determine the safety and the pharmacokinetic profile of 50 mg of amisulpride administered orally as a single dose to elderly volunteers. METHODS: Twenty healthy volunteers (10 men and 10 women) aged 65 79 years were included in this open trial. Frequent measurements of blood pressure and heart rate were made and ECG and blood samples were performed up to 72 h after drug intake. RESULTS: The overall clinical and cardiovascular safety was satisfactory. The mean Cmax of the racemate amisulpride in elderly people was 64.1+/-6.7 ng ml(-1), and was not different from the value of 56+/-4.1 ng ml(-1) in young subjects. As with the Cmax, the mean values of t1/2 and AUC in elderly people (15.6+/-1.3 h and 667+/-51 ng. ml(-1).h, respectively) were not different to values observed in young subject (respectively 11.7+/-0.5 h and 603+/-25 ng m1(-1) h). CONCLUSION: A single oral dose of amisulpride was well tolerated and showed a similar pharmacokinetic profile in healthy elderly and young subjects. However, these findings should be confirmed after multiple dosing in a larger population in order to establish the lack of need of dosage adjustment in this elderly population.

Administration, Oral↗
PubMed1998

Zenker's diverticulum in the elderly: is operation justified?

BACKGROUND: Surgical correction of symptomatic Zenker's diverticulum is effective; however, elderly symptomatic patients may be denied surgical intervention because of perceived increased risks. METHODS: To address this concern, we reviewed 75 patients (46 men and 29 women) found to have this condition during the past two decades. RESULTS: Median age was 79 years (range, 75 to 91 years). Preoperative symptoms included dysphagia in 69 patients (92%), regurgitation in 61 (81%), pneumonia in 9 (12%), halitosis in 3 (4%), and weight loss in 1 (1%). Gastroesophageal reflux symptoms were noted in 27 patients (36%). Diagnosis was made by barium swallow in 63 patients, esophagoscopy in 5, and a combination of both in 7. Surgical procedures included both diverticulectomy and myotomy in 57 patients (76%), myotomy alone in 9 (12%), diverticulopexy and myotomy in 5 (7%), and diverticulectomy alone in 4 (5%). There was no in-hospital mortality. Complications occurred in 8 patients (11%) and included esophagocutaneous fistula in 4, pneumonia and urinary tract infection in 1, and wound infection, myocardial infarction, and persistent diverticulum in 1 each. Follow-up was available in 72 patients (96%) and ranged from 8 days to 17 years (median, 3.3 years). At follow-up, 64 patients (88%) were asymptomatic and 4 (6%) were improved with minimal symptoms. The remaining 4 patients (6%) have had varying degrees of dysphagia and all have been treated with periodic esophageal dilations. CONCLUSIONS: Operation for symptomatic Zenker's diverticulum in the elderly is safe and effective and will result in resolution of symptoms and improved quality of life in most patients.

Aged↗
PubMed1998

Leiomyosarcoma of the esophagus: results of surgical treatment.

BACKGROUND: This study examined the results of surgical treatment of leiomyosarcoma of the esophagus. METHODS: Between January 1920 and December 1996, 17 patients (9 men and 8 women) with leiomyosarcoma of the esophagus were treated surgically at the Mayo Clinic. Median age was 58 years and ranged from 26 to 76 years. Symptoms included dysphagia in 11 patients (64.7%) and odynophagia in 6 (35.3%). The tumor was located in the middle third of the esophagus in 10 patients (58.8%) and in the cervical esophagus in 7 (41.2%). Procedures performed included esophagogastrectomy in 9 patients (Ivor Lewis in 5, left thoracoabdominal in 3, and transhiatal in 1), enucleation in 3, transgastric excision in 1, and exploration without resection in 4. RESULTS: The procedure was considered curative in 11 patients (64.7%). There was one operative death (mortality, 5.9%). Complications occurred in 3 patients (17.6%) and included anastomotic leak in 2 and bleeding requiring reoperation in 1. Growth pattern was infiltrating in 7, polypoid in 5, and intramural in 5. Histologically, the tumor was grade 1 in 6 patients, grade 2 in 2, grade 3 in 7, and grade 4 in 2. The tumor was postsurgically classified as stage I in 2 patients, stage IIA in 7, stage IIB in 1, stage IIIA in 5, stage IV in 1, and unknown in 1. Six patients (35.3%) received adjuvant treatment. Follow-up was complete in 16 patients (94.1%) and ranged from 1 to 182 months (median, 48 months). Five- and 10-year actuarial survivals were 47.0% and 31.0%, respectively. Seven patients (41.2%) are currently alive (median survival, 72 months); all underwent curative resection. Factors affecting survival included completeness of resection, growth pattern, postsurgical stage, tumor grade, and tumor location (p < 0.05). CONCLUSIONS: We conclude that leiomyosarcoma of the esophagus is rare. Complete resection provides long-term survival.

