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1.
Comput Math Methods Med ; 2022: 1301361, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36110570

RESUMO

To investigate the influences of ultrasonic image-guided erector spinae plane block (ESPB) on postoperative pulmonary air content of lung carcinoma patients undergoing thoracoscopic surgery, 42 patients performed with thoracoscopic radical surgery for lung carcinoma were selected. The patients in the experimental group were performed with ultrasound-guided unilateral ESPB and intravenous general anesthesia. The patients in the control group only underwent intravenous anesthesia. The changes in postoperative pulmonary air content between the two groups were compared. After that, all included patients were divided into the experimental (senior) group (13 cases), the experimental (adult) group (8 cases), the control (senior) group (11 cases), and the control (adult) group (10 cases) according to age. The changes in postoperative pulmonary air content of patients in the four groups were compared. The results showed that lung ultrasound score (LUS) of patients in experimental group was 6.4 ± 3.2 points 0.5 hour after catheter extraction and LUS was 4.1 ± 2.3 points 20 to 30 hours. Both scores were remarkably lower than those of patients in control group (P < 0.05). LUS of lower left anterior area, upper left posterior area, lower left posterior area, upper right posterior area, and lower right posterior area of patients in experimental group was all apparently lower than those in control group 0.5 hour after catheter extraction (P < 0.05). LUS of upper left posterior area, lower left posterior area, lower right anterior area, upper right posterior area, and lower right posterior area of patients in experimental group was all remarkably lower than those in control group 20 to 30 hours after surgery (P < 0.05). LUS of senile patients and middle-aged patients in experimental group 0.5 hour after catheter extraction was 8.01 ± 2.48 points and 5.93 ± 3.91 points, respectively, which were both notably lower than those in control group (P < 0.05). Ultrasound-guided ESPB exerted fewer influences on lung and could effectively improve postoperative pulmonary air content among patients. Hence, it was worthy of clinical promotion.


Assuntos
Carcinoma , Neoplasias Pulmonares , Bloqueio Nervoso , Adulto , Humanos , Pulmão/diagnóstico por imagem , Pulmão/cirurgia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Pessoa de Meia-Idade , Bloqueio Nervoso/métodos , Dor Pós-Operatória/tratamento farmacológico , Toracoscopia , Ultrassom , Ultrassonografia de Intervenção
2.
Cancer Radiother ; 26(6-7): 755-759, 2022 Oct.
Artigo em Francês | MEDLINE | ID: mdl-36075829

RESUMO

The historical treatment for stage I non-small cell lung cancer is surgical. Parenchymal amputation is not always possible due to cardiopulmonary comorbidities and stereotactic radiotherapy is one of the alternatives to an invasive procedure. The excellent results observed for inoperable tumors raised the question of this treatment in operable patients. This article presents the data in these two situations and the future perspectives.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Radiocirurgia , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Humanos , Pulmão/patologia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/radioterapia , Neoplasias Pulmonares/cirurgia , Estadiamento de Neoplasias , Radiocirurgia/métodos , Resultado do Tratamento
3.
Lung Cancer ; 172: 127-135, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36084376

RESUMO

OBJECTIVE: The COVID-19 pandemic has far-reaching collateral health impacts on the ongoing delivery of surgical care worldwide. The current study was designed to analyze the impact of the COVID-19 pandemic on the number of surgeries of general thoracic surgery in Japan. METHODS: Changes in the number of surgeries for total and three representative tumors were analyzed using the National Clinical Database data with reference to the pandemic infection rate and lung cancer screening. RESULTS: In 2020, the number of surgeries in total and for primary lung cancer and mediastinal lung tumor decreased by 4.9, 5.1, and 5.0 %, respectively. Considering the five-year trend towards a 5 % annual increase, there was a potential 10 % decrease in the number of primary lung cancer surgeries. The number of primary lung cancer surgeries bottomed in July 2020 but recovered towards the end of the year. In contrast, the number of metastatic lung tumor surgeries in 2020 increased by 3.2 %, following a similar trend observed over the previous five years. The number of lung cancer screening examinees decreased markedly with the lowest number in May. Our findings indicate that surgical triage had a limited impact on the decrease in primary lung cancer surgeries during the pandemic; rather, the decrease in lung cancer screening, which was a few months preceding, is most likely responsible. CONCLUSIONS: The decrease in primary lung cancer was mainly caused by the decrease in lung cancer screening, indicating that continuing screening is vital even during a pandemic.


