Feasibility and comparative prognosis of segmentectomy versus lobectomy in centrally located small and solid dominant cN0 non-small cell lung cancer.

OBJECTIVES: To determine the feasibility of segmentectomy in patients with central, whole tumor size ≤2 cm and radiologically solid-dominant cN0 non-small cell lung cancer (NSCLC). METHODS: We retrospectively reviewed 1240 patients who underwent lobectomy or segmentectomy for small and radiologically solid-dominant cN0 NSCLC between January 2010 and December 2022. The inclusion criteria encompassed centrally located tumors, defined as tumors located in the inner two-thirds of the pulmonary parenchyma. Propensity score matching was applied to balance the baseline characteristics in the 2 study groups. RESULTS: Among the 299 eligible patients, no significant differences in recurrence-free survival (RFS) and overall survival (OS) were observed between the segmentectomy (n = 121) and lobectomy (n = 178) groups (P = .794 and .577, respectively). After propensity score matching, no significant differences in hilar and mediastinal lymph node upstaging were found among the 93 matched patients (P = 1.00), and locoregional recurrence was comparable in the segmentectomy (n = 4) and lobectomy (n = 4) groups. RFS and OS did not differ significantly between the 2 groups (P = .700 and .870, respectively). Propensity score-adjusted multivariable Cox analysis for RFS and OS indicated that segmentectomy was not an independent prognostic factor (RFS: hazard ratio [HR], 0.89; 95% confidence interval [CI], 0.43-1.85; P = .755; OS: HR, 1.09; 95% CI, 0.38-3.14; P = .860). CONCLUSIONS: Segmentectomy may be a viable treatment option, with local control and prognosis comparable to that of lobectomy in appropriately selected patients with central, small (≤2 cm), and radiologically solid-dominant NSCLC.

Association between pathological infiltrative tumor growth pattern and prognosis in patients with resected lung squamous cell carcinoma.

INTRODUCTION: Lung squamous cell carcinoma (LUSC) usually shows expansive growth with large tumor nests; few reports on invasive growth patterns (INF) in LUSC have been associated with poor prognosis in gastrointestinal and urothelial cancers. In this study, we examine the association between INF and the prognosis of LUSC. MATERIALS AND METHODS: We analyzed INF as a potential prognostic factor in 254 consecutive patients with LUSC who underwent complete surgical resection at our hospital between 2008 and 2017. INF was classified into 3 categories based on the structure of the tumor other than the large round solid nest of tumor cells. RESULTS: INF was categorized as INFa in 59 patients (23 %) with only well-demarcated large solid tumor cell nests, INFb in 89 patients (35 %) with medium to small, alongside large solid nests, and INFc in 98 patients (39 %) with cord-like/small nests or isolated cells plus large or medium solid nests. No significant lymph node metastasis differences were observed between INFc and INFa/b tumors. However, in patients with p-stage I, INFc had a poorer prognosis with regard to recurrence-free survival (RFS), with a 5-year RFS rate of 53.3 %, compared to 74.9 % for INFa/b (p = 0.010). CONCLUSION: Our study highlights a novel pathological concept of INF in LUSC, and contributed to the proposal that it is a factor indicating an unfavorable prognosis in patients with early-stage LUSC. A prospective multicenter study is warranted for INFc patients, as careful follow-up and adjuvant chemotherapy might lead to the early detection and prevention of recurrence.

Sublobar resection utilizing near-infrared thoracoscopy with intravenous indocyanine green for intralobar pulmonary sequestration: a case report and literature review.

BACKGROUND: Pulmonary sequestration is a rare pulmonary malformation, with intralobar pulmonary sequestration being the most common subtype. Lobectomy has generally been performed for its treatment, owing to unclear boundaries of the lesion. However, recent reports have introduced lung resection using intravenous indocyanine green (ICG) as a treatment for pulmonary sequestrations. CASE DESCRIPTION: A 34-year-old woman presented with chest pain, and enhanced chest computed tomography (CT) displayed a solid mass of 4.5 × 3.1 cm in the right S10 area. An aberrant artery was found running from the celiac artery through the diaphragm to the thoracic cavity. The patient was diagnosed as having pulmonary sequestration Pryce type III, and surgical resection was performed. Intrathoracic findings demonstrated that the precise area of the pulmonary sequestration could not be clearly identified, and a 5-mm aberrant artery was present in the pulmonary ligament. Following the separation of the aberrant artery, intravenous injection of ICG clearly delineated the border between the normal lung tissue and the pulmonary sequestration. Wedge resection was then performed without any postoperative events, and the pathological diagnosis was also pulmonary sequestration. CONCLUSIONS: We herein reported a case of a patient who underwent sublobar resection for intrapulmonary sequestration using intravenous ICG injection, together with a literature review. Our case suggests that a comprehensive understanding of abnormal vessels and pulmonary vasculature in pulmonary resection for intrapulmonary sequestrations, complemented with the use of ICG, might potentially avoid unnecessary pulmonary resection and enable sublobar surgical resection.

Fluorometric determination of fluoride ion by reagent tablets containing 3-hydroxy-2'-sulfoflavone and zirconium(IV) ethylenediamine tetraacetate.

A reagent tablet for determination of fluoride ion has been prepared using ethylenediamine-N,N,N',N'-tetraacetate complex of zirconium (Zr-EDTA), 3-hydroxy-2'-flavone (FS) and an appropriate pH buffer. Dissolving of the tablet into water exhibits an intense blue fluorescence (lambda(max)=460 nm) upon excitation at 377 nm and the fluorescence intensity decreases with the presence of fluoride ion. Hence, a simple fluorescent detection procedure for fluoride ion in aqueous media was successfully constructed with this tablet. The principle of this detection system is the ligand exchange reaction of FS bound to Zr-EDTA with fluoride ion. The present system provides an easy, rapid and selective determination method of fluoride ion ranging from 5 x 10(-6) to 1 x 10(-3)mol dm(-3). The measurement of real samples with this tablet showed the similar results as those by the common method with the Alfusone reagent.

Naked-eye detection of trace arsenic(V) in aqueous media using molybdenum-loaded chelating resin having beta-hydroxypropyl-di(beta-hydroxyethyl)amino moiety.

A naked-eye detection method for a trace amount of arsenic in aqueous samples has been newly developed. The proposed method is based on the formation of a hetero poly acid in a chelating resin phase. Molybdenum loaded on a chelating resin having beta-hydroxypropyl-di(beta-hydroxyethyl) amino moiety reacts with arsenic(V) to form the hetero poly acid, which makes the resin beads greenish blue in the presence of a reducing agent under acidic conditions. It was also found that the intensity of the color of the resin depends on the concentration of arsenic(V) in the sample solutions. Since the development of the color occurs in 20min by heating of the mixture at 40 degrees C, this system can provide a simple, rapid and low-cost detection method of a trace amount of arsenic(V) in an aqueous media. The detection limit of this method is 1x10(-6)moldm(-3). A longer preconcentration time with the same resin gave the higher sensitivity of 1x10(-7)moldm(-3) that is comparable with that of the instrumental analysis. The present method comprises both the concentration and detection step with the same solid material, and hence it gives higher sensitivity and easier handling than the ordinary colorimetric methods using a liquid medium.