Adult↗
PubMed1998

Uncut Collis-Nissen fundoplication: learning curve and long-term results.

BACKGROUND: Between September 1985 and July 1990, the first 100 consecutive patients (50 female and 50 male) undergoing primary uncut Collis-Nissen fundoplication performed by one surgeon were reviewed. METHODS: Median age was 62 years and ranged from 19 to 89 years. Indications for repair included gastroesophageal reflux in 56 patients, obstructive symptoms in 34, and a combination of both in 10. An upper gastrointestinal endoscopy was performed in 99 patients; all were abnormal. Esophagitis was documented in 53 patients, large diaphragmatic hernia in 36, stenosis in 18, "Cameron's erosions" in 17, Barrett's disease in 13, and other findings in 9 patients. An abnormal upper gastrointestinal series was demonstrated in 96 of 97 patients evaluated. Motility studies were performed in 95 patients, and 11 had abnormal peristalsis. All procedures were performed through a left thoracotomy. RESULTS: Complications occurred in 23 patients and included respiratory failure in 6, atrial fibrillation in 3, atelectasis in 3, pneumonia in 2, myocardial infarction in 2, and chylothorax, severe dysphagia, early breakdown of repair, cardiac tamponade, hematuria, spinal headache, and intraoperative perforation by dilator in 1 each. There were 2 postoperative deaths, both cardiac in origin. Median hospitalization was 8 days (range, 6 to 76 days). The first 25 patients had 10 complications (40%) and 2 deaths (8%). The remaining 75 patients had 13 complications (17%) and no deaths (mortality, p = 0.06; morbidity, p = 0.03). Follow-up was complete in all patients for a median of 100 months (range, 3 to 138 months). Eighty-six of the 98 operative survivors are currently alive. At last follow-up, excellent functional results were observed in 58 patients (59%), good in 24 (25%), fair in 8 (8%), poor in 7 (7%), and unknown in 1 (1%). CONCLUSION: We conclude that the uncut Collis-Nissen fundoplication provides good to excellent long-term results in 84% of patients. Operative mortality and morbidity is acceptable but is associated with a learning curve.

Adult↗
PubMed1998

Early experience and learning curve associated with laparoscopic Nissen fundoplication.

BACKGROUND: Laparoscopic approach for hiatal hernia repair is relatively new. Information on the learning curve is limited. METHODS: From January 1994 to September 1996, 280 patients underwent antireflux surgery at our institution. A laparoscopic repair was attempted in 60 patients (21.4%). There were 38 men and 22 women. Median age was 49 years (range 21 to 78 years). Indications for operation were gastroesophageal reflux in 59 patients and a large paraesophageal hernia in one. A Nissen fundoplication was performed in all patients; 53 (88.3%) had concomitant hiatal hernia repair. RESULTS: In eight patients (13.3%) the operation was converted to an open procedure. Median operative time for the 52 patients who had laparoscopic repair was 215 minutes (range 104 to 320 minutes). There were no deaths. Complications occurred in five patients (9.6%). Median hospitalization was 2 days (range 1 to 5 days). Median operative time and median hospitalization were significantly longer in the first 26 patients than in the subsequent 25 patients (248 vs 203 minutes and 2 days vs 1 day, respectively; p = 0.03). Seven of the first 30 patients (23.3%) required laparotomy as compared with two of the second 30 (6.7%) (p = 0.07). Follow-up in the 51 patients who had laparoscopic fundoplication for reflux was complete in 50 (98.0%) and ranged from 7 to 38 months (median 13 months). Functional results were classified as excellent in 34 patients (68.0%), good in 6 (12.0%), fair in 7 (14.0%), and poor in 3 (6.0%). Three patients were reoperated on for recurrent reflux symptoms at 5, 5, and 11 months. CONCLUSIONS: We conclude that laparoscopic Nissen fundoplication can be performed safely. The operative time, hospitalization, and conversion rate to laparotomy are higher during the early part of the experience, but all are reduced after the learning curve.

Adult↗
PubMed1998

Bronchial carcinoid tumors: importance of prognostic factors that influence patterns of recurrence and overall survival.