Assuntos
COVID-19 , Neoplasias Pulmonares , Procedimentos Cirúrgicos Torácicos , COVID-19/epidemiologia , Detecção Precoce de Câncer , Humanos , Japão/epidemiologia , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/cirurgia , Pandemias
4.
Can Respir J ; 2022: 9149385, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36106062

RESUMO

Introduction: This study is conducted to investigate the correlation between perioperative fractional exhaled nitric oxide and postoperative pneumonia (POP) and the feasibility of perioperative FeNO for predicting POP in surgical lung cancer patients. Methods: Patients who were diagnosed with non-small-cell lung cancer (NSCLC) were prospectively analyzed, and the relationship between perioperative FeNO and POP was evaluated based on patients' basic characteristics and clinical data in the hospital. Results: There were 218 patients enrolled in this study. Finally, 183 patients were involved in the study, with 19 of them in the POP group and 164 in the non-POP group. The POP group had significantly higher postoperative FeNO (median: 30.0 vs. 19.0 ppb, P < 0.001) as well as change in FeNO (median: 10.0 vs. 0.0 ppb, P < 0.001) before and after the surgery. For predicting POP based on the receiver operating characteristic (ROC) curve, a cutoff value of 25 ppb for postoperative FeNO (Youden's index: 0.515, sensitivity: 78.9%, and specificity: 72.6%) and 4 ppb for change in FeNO (Youden's index: 0.610, sensitivity: 84.2%, specificity: 76.8%) were selected. Furthermore, according to the bivariate regression analysis, FEV1/FVC (OR = 0.948, 95% CI: 0.899-0.999, P=0.048), POD1 FeNO (OR = 1.048, 95% CI: 1.019-1.077, P=0.001), and change in FeNO (OR = 1.087, 95% CI: 1.044-1.132, P < 0.001) were significantly associated with occurrence of POP. Conclusions: This prospective study revealed that a high postoperative FeNO (>25 ppb), as well as an increased change in FeNO (>4 ppb), may have the potential in detecting the occurrence of POP in surgical lung cancer patients.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Pneumonia , Testes Respiratórios , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Humanos , Neoplasias Pulmonares/cirurgia , Óxido Nítrico/análise , Pneumonia/diagnóstico , Estudos Prospectivos
5.
Semin Respir Crit Care Med ; 43(4): 480-491, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36104025

RESUMO

Lobar resection has been the established standard of care for peripheral early-stage non-small cell lung cancer (NSCLC). Over the last few years, surgical lung sparing approach (sublobar resection [SLR]) has been compared with lobar resection in T1N0 NSCLC. Three nonsurgical options are available in those patients who have a prohibitive surgical risk, and those who refuse surgery: stereotactic body radiotherapy (SBRT), percutaneous ablation, and bronchoscopic ablation. Local ablation involves placement of a probe into a tumor, and subsequent application of either heat or cold energy, pulsing electrical fields, or placement of radioactive source under an image guidance to create a zone of cell death that encompasses the targeted lesion and an ablation margin. Despite being in their infancy, the bronchoscopic ablative techniques are undergoing rapid research, as they extrapolate a significant knowledge-base from the percutaneous techniques that have been in the radiologist's armamentarium since 2000. Here, we discuss selected endoscopic and percutaneous thermal and non-thermal therapies with the focus on their efficacy and safety.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Ablação por Cateter , Neoplasias Pulmonares , Carcinoma de Pequenas Células do Pulmão , Broncoscopia , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Ablação por Cateter/métodos , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Pulmão/cirurgia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia
6.
In Vivo ; 36(5): 2303-2307, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36099121

