Contribution of Metabolic Tumor Volume and Total Lesion Glycolysis to Predict Prognosis in Early-Stage Lung Cancer at Preoperative Staging.

OBJECTIVE: To evaluate the effect of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) values of the primary tumor measured by preoperative positron emission tomography/computed tomography (FDG-PET/CT) on survival in patients with operated non-small cell lung cancer (NSCLC). STUDY DESIGN: Cohort study. PLACE AND DURATION OF STUDY: Recep Tayyip Erdogan University, Faculty of Medicine, Department of Medical Oncology from January 2017 to June 2020, Turkey. METHODOLOGY: Patients with operated NSCLC were reviewed retrospectively. Metabolic parameters of FDG-PET/CT such as pathological tumor features, type of operation, MTV/TLG values, and whether they received adjuvant therapy were evaluated. Disease-free survival (DFS) and overall survival (OS) times were calculated. RESULTS: Most of the 77 patients (96.1%) were male. The mean age is 64±8 years. Lobectomy was performed in 66 (85.7%) patients, and pneumonectomy was performed in 11 (14.3%) patients. The mean tumor diameter was 3.7±2.015cm. Squamous cell carcinoma was detected in 37 patients (48.1%) and adenocarcinoma in 35 patients (45.5%). Thirty-eight patients (49.4%) received adjuvant chemotherapy. SUVmax, MTV, and TLG values of the primary tumor were high in patients under 65 years of age and with a tumor diameter of ≥3cm. DFS was nine months (4.5-18), and OS was 19 months (11-29). The 2-year survival rate was 75.6%. It was observed that patients with adenocarcinoma relapsed more frequently, which negatively affected survival (p=0.023, and p=0.024 respectively). High MTV (p=0.01) and TLG (p=0.015) values were associated with poor prognosis. CONCLUSION: NSCLC is a heterogeneous disease, and survival is affected by many factors. Our study showed that the subtype of adenocarcinoma and high MTV and TLG values of the primary tumor are poor prognostic factors in operated early-stage lung cancers. KEY WORDS: Early-stage, Non-small cell lung cancer, MTV, TLG, NSCLC, Survival, FDG-PET/CT.

Management of primary spontaneous pneumothorax: Our single-center, five-year experience.

Background: In this study, we aimed to analyze the effects of admission time to the hospital and different variables on the treatment efficiency and to evaluate the recurrence during the clinical management process in patients with the diagnosis of primary spontaneous pneumothorax. Methods: A total of 149 patients with primary spontaneous pneumothorax (131 males, 18 females; mean age: 24.8±6.8 years; range, 17 to 35 years) treated in our clinic between January 2015 and December 2019 were retrospectively analyzed. Time from symptom onset to hospital admission (admission time) was classified as three periods: <24 h, between 24 and 72 h, and >72 h. Data including admission time, demographic and clinical characteristics, smoking history, body mass index, the use of pleurectomy or pleural abrasion during surgery were collected from the charts of the patients. Results: Admission time had no statistically significant effect on the length of hospital stay, recurrence, and the need for surgery. Male sex, smoking history, and lower body mass index had no significant effect on the recurrence. Recurrence and length of hospital stay did not significantly differ between the patients in whom pleurectomy or pleural abrasion added to the procedure during the operation. Conclusion: A longer interval between symptom onset and hospital admission and lower body mass index have no adverse effect on treatment outcomes and the recurrence in patients with primary spontaneous pneumothorax. Despite the fact that surgical treatment significantly decreases the recurrence rate, pleurectomy and pleural abrasion techniques have no significant difference on the clinical influence and recurrence of these patients.

Effect of meteorological factors on first episode and recurrence of primary spontaneous pneumothorax.

OBJECTIVE: In this study, we evaluated the clinical characteristics and seasonal distribution of patients with primary spontaneous pneumothorax and examined the relationships between meteorological factors and pneumothorax development overall and in terms of first episode and recurrence. METHODS: The hospital records of 168 pneumothorax patients treated in our clinic between January 2016 and December 2020 were reviewed retrospectively. A cluster was defined as two or more patients with pneumothorax presenting within three consecutive days. Meteorological factors were compared between days with and without pneumothorax patients. This comparison was based on meteorological data from the day of symptom onset (D), the day before symptom onset (D1), and the difference between those days (D-D1). Meteorological data from the index day (D) were also compared between patients with first episode and recurrence of pneumothorax. RESULTS: The study included 149 (88.7%) men and 19 (11.3%) women. The mean age was 25.02±6.97 (range, 17-35; median, 26) years. Of note, 73 (43.4%) patients underwent surgery. The highest number of patients presented in November (n=19, 11.3%). In terms of season, most presentations occurred in autumn. Humidity was significantly lower on recurrence days compared with first episode (p=0.041). CONCLUSION: Our results indicated that meteorological factors (i.e., atmospheric pressure, humidity, wind speed, temperature, and precipitation) were not associated with pneumothorax development. By comparing the patients with first episode and recurrence, the humidity was significantly lower in the recurrence group.

Effect of meteorological factors on first episode and recurrence of primary spontaneous pneumothorax

SUMMARY OBJECTIVE: In this study, we evaluated the clinical characteristics and seasonal distribution of patients with primary spontaneous pneumothorax and examined the relationships between meteorological factors and pneumothorax development overall and in terms of first episode and recurrence. METHODS: The hospital records of 168 pneumothorax patients treated in our clinic between January 2016 and December 2020 were reviewed retrospectively. A cluster was defined as two or more patients with pneumothorax presenting within three consecutive days. Meteorological factors were compared between days with and without pneumothorax patients. This comparison was based on meteorological data from the day of symptom onset (D), the day before symptom onset (D1), and the difference between those days (D-D1). Meteorological data from the index day (D) were also compared between patients with first episode and recurrence of pneumothorax. RESULTS: The study included 149 (88.7%) men and 19 (11.3%) women. The mean age was 25.02±6.97 (range, 17-35; median, 26) years. Of note, 73 (43.4%) patients underwent surgery. The highest number of patients presented in November (n=19, 11.3%). In terms of season, most presentations occurred in autumn. Humidity was significantly lower on recurrence days compared with first episode (p=0.041). CONCLUSION: Our results indicated that meteorological factors (i.e., atmospheric pressure, humidity, wind speed, temperature, and precipitation) were not associated with pneumothorax development. By comparing the patients with first episode and recurrence, the humidity was significantly lower in the recurrence group.

Primary pulmonary adenoid cystic carcinoma: report of two cases.

A 51-year-old man with adenoid cystic carcinoma in the main stem bronchus was treated by a left lower lobectomy. A 44-year-old man with adenoid cystic carcinoma in the peripheral small bronchi underwent a right sleeve upper lobectomy with tracheobronchoplasty and neo-carina reconstruction; because of positive tumor margins, radiotherapy was administered postoperatively. Both patients were alive without any signs of tumor after 30 and 24 months of follow-up, respectively.