PURPOSE: To analyze bronchial carcinoid characteristics that might influence patterns of disease recurrence and overall survival in patients with these tumors. MATERIALS AND METHODS: In a retrospective review, the actuarial rates of local relapse, regional relapse, and overall survival were determined in patients who had undergone resection of bronchial carcinoid tumors. The evaluable files for 87 patients (50 male, 37 female; age range, 15-82 years) who underwent resection of bronchial carcinoid cancer at the authors' institution between 1980 and 1993 were reviewed for pathologic findings, extent of disease, and recurrence patterns after surgery. RESULTS: The actuarial 4-year overall survival, local control, and regional control rates in the entire cohort of patients were 89%, 92%, and 94%, respectively. Univariate analyses revealed that an atypical histologic pattern was the only tumor-related factor that substantially affected local and regional control. Atypical histologic pattern and tumor size were among the multiple factors that independently affected overall survival. CONCLUSION: Atypical histologic findings in patients who had undergone complete resection of bronchial carcinoid tumors were associated with increased local-regional disease recurrence and decreased survival compared with recurrence and survival in patients with typical histologic findings.

Actuarial Analysis↗
PubMed1998

Lung volume reduction surgery for emphysema: out on a limb without a NETT.

Lung volume reduction surgery (LVRS) has recently been rediscovered and offers the potential of improving the quality of life of patients with advanced emphysema. In this article, we discuss the historical and contemporary versions of LVRS. Although initial enthusiasm has been substantial, existing data seem insufficient to demonstrate the safety and efficacy of the procedure in comparison with conventional medical therapy. Fundamental questions remain regarding the long-term effects of an operation versus medical therapy, the optimal selection criteria, the best measures of efficacy, the mechanisms of improvement, the cost-effectiveness of the procedure, and the optimal surgical technique. Until such questions are answered, advising patients about the best management their emphysema will be difficult. The National Emphysema Treatment Trial will address many of these issues and should be embraced by both health-care providers and patients.

Forced Expiratory Volume↗
PubMed1998

Lack of effect of mizolastine on the safety and pharmacokinetics of digoxin administered orally in repeated doses to healthy volunteers.

The effects of mizolatine, a new H1 receptor antagonist, on safety and pharmacokinetics of digoxin were studied in a double-blind placebo-controlled crossover study. After administration of digoxine alone (0.25 mg o.d. for 7 days), 12 healthy young male volunteers (23+/-2 years) received either placebo and digoxin (0.25 mg o.d.) or mizolastine (10 mg o.d.) and digoxin (0.25 mg o.d.) during 7 days. The assessment criteria consisted in hemodynamic and ECG parameters recordings and the pharmacokinetics of digoxin during the last day of coadministration (day 14). No difference between the 2 treatment groups was evidenced on ECG, hemodynamic, and clinical and laboratory safety parameters. No change in AUC and tmax was recorded. No clinically relevant effect of mizolastine on the digoxin pharmacokinetics was found. However, a statistically significant increase in digoxin Cmax (3.03+/-0.18 nmolxl(-1) vs 2.52+/-0.19 nmolxl(-1), p < 0.05) and Cmin (0.99+/-0.08 nmolxl(-1) vs 0.87+/-0.07 nmolxl(-1), p=0.05) occurred after the coadministration vs digoxin alone. It can be concluded that mizolastine and digoxin at therapeutic dosages can be safely coadministered.

Adult↗
PubMed1997

The impact of surgical adjuvant thoracic radiation therapy for patients with nonsmall cell lung carcinoma with ipsilateral mediastinal lymph node involvement.

BACKGROUND: Previous nonsmall cell lung carcinoma studies have shown that patients with ipsilateral mediastinal (N2) lymph node involvement who underwent surgical resection have a greater local recurrence rate than those with less lymph node involvement (N0, N1). Therefore, it was hypothesized that complete surgical clearance of subclinical lymph node disease is difficult in N2 patients and that adjuvant postoperative thoracic radiotherapy (TRT) may be beneficial. METHODS: A retrospective review was performed to determine the local recurrence and survival rates for patients with N2 disease undergoing complete surgical resection with or without adjuvant TRT. Between 1987 and 1993 at the Mayo Clinic, 224 patients underwent complete resection of N2 nonsmall cell lung carcinoma. More than one mediastinal lymph node station was sampled in 98% of patients; 39% then received adjuvant TRT (median dose, 50.4 grays). RESULTS: The median follow-up time was 3.5 years for the patients who were alive at the time of the analysis. The surgery alone versus surgery plus TRT groups were well balanced with respect to gender, age, histology, tumor grade, number of mediastinal lymph node stations dissected or involved, and involved N1 lymph node number. There were slightly more patients with right lower lobe lesions (compared with other lobes), patients with multiple lobe involvement, and patients with only one N2 lymph node involved in the surgery alone group. After treatment with surgery alone, the actuarial 4-year local recurrence rate was 60%, compared with 17% for treatment with adjuvant TRT (P < 0.0001). The actuarial 4-year survival rate was 22% for treatment with surgery alone, compared with 43% for treatment with adjuvant TRT (P = 0.005). On multivariate analysis, the addition of TRT (P = 0.0001), absence of superior mediastinal lymph node involvement (P = 0.005), and fewer N1 lymph nodes involved (P = 0.02) were independently associated with improved survival rate. CONCLUSIONS: This study, which to the authors' knowledge is the largest evaluating adjuvant TRT in N2 nonsmall cell lung carcinoma, suggests that adjuvant TRT may improve local control and survival.