RESUMO

BACKGROUND/AIM: The neutrophil-to-lymphocyte ratio (NLR) plays key roles in cancer growth. This study aimed to identify novel prognostic factors in patients who underwent complete resection of centrally located lung squamous cell carcinoma. PATIENTS AND METHODS: We retrospectively investigated the clinical courses of 45 patients who underwent sleeve lobectomy or pneumonectomy for centrally located squamous cell carcinoma. RESULTS: High NLR (p<0.001) and pathological T3/4 (p=0.008) were significant poor prognostic factors according to univariate analysis. Patients with pathological N2 had poor prognosis; however, there was no significant difference (p=0.095). Among these factors, only high NLR (p=0.003) was an independent poor prognostic factor according to multivariate analysis. Of the 23 patients with high NLR, 11 (49%) had recurrence, whereas in the 22 patients without high NLR, only two (9%) had recurrence. CONCLUSION: High NLR is an independent poor prognostic factor in centrally located lung squamous cell carcinoma. Our findings may guide the selection of optimal treatments for this subgroup of patients.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Carcinoma de Células Escamosas , Neoplasias Pulmonares , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Humanos , Pulmão/patologia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Linfócitos/patologia , Neutrófilos/patologia , Prognóstico , Estudos Retrospectivos
7.
In Vivo ; 36(5): 2260-2264, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36099122

RESUMO

BACKGROUND/AIM: Distant metastasis has a strong influence on prognosis in patients with soft tissue sarcoma (STS). While various risk factors have been reported for distant metastases, risk factors for distant metastases early after treatment of primary tumor have not been investigated. This study aimed to evaluate the factors of early distant metastasis after primary tumor resection in patients with STS. PATIENTS AND METHODS: We retrospectively identified patients with STS involving the extremities or trunk without any metastasis at the first visit. Data on clinical information and detailed assessment were collected. We evaluated clinical information as a risk factor for distant or lung metastases. Additionally, we evaluated risk factors for metastases in patients with distant metastases as early as 6 months after the initial resection of the primary tumor. RESULTS: A total of 337 patients were included in the study. Multivariate analysis revealed that the size of the primary tumor (p=0.0011 and p=0.0167), consultation in a short period after onset (p=0.0325 and p=0.0402), histological high grade (p=0.0006 and p=0.0002), and inadequate surgical margin (p=0.0151 and p=0.0055) were significant predictors for poor prognosis for all distant and lung metastases, respectively. However, the only risk factor for early metastases within 6 months was young age (p=0.0148). CONCLUSION: The only risk factor for early distant metastasis after primary tumor resection in patients with STS was young age, even though large tumor diameter and histological high grade were risk factors for distant metastasis.


Assuntos
Neoplasias Pulmonares , Sarcoma , Neoplasias de Tecidos Moles , Humanos , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/cirurgia , Estudos Retrospectivos , Fatores de Risco , Neoplasias de Tecidos Moles/patologia
8.
J Surg Oncol ; 126(5): 921-925, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36087084

RESUMO

During the past 50 years, there has been a remarkable transformation in the management of lung and esophageal cancers. Improved methods of diagnosis, better staging and patient selection for surgery, the advent of minimally invasive approaches to resection, decreasing operative mortality, greater insights into tumor biology, and the development of effective multimodality therapies and precision medicine have contributed to this transformation. Progress has been most notable in lung cancer.


Assuntos
Neoplasias Esofágicas , Neoplasias Pulmonares , Oncologia Cirúrgica , Neoplasias Esofágicas/cirurgia , Humanos , Pulmão/patologia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia
9.
JAMA Netw Open ; 5(9): e2230704, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36074462

