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Thoracic

February 3, 2015
This consensus statement from the European Neuroendocrine Society is based on extensive bibliographic searches and systematic review.  Surgery is the mainstay of therapy for most tumors, and includes resection of metastases when this can be accomplished in a curative manner.  Somatostatin analogues are considered first line therapy for unresectable c
February 2, 2015
The authors queried the National Cancer Data Base to assess outcomes of patients with R1 resection margins related to the presence and type of postoperative adjuvant therapy.  3.1% of over 54,000 resections had R1 margins, which negatively affected long-term survival.  Combined chemotherapy and radiation therapy improved outcomes; administration of c
February 2, 2015
This study propensity-score matched patients from a cohort who underwent resection for stage I or II lung cancer and compared 175 pairs who underwent VATS or open lobectomy.  The VATS group experienced shorter hospital length of stay, fewer complications, and more frequent discharge to home.  Survival was similar.
February 2, 2015
This video shows a segmentectomy for a lobulated pulmonary mass in the posterior and lateral segments of the left lower lobe.
January 29, 2015
This meta-analysis of 6 prior publications analyzed factors associated with outcomes after resection of synchronous lung cancers.  Favorable predictors of survival were exclusive adenocarcinoma, small T size, bilateral disease, no nodal involvement, young age, and female sex.
January 29, 2015
There is growing recognition of the utility of EBUS in staging NSCLC.  In this study EBUS and mediastinoscopy were performed in 127 patients requiring mediastinal staging for clinical N1-3 NSCLC.  The authors found that EBUS had superior accuracy (93% vs 89%) and negative predictive value (85% vs 79%). 
January 29, 2015
This analysis of nearly 40,000 patients with inoperable early stage lung cancer explored factors associated with delivery of potentially curative conventional radiotherapy (ConvRT) or SBRT.  Treatment was less likely in blacks and hispanics.  SBRT was more likely than ConvRT in high volume and academic centers.  Overall use of SBRT, ConvRT, and no tr
January 29, 2015
There is growing recognition that hospital mortality is not an accurate metric for surgery-related mortality after cancer operations.  This article evaluated SEER data for 1-month mortality after cancer surgery in nearly 54,000 patients.  4.8% died within 1 month of surgery.  Favorable factors included being married, being insured, having an above-me
January 29, 2015
This meta-analysis evaluated 6 published studies involving over 71,000 cancer patients who experienced 2002 instances of cancer mortality.  Compared to patients with low fitness, those with high levels of cardiorespiratory fitness had a 50% reduction in their cancer mortality risk.
January 29, 2015
The author recounts the posttraumatic distress that Captain Scully and other crewmembers experienced after the emergency landing of US Airways Flight 1549 on the Hudson River in New York City.  She describes the counseling this team required after executing a nearly perfect recovery from a potentially disastrous aviation event.  The author wonders wh

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