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The primary purpose of this study was to evaluate whether preservation of lung function parallels preservation of anatomy following elective bronchial sleeve-lobectomy (BSL). Between January 1984 and July 1988, 21 male patients (median age 51 years) with non-small cell lung cancer (n = 18), atypical carcinoid (n = 2) and inflammatory stenosis (n = 1) entered the study. Pulmonary function tests were performed pre- and postoperatively (at 3 and 12 months) and included spirometry, a quantitative perfusion lung scan and arterial blood gas analysis. The majority of operations were performed on the right lung (n = 15, 71%), with no operative deaths or major complications. Three months after surgery, the values of PaO2, PaCO2 and overall perfusion improved significantly (P less than 0.05), while there was a non significant improvement of the forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). The only parameter correlating (r = 0.46) and significantly (p = 0.032) predicting outcome after resection was overall perfusion. The preserved, reimplanted lobe rather than contralateral lobe(s) significantly (p = 0.014) contributed to remaining overall function. In 16 patients examined 12 months post-operatively a further improvement in pulmonary function occurred. The data presented demonstrate that preservation of pulmonary function parallels preservation of anatomy following BSL and that the functional contribution of reimplanted, ipsilateral lobe(s) is of paramount importance.

352 Background: Hepatocellular carcinoma (HCC) from alcoholic cirrhosis, associated or not with chronic hepatitis C virus (HCV) infection, is a particularly severe liver disease. Scanty and inconsistent data concerning the efficacy of sorafenib in patients (pts) with this disease are available. Methods: Since February 2009 we screened 26 Child-Pugh liver function class A pts bearing the above characteristics. Sixteen of them (61.5%), 15 males and 1 female with median age of 69 years (range 54-79), received 400 mg sorafenib b.i.d. Predominant cause of HCC was alcohol consumption in 13 pts (81.2%), associated with chronic HCV infection in 2 pts (12.5%), and hemosiderosis in 1 pt (6.2%). All pts suffered from multiple comorbidities, and 3 had been previously treated for Burkitt lymphoma, bladder and breast cancer. One pt with prostate cancer was on treatment with androgen blockade. Median number of concomitant medications was 4 (range 2-9). Four pts never received locoregional treatment, and none had received previous antineoplastic therapy. Results: Twelve pts (73%) discontinued sorafenib after a median time of 2 months (range 2-6). The reasons for treatment discontinuation were disease progression (4 pts), liver function deterioration (5 pts), and mild gastrointestinal adverse events (2 pts): 1 pt refused sorafenib treatment after 15 days. 2/4 patients still on treatment with sorafenib at 7, 8, 11, and 18 months showed partial response (RECIST criteria). Seven pts (40%) died because of disease progression at a median time of 5.5 months (range 2-9) and at a median overall survival time of 36 months from diagnosis (range 2-84). Conclusions: Treatment with sorafenib in pts affected by HCC and alcoholic cirrhosis seems effective and well tolerated with high-level compliance. The most common cause of discontinuation was progression of disease and liver function deterioration. No significant financial relationships to disclose.