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Objective: To assess the predictive and prognostic value of progressive metabolic disease (PMD) by the use of early 18Fluorodeoxyglucose positron emission tomography (18FDG-PET) in patients with clinical stage IV non-small cell lung cancer (NSCLC) treated with first-line chemotherapy. Methods: An 18FDG-PET performed following the first cycle of chemotherapy (PET-1) was compared with a pretreatment 18FDG-PET (PET-0) and a computed tomography (CT) scan after the third cycle (CT-3). The primary endpoint was the positive predictive value (PPV) of PMD. Secondary endpoints included the prognostic value of PMD. Results: Eleven of 38 patients (29%) had a PMD by PET-1, and 15 (39%), including all patients with a PMD, experienced a progressive disease by CT-3. The PPV of PMD was 100% according to both the European Organization for Research and Treatment of Cancer (EORTC) criteria and the PET Response Criteria In Solid Tumors (PERCIST) (p value for both, <0.0001). Patients with a PMD by PET-1 had a median overall survival of 7.0 months versus 14.0 months for those without a PMD (p = 0.04, according to the EORTC criteria). Conclusions: Early 18FDG-PET assessment deserves further investigation for the identification of NSCLC patients who do not benefit from first-line chemotherapy. [ABSTRACT FROM AUTHOR]

Primary malignant neoplasms of trachea are extremely rare, accounting for 0.2% out of all malignancies and represent 0.12% of all death from trachea and lung cancer in UK. Furthermore, just a few reports featuring primary adenocarcinoma have been identified among large series of tracheal resections. Clinical presentation and histopathologic characteristics of a case of tracheal adenocarcinoma, treated at our Division, are described. A 60- year-old male, treated with bronchodilators and oral steroids for a presumed diagnosis of asthma during the previous three years, was admitted to our hospital with cough, dyspnea and wheezing. Computerized tomography showed a tracheal tumor. Bronchoscopy confirmed a wide-base polypoid tumor at the left wall of trachea, spot 4 cm above the carina and occluding >90% of lumen. A biopsy was taken and pathological examination reported a poorly differentiated adenocarcinoma (PDA). Through cervicosternotomy, a tracheal resection that contains two rings of trachea with malignant lesion was performed. No operative mortality and intraoperative or postoperative complications were observed. Nowadays, at the time of the article, the patient is alive and disease free 19 months after surgery. We conclude that primary malignant adenocarcinoma of trachea is an exceedingly rare neoplasm. Complete surgical resection remains the treatment of choice for improving the overall prognosis of tracheal tumors of this kind. To our knowledge this is the 10th case described in literature and we describe it for its rarety. [ABSTRACT FROM AUTHOR]

Aim: To explore the feasibility and activity of a histology-based induction combination chemotherapy for elderly patients with clinical stage III non-small cell lung cancer (NSCLC)., Patients and Methods: Patients aged ≥70 years with stage IIIA and IIIB lung squamous cell carcinoma (SCC) or adenocarcinoma were treated with three cycles of carboplatin and gemcitabine or pemetrexed, respectively, followed by definitive radiotherapy or surgery. The primary endpoint was the overall response rate (ORR) following induction., Results: Twenty-seven patients, with a median age of 74 years (range=70-80 years) were treated for adenocarcinoma in 14 (52%) and SCC in 13 (48%), clinical stage IIIA in eight (30%) and IIIB in 19 (70%). Grade 3 or 4 toxicity was reported for five patients (18.5%). The ORR was 46% in 12 (partial responses) out of 26 assessable patients., Conclusion: Histology-based induction combination chemotherapy is active and feasible in elderly patients with stage III NSCLC., (Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Clinical recurrence in the absence of biochemical PSA failure is uncommon and accounts for less than 1%; we report a rare case of solitary lung metastasis in a patient with undetectable PSA level (<0.1 ng/mL) after radical prostatectomy (RP) for prostate cancer (PCa). An asymptomatic 75-year-old man nine years after RP showed a solitary lung mass (about 2 cm) at chest radiography; the 18-FDG-PET/CT confirmed the presence of an isolated mass suspicious for primitive pulmonary cancer. The initial histological specimen after RP showed a mixed acinar and ductal PCa (Gleason score 7, pT3aNO stage, negative surgical margins). A segmental pulmonary resection was performed and definitive specimen demonstrated a single ductal PCa metastasis; after six months from surgery the patient was free from recurrence. In conclusion, in patients with atypical PCa variants imaging studies may be considered in the follow up even in presence of undetectable PSA because they could benefit from early salvage therapy.