Carcinoma, Non-Small-Cell Lung↗
PubMed1997

Esophageal resection for cancer of the esophagus: long-term function and quality of life.

BACKGROUND: Information on function and quality of life of long-term survivors after esophageal resection for carcinoma is limited. METHODS: Between 1972 and 1990, 359 patients underwent esophagectomy for stage I or II esophageal carcinoma at Mayo Clinic. We evaluated long-term function and quality of life in 107 of these patients (81 men and 26 women) who survived 5 or more years. Median age at operation was 62 years (range, 30 to 81 years). The operation performed was an Ivor Lewis resection in 77 patients (72%), transhiatal esophagectomy in 14 (13%), extended esophagectomy in 4 (4%), thoracoabdominal esophagectomy in 4 (4%), and other in 8 (7%). Adenocarcinoma was present in 72 patients (67%), squamous cell carcinoma in 28 (26%), and other in 7 (7%). Thirty-four patients (32%) were in postsurgical stage I, 65 (61%) in stage IIA, and 8 (8%) in stage IIB. Median survival was 10.2 years (range, 5.0 to 23.2 years). Follow-up was complete for all patients. RESULTS: Gastroesophageal reflux was present in 64 patients (60%), symptoms of dumping in 53 (50%), and dysphagia to solid food in 27 (25%). Seventeen patients (16%) were asymptomatic. Factors affecting late functional outcome were analyzed. Patients who had a cervical anastomosis had significantly fewer reflux symptoms (p < 0.05). Dumping syndrome occurred more frequently in younger patients (p < 0.05) and women (p < 0.01). Quality of life was assessed separately by the Medical Outcomes Study 36-Item Short-Form Health Survey and compared with the national norm. Scores measuring physical functioning were decreased (p < 0.01). Scores measuring ability to work, social interaction, daily activities, emotional dysfunction, perception of health, and levels of energy were similar. Mental health scores were higher (p < 0.05). CONCLUSIONS: We conclude that long-term functional outcome after esophagectomy for esophageal carcinoma is affected by age, sex, and type of reconstruction. Quality of life as judged by the patients is similar to the national norm.

Actuarial Analysis↗
PubMed1997

Effectiveness of postoperative irradiation in stage IIIA non-small cell lung cancer according to regression tree analyses of recurrence risks.

BACKGROUND: In the setting of grossly resected stage IIIA (N2 involvement) non-small cell lung carcinoma, the role of adjuvant postoperative thoracic radiation therapy (TRT) remains controversial. This study was initiated to subcategorize these patients into high-, intermediate-, and low-risk groups with respect to local recurrence and survival rates, and to determine whether there were certain subgroups of patients who were particularly likely or unlikely to benefit from postoperative TRT. METHODS: Two hundred twenty-four patients were studied. A regression tree analysis was used to separate patients who had undergone operation alone into groups that had a high, intermediate, or low risk of local recurrence and death. The effect of adjuvant postoperative TRT then was examined in each of these groups. RESULTS: The use of adjuvant postoperative TRT (compared with operation alone) was associated with an improvement in freedom from local recurrence and survival for patients who had an intermediate or high risk of local recurrence and death. However, the greatest level of improvement in freedom from local recurrence (p < 0.0001) and survival (p = 0.0002) associated with the use of adjuvant postoperative TRT was in the high-risk group. Similarly, but of lesser magnitude, the intermediate-risk group had improved freedom from local recurrence and survival rates with the use of adjuvant post-operative TRT (p = 0.002 and p = 0.01, respectively). For the low-risk group, the freedom from local recurrence and survival rates were not statistically different between the patients who received adjuvant postoperative TRT and those who underwent observation. CONCLUSIONS: Patients with non-small cell lung carcinoma involving ipsilateral mediastinal lymph nodes (stage IIIA) who undergo gross resection and who are at either high or intermediate risk for local recurrence and death are likely to benefit from adjuvant postoperative irradiation. The role of radiation therapy in low-risk patients is unclear. Prospective confirmation of these observations is warranted.

Carcinoma, Non-Small-Cell Lung↗