Multidisciplinary management improves survival at 1 year after surgical treatment for non-small-cell lung cancer: a propensity score-matched study.

OBJECTIVES: The management of patients affected by lung cancer requires the expertise of specialists from different disciplines. Although the advantages of multidisciplinary team discussions seem obvious, there are limited studies evaluating the influence of this approach on postoperative outcomes in non-small-cell lung cancer (NSCLC). The aim of this study is to examine the impact of a multidisciplinary approach on survival of patients undergoing surgery for NSCLC. METHODS: A retrospective analysis was performed on consecutive patients who underwent surgery for NSCLC between January 2008 and December 2015. Data were compared between patients treated before the implementation of a multidisciplinary tumour board (MTB), between 2008 and 2012, and those who received treatment after the implementation of the MTB, between 2012 and 2015. Patients were matched one to one according to the discussion of the MTB and on the basis of a propensity score built using several patient characteristics. A propensity score-matched analysis was performed to compare patient outcomes. RESULTS: A total of 246 patients were treated prior to the initiation of the MTB and 231 patients after the initiation of the MTB. Based on the propensity score, 2 well-matched groups of 170 patients were identified. Patients who were discussed at the MTB were noted to have better outcomes when compared with those who were not discussed at the MTB on different terms including complete staging evaluation, early tumour, node and metastasis (TNM) stages and 1-year survival rate. CONCLUSIONS: Implementation of a multidisciplinary thoracic malignancy conference increased the 1-year survival rate of patients who underwent a surgical resection for NSCLC.

[Chronic cough and worsening dyspnea: a case of idiopathic tracheal stenosis]. / Tosse cronica persistente e dispnea ingravescente: un caso di bronchite difficile.

We report a case of idiopathic tracheal stenosis in a 75-year-old woman, who presented to our observation with a diagnosis of asthmatic bronchitis characterized by cough and exertional dyspnea, later complicated by the appearance of tirage. Biopsy of the lesion showed focal squamous metaplasia of the epithelium lining, multiple sclerosis and chronic inflammatory infiltration of the corium. The patient was treated with endoscopic destruction via rigid bronchoscopy, through the combined action of YAG laser and mechanical debulking.

Primary Pulmonary Epithelioid Hemangioendothelioma: A Rare Cause of PET-Negative Pulmonary Nodules.

We report here a case of primary pulmonary epithelioid hemangioendothelioma diagnosed in a 67-year-old Caucasian man, presenting with exertion dyspnoea, dry cough, and multiple bilateral pulmonary nodules revealed by computed tomography. At the 18F-fluorodeoxyglucose positron emission tomography, these nodules were negative. The histopathological diagnosis was made on a pulmonary wedge resection (performed during video-thoracoscopic surgery).

Sonographically guided biopsy and sonographic monitoring in the diagnosis and follow-up of 2 cases of sarcoidosis with hepatic nodules and inconclusive thoracic findings.

OBJECTIVE: To report 2 cases in which abdominal sonography played a useful role in diagnosing sarcoidosis with early nodular hepatosplenic manifestations. METHODS: In the first case, an asymptomatic woman with increased liver enzyme values underwent sonography, which showed multiple hypoechoic nodules in the liver and spleen. Computed tomography confirmed the hepatosplenic findings and showed micronodular infiltrates of both lung fields, without hilar and mediastinal lymphadenopathy. In the second case, in a woman with a cough, dyspnea, and increased liver enzyme levels, thoracic computed tomography showed right pleural effusion causing partial atelectasis of the lower and middle lobes and mediastinal lymphadenopathy. RESULTS: Sonography and computed tomography showed multiple nodules of the liver and spleen and retroperitoneal lymphadenopathy. In both cases, bronchoscopy, bronchial and bronchioloalveolar lavages, and transbronchial and mediastinal biopsies had negative results. Sonographically guided biopsy of the hepatic nodules was carried out and sarcoid granulomas were detected in the portal areas. After 3 months of steroid therapy, liver enzyme values nearly normalized, and sonography showed the disappearance of all abdominal lesions. The first patient underwent control computed tomography, which confirmed the regression of the disease; the second patient refused control computed tomography. CONCLUSIONS: Sarcoidosis can occur with atypical onset, and in selected cases sonography may play a useful role in its diagnosis and follow-up.