RESUMO

Importance: National guidelines allow consideration of postoperative radiation therapy (PORT) among patients with incompletely resected non-small cell lung cancer (NSCLC). However, there is a paucity of prospective data because recently completed trials excluded patients with positive surgical margins. In addition, unlike for locally advanced NSCLC, the role of intensity-modulated radiation therapy (IMRT) for PORT remains unclear. Objective: To evaluate trends of IMRT use for PORT in the US and the association of IMRT with survival outcomes among patients with incompletely resected NSCLC. Design, Setting, and Participants: This retrospective cohort study used data from the National Cancer Database for patients diagnosed between January 2004 and December 2019 with incompletely resected NSCLC who underwent upfront surgery with positive surgical margins followed by PORT. Exposures: IMRT vs 3D conformal radiation therapy (3DCRT) for PORT. Main Outcomes and Measures: The main outcome was overall survival. Multivariable Cox proportional hazards regression assessed the association of IMRT vs 3DCRT with overall survival. Multivariable logistic regression identified variables associated with IMRT. Propensity score matching (1:1) was performed based on variables of interest. Results: A total of 4483 patients (2439 men [54.4%]; median age, 67 years [IQR, 60-73 years]) were included in the analysis. Of those, 2116 (47.2%) underwent 3DCRT and 2367 (52.8%) underwent IMRT. Median follow-up was 48.5 months (IQR, 31.1-77.2 months). The proportion of patients who underwent IMRT increased from 14.3% (13 of 91 patients) in 2004 to 70.7% (33 of 471 patients) in 2019 (P < .001). IMRT was associated with improved overall survival compared with 3DCRT (adjusted hazard ratio, 0.84; 95% CI, 0.78-0.91; P < .001). Similar findings were observed for 1463 propensity score-matched pairs; IMRT was associated with improved 5-year overall survival compared with 3DCRT (37.3% vs 32.2%; hazard ratio, 0.88; 95% CI, 0.80-0.96; P = .003). IMRT use was associated with receipt of treatment at an academic facility (adjusted odds ratio [aOR], 1.15; 95% CI, 1.00-1.33; P = .049), having T4 stage tumors (aOR, 1.50; 95% CI, 1.13-1.99; P = .005) or N2 or N3 stage tumors (aOR, 1.25; 95% CI, 1.04-1.51; P = .02), and receipt of pneumonectomy (aOR, 1.35; 95% CI, 1.02-1.80; P = .04). Conclusion and Relevance: This cohort study found that use of IMRT for PORT among patients with incompletely resected NSCLC increased in the US from 2004 to 2019 and was associated with improved survival compared with 3DCRT. Further studies are warranted to investigate the role of different radiation therapy techniques for PORT.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Radioterapia de Intensidade Modulada , Idoso , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Estudos de Coortes , Humanos , Neoplasias Pulmonares/radioterapia , Neoplasias Pulmonares/cirurgia , Masculino , Margens de Excisão , Estadiamento de Neoplasias , Estudos Prospectivos , Radioterapia de Intensidade Modulada/métodos , Estudos Retrospectivos , Resultado do Tratamento
10.
J Cardiothorac Surg ; 17(1): 221, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36050769

RESUMO

BACKGROUND: Situs inversus totalis (SIT) is a relatively rare congenital abnormality in which the major thoracic and abdominal visceral organs are reversed from their usual positions. In patients with SIT and bronchial carcinoma, surgical difficulty increases sharply. It has been reported that the video-assisted thoracic surgery (VATS) still poses the operator to a challenge situation. The similarity of surgical positions and the flexibility of the mechanical arm in robotic surgery, may be beneficial to SIT patients due to reducing technical difficulties. Here, we present a first case of SIT patient with lung cancer, in which Da Vinci robot-assisted thoracic surgery (RATS) was performed successfully. CASE PRESENTATION: A 66-year old patient, previously diagnosed with SIT since childhood, came to our hospital with two pulmonary nodules in his left lung field. The bigger one had increased somewhat for the last 2 years of follow-up. Software Mimics was preoperatively carried out to analyze anatomical variations. RATS was conducted to complete left upper lobectomy and left middle wedge resection. The patient had no intraoperative complications and was discharged day 5 after the operation. CONCLUSIONS: This is the first report of a successful robot-assisted lung cancer resection in a patient with SIT. In such challenging cases as lung cancer and rare anomaly as SIT, RATS is more advantageous and suitable than VATS with the help of software Mimics utilized for 3D reconstruction, which can identify the anatomical abnormalities and facilitate the surgical procedures.


Assuntos
Dextrocardia , Neoplasias Pulmonares , Procedimentos Cirúrgicos Robóticos , Situs Inversus , Idoso , Dextrocardia/complicações , Humanos , Pulmão , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Situs Inversus/complicações , Situs Inversus/cirurgia , Cirurgia Torácica Vídeoassistida
11.
J Cardiothorac Surg ; 17(1): 229, 2022 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-36057613

