The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2015
Multicenter StudyThymic carcinoma outcomes and prognosis: results of an international analysis.
The objectives of this collaborative study were to characterize patients with thymic carcinoma, their treatment patterns, and association with overall survival (OS) and recurrence-free survival (RFS). ⋯ R0 resection and radiation therapy are associated with improved OS, whereas radiation therapy and male gender are associated with longer RFS.
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J. Thorac. Cardiovasc. Surg. · Jan 2015
Multicenter Study Observational StudyPneumonectomy for lung cancer: contemporary national early morbidity and mortality outcomes.
The study objective was to determine contemporary early outcomes associated with pneumonectomy for lung cancer and to identify their predictors using a nationally representative general thoracic surgery database (EPITHOR). ⋯ Several risk factors for major adverse early outcomes after pneumonectomy for cancer were identified. Overweight patients and those who received induction therapy had paradoxically lower adjusted risks of mortality.
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J. Thorac. Cardiovasc. Surg. · Jan 2015
Comparative StudyAvoiding aortic clamping during coronary artery bypass grafting reduces postoperative stroke.
The purpose of this study was to determine whether the incidence of postoperative stroke could be reduced by eliminating aortic clamping during coronary artery bypass grafting. ⋯ A no-aortic touch technique has the lowest risk for postoperative stroke for patients undergoing coronary artery bypass grafting. Clamping the aorta during coronary artery bypass grafting increases the risk of postoperative stroke, regardless of the severity of aortic disease.
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J. Thorac. Cardiovasc. Surg. · Jan 2015
Multicenter Study Observational StudyUtility of mediastinoscopy in clinical stage I lung cancers at risk for occult mediastinal nodal metastases.
The prevalence of mediastinal lymph node metastases is unknown for patients with clinical N0 lung cancer who are thought to be at high risk for occult nodal metastases. Further, the utility of mediastinoscopy in these patients is unknown. We performed a prospective trial to evaluate the utility of routine cervical mediastinoscopy for patients who may be at high risk of occult nodal metastases. ⋯ Mediastinoscopy seems to have limited utility in these patients with T1 and T2 clinically staged N0 by positron emission tomography/computed tomography. Selective use of mediastinoscopy is recommended, along with thorough mediastinal lymph node evaluation in all patients at the time of lung cancer resection.
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J. Thorac. Cardiovasc. Surg. · Jan 2015
Comparative StudyDoes the method of radiologic surveillance affect survival after resection of stage I non-small cell lung cancer?
Controversy persists regarding appropriate radiographic surveillance strategies after lung cancer resection. We compared the impact of surveillance computed tomography scan versus chest radiography in patients who underwent resection for stage I lung cancer. ⋯ Surveillance computed tomography may result in earlier diagnosis of successive malignancy versus chest radiography in stage I lung cancer, although no difference in survival was demonstrated. A randomized trial would help determine the impact of postoperative surveillance strategies on survival.