RESUMO

BACKGROUND: Following lung cancer surgery, patients often experience severe symptoms which are not properly assessed at discharge. The aim of this study was to identify the clinical presentation at discharge and the influencing factors of postoperative symptoms in patients who have undergone lung cancer surgery. METHODS: This cross-sectional study analysed data from patients who participated in a prospective cohort study that enrolled patients who underwent lung cancer surgery at six tertiary hospitals in the People's Republic of China, from November 2017 to January 2020. Patient symptoms at discharge were measured using the MD Anderson Symptom Inventory Lung Cancer module. The five core symptoms were defined according to ratings of moderate to severe symptoms (≥ 4 on a 0-10 scale). A multivariate linear regression model was used to identify the influencing factors of each symptom at discharge. RESULTS: Among the 366 participants, 51.9% were male and the mean (SD) age was 55.81 (10.43) years. At discharge, the core symptoms were cough (36.4%), pain (28.2%), disturbed sleep (26.3%), shortness of breath (25.8%), and fatigue (24.3%), and more than half of the participants (54.6%) had one to five of the core symptoms, with moderate to severe severity. A low annual income and the use of two chest tubes were significantly associated (P = 0.030 and 0.014, respectively) with higher mean scores of the core symptoms. CONCLUSION: Though clinically eligible for discharge, more than half of the participants had severe symptoms at discharge after lung cancer surgery. Special attention should be given to patients who have two chest tubes after surgery and those who have a low annual income.


Assuntos
Neoplasias Pulmonares , Estudos Transversais , Feminino , Humanos , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Estudos Prospectivos , Índice de Gravidade de Doença
12.
BMC Pulm Med ; 22(1): 336, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064381

RESUMO

BACKGROUND: Direct localization of small and deep pulmonary nodules before thoracoscopic surgery using the hookwire or methylene blue techniques has been recently attempted for better surgical outcomes. In this study, we compare the outcomes of the above two techniques. METHODS: Two hundred and nineteen patients undergoing 135 hookwire and 151 methylene blue techniques in our University Hospital between July 2020 and January 2022 were compared for localization and hospitalization durations, and the complication risk. Other confounders included patients' age, gender, localization position, nodules location, count, diameter, and depth. RESULTS: After adjustment of all predictors, the methylene blue technique was associated with a significant 0.6-min (parameter estimate (PE) = -0.568, p value = 0.0173) and an 0.7-day shorter localization and hospitalization time (PE = -0.713, p value = < 0.0001) as compared to using the hookwire technique. The hookwire technique was significantly associated with 5 times the risk of developing a post-localization complication (Adjusted Odds Ratio (Adj OR) = 4.52, 95% CI 1.53-13.33) and 3.6 times the risk of developing a pneumothorax (Adj OR = 3.57, 95% CI 1.1-11.62) as compared to adopting the methylene blue technique. CONCLUSIONS: Compared to the hook wire technique, the methylene blue technique offers a shorter procedure and hospitalization stay, as well as a safer post-operative experience.


Assuntos
Neoplasias Pulmonares , Nódulo Pulmonar Solitário , Humanos , Tempo de Internação , Neoplasias Pulmonares/cirurgia , Azul de Metileno , Nódulo Pulmonar Solitário/diagnóstico por imagem , Nódulo Pulmonar Solitário/cirurgia , Toracoscopia/efeitos adversos , Toracoscopia/métodos , Tomografia Computadorizada por Raios X/métodos
13.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 4974-4977, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36085605

RESUMO

Microwave ablation (MWA) is a clinically widespread minimally invasive treatment method for lung tumors. Preoperative planning plays a vital role in MWA therapy. However, previous planning methods are far from satisfactory in clinical practice because they only one-sidedly consider the surgical path or energy parameters of an MWA surgery. In this paper, we propose a novel planning model with a computational model of thermal damage to integrally optimize both the surgical path and energy parameters. To ensure the model can be solved in a reasonable time, we elaborate a search space reducing strategy based on clinical constraints. Simulation and ex vivo experimental results were compared with an average mean absolute error of 0.82 K and an average root mean square error of 1.01 K. Our planning model was evaluated on clinical data, and the experimental results demonstrate the effectiveness of our model.


Assuntos
Neoplasias Pulmonares , Ablação por Radiofrequência , Simulação por Computador , Humanos , Neoplasias Pulmonares/cirurgia , Micro-Ondas/uso terapêutico , Manejo da Dor
15.
Contrast Media Mol Imaging ; 2022: 7042014, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36128170

RESUMO

The rapid development of science and technology has become an indispensable part of human life. Minimally invasive lung cancer surgery, that is, thoracoscopic surgery and da Vinci robotic surgery, has many advantages over previous surgeries, there is no need to make a large incision in the chest, the patient after such surgery, and recovery is also better and can also reduce the incision of the operation. Therefore, with the rapid development of science and technology today, how to detect changes in patients' health and establish an intelligent health monitoring system has become a development trend. This paper proposes to apply health monitoring in CYP1B1 gene polymorphism and nursing after clinical treatment of minimally invasive lung cancer surgery, after analyzing the society's demand for real-time health monitoring in this paper. It also studies the health monitoring system based on the advantages of smart phones. The system is suitable for the Android operating system and can monitor the temperature, weight, and other data of the human body. The experimental results show that the data value of the information displayed by the android software has a high degree of matching with the measured value, which basically keeps floating around 80, and the data consistency is strong.


Assuntos
Neoplasias Pulmonares , Procedimentos Cirúrgicos Robóticos , Citocromo P-450 CYP1B1/genética , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Polimorfismo Genético , Procedimentos Cirúrgicos Robóticos/métodos , Toracoscopia/métodos
16.
J Int Med Res ; 50(9): 3000605221121968, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36129883

RESUMO

We report a case of a 50-year-old woman presenting with a solid nodule in each lung. She was previously suspected of having lung cancer and distant pulmonary metastasis on the basis of imaging findings. Surgical pathology revealed that the left lung nodule was adenocarcinoma, but the contralateral nodule was papillary thyroid carcinoma (PTC). We subsequently performed total thyroidectomy, and the histological findings of the resected specimen showed no suspicious tumor tissue. Overall, the results led to a diagnosis of ectopic intrapulmonary PTC with synchronous lung adenocarcinoma. Ectopic intrapulmonary PTC is a rare but true phenomenon that may be easily mistaken for pulmonary metastasis in daily practice. It is important to improve the recognition of ectopic intrapulmonary thyroid tumors to avoid misdiagnosis.


Assuntos
Carcinoma Papilar , Neoplasias Pulmonares , Neoplasias da Glândula Tireoide , Carcinoma Papilar/diagnóstico por imagem , Carcinoma Papilar/cirurgia , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Pessoa de Meia-Idade , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
17.
Rev Assoc Med Bras (1992) ; 68(8): 1090-1095, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36134838

RESUMO

OBJECTIVE: The aim of the study was to evaluate the effect of body mass index on patients' short-term results following lung lobectomy. METHODS: In this retrospective study, we compared the perioperative and short-term postoperative results of obese (BMI≥30 kg/m2) versus non-obese patients (BMI<30 kg/m2) who underwent anatomical lung resection for cancer. The two groups had the same distribution of input risk factors and the same ratio of surgical approaches (thoracoscopy vs. thoracotomy). RESULTS: The study included a total of 144 patients: 48 obese and 96 non-obese patients. Both groups had the same ratio of thoracoscopic vs. thoracotomy approach (50/50%), and were comparable in terms of demographics and clinical data. The g roups did not significantly differ in the frequency of perioperative or postoperative complications. Postoperative morbidity was higher among non-obese patients (34.4 vs. 27.1%), but this difference was not statistically significant (p=0.053). Hospital stay was similar in both study groups (p=0.100). Surgery time was significantly longer among obese patients (p=0.133). Postoperative mortality was comparable between the study groups (p=0.167). CONCLUSIONS: Obesity does not increase the frequency of perioperative and postoperative complications in patients after lung lobectomy. The slightly better results in obese patients suggest that obesity may have some protective role.


Assuntos
Neoplasias Pulmonares , Pneumonectomia , Humanos , Tempo de Internação , Pulmão , Neoplasias Pulmonares/cirurgia , Obesidade/etiologia , Pneumonectomia/efeitos adversos , Pneumonectomia/métodos , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Toracotomia/efeitos adversos , Toracotomia/métodos , Resultado do Tratamento
18.
Cancer Radiother ; 26(6-7): 823-833, 2022 Oct.
Artigo em Francês | MEDLINE | ID: mdl-36055908

RESUMO

This section highlights selected specific new recommendations and/or updates that have been published during the very last years in the fields of stereotactic radiotherapy, pediatrics, lung cancer, gynecologic and breast cancer, as well as in the area of radiation oncology of urogenital cancer.


Assuntos
Neoplasias da Mama , Neoplasias Pulmonares , Radioterapia (Especialidade) , Radiocirurgia , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/radioterapia , Criança , Ensaios Clínicos como Assunto , Feminino , Humanos , Neoplasias Pulmonares/radioterapia , Neoplasias Pulmonares/cirurgia
19.
Lung Cancer ; 172: 108-116, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36058174

RESUMO

OBJECTIVES: The oncological equivalence of anatomical segmentectomy for early stage non-small cell lung cancer (NSCLC) is still controversial. Primary aim of this study was survival outcomes in combination with improved quality of life after segmentectomy compared with lobectomy in patients with pathological stage Ia NSCLC (up to 2 cm, 7th edition) MATERIALS AND METHODS: We conducted a prospective, randomized, multicenter phase III trial to confirm the non-inferiority of segmentectomy to lobectomy in regard to prognosis (trial No. DRKS00004897). Patients were randomized to undergo either segmentectomy or lobectomy and followed up for 5-years survival and tumor recurrence. The 5-year hazard ratio comparing lobectomy with segmentectomy was required to remain above 0.5. RESULTS: Between October 2013 and June 2016, 108 patients with verified or suspected NSCLC up to 2 cm diameter were enrolled; 54 were assigned to lobectomy and 54 (1 drop-out) to segmentectomy. In-hospital and 90 days mortality was 0% in both groups. Overall survival at 5 years was 86.52% in the lobectomy compared to 78.21% in the segmentectomy group (HR = 0.61, (95% CI 0.23-1.66), p-value of non-inferiority test, p-ni = 0.687). Disease free survival was 77.29% for the lobectomy and 77.96% for the segmentectomy patients (HR = 1.50, (95% CI 0.60-3.76), p-ni = 0.019). At a median follow-up of 5 years, no differences were noted in either the locoregional or distant recurrent disease in both groups (9.4% vs 7.4%, p-ni = 0.506). CONCLUSION: Overall survival, locoregional and distant recurrences was not significantly difference for patients undergoing either segmentectomy or lobectomy for stage Ia NSCLC. The targeted non-inferiority of segmentectomy to lobectomy could not be proven for primary endpoint overall survival, but was significant for the secondary endpoint of disease free survival.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Estadiamento de Neoplasias , Pneumonectomia , Estudos Prospectivos , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento
20.
Respir Res ; 23(1): 245, 2022 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-36104691

RESUMO

BACKGROUND: A feasible and economical bronchoscopic navigation method in guiding peripheral pulmonary nodule biopsy is lacking. OBJECTIVE: To investigate the utility of hierarchical clock-scale hand-drawn mapping for bronchoscopic navigation in peripheral pulmonary nodules. METHODS: We developed a hierarchical clock-scale hand-drawn mapping for bronchoscopic navigation in peripheral pulmonary nodules. Patients with peripheral pulmonary nodules were recruited and assigned to two groups in this retrospective study, subjects in VBN group received conventional bronchoscopy in conjunction with virtual bronchoscopic navigation (VBN) and radial probe endobronchial ultrasound (RP-EBUS) for biopsy (VBN group), while HBN group underwent ultrathin bronchoscopy and RP-EBUS under the guidance of hand-drawn bronchoscopic navigation (HBN). The demographic characteristics, procedural time, operating cost and diagnostic yield were compared between these two groups. RESULTS: Forty-eight patients with peripheral pulmonary nodule were enrolled in HBN group, while 42 in VBN group. There were no significant differences between VBN and HBN groups in terms of age, gender, lesion size, location and radiographic type. The time of planning pathway (1.32 vs. 9.79 min, P < 0.001) and total operation (23.63 vs. 28.02 min, P = 0.002), as well as operating cost (758.31 ± 125.21 vs.1327.70 ± 116.25 USD, P < 0.001) were markedly less in HBN group, compared with those in VBN group. The pathological diagnostic efficiency of benign and malignant disease in HBN group appeared similar with those in VBN group, irrespective of the size of pulmonary lesion (larger or smaller than 20 mm). The total diagnostic yield of HBN had no marked difference from that of VBN (75.00% vs. 61.90%, P = 0.25). CONCLUSIONS: Hierarchical clock-scale hand-drawn mapping for bronchoscopic navigation could serve as a feasible and economical method for guiding peripheral pulmonary nodule biopsy, providing a comparable diagnostic yield in comparison with virtual bronchoscopic navigation.


Assuntos
Neoplasias Pulmonares , Broncoscopia/métodos , Endossonografia/métodos , Humanos , Pulmão/patologia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Estudos Retrospectivos
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