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Should sampling of three N2 stations be a quality metric for curative resection of stage I lung cancer? 三个N2站的采样是否应该是I期癌症根治性切除的质量指标?
IF 4.9 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 DOI: 10.1016/j.jtcvs.2023.10.058
Shaikha Al-Thani MD, Abu Nasar MSc, Jonathan Villena-Vargas MD, Oliver Chow MD, Benjamin Lee MD, Jeffrey L. Port MD, Nasser Altorki MD, Sebron Harrison MD

Objective

In 2022, the American College of Surgeons Commission on Cancer issued standard 5.8 quality metric for curative lung cancer resections requiring nodal resection from 3 N2 stations. In this report, we compare oncologic outcomes after resection of 3 N2 stations versus 2 N2 stations in stage I non–small cell lung cancer.

Methods

A retrospective review from a single institution database was conducted from 2011 to 2020 to identify patients with clinical stage I non–small cell lung cancer. Patients with a history of lung cancer, carcinoid tumors, and ground-glass lesions less than 50% solid component were excluded. The primary outcome was overall survival. Secondary outcomes included disease-free survival, recurrence patterns, and nodal upstaging.

Results

A total of 581 patients were identified and divided into 2 groups based on the number of N2 stations examined: Group A had 2 N2 stations examined (364 patients), and group B had 3 or more N2 stations examined (217 patients). Baseline demographic and clinical characteristics were similar between groups. In group A, N1 and N2 positive nodal stations were present in 8.2% (30/364) and 5.2% (19/364) of patients versus 7.4% (16/217) and 5.5% (12/217), respectively, in group B. Five-year overall survival and disease-free survival were 89% and 74% in group A versus 88% and 78% in group B, respectively. Recurrence occurred in 56 patients (15.4%) in group A (6.6% local and 8.8% distant) and 29 patients (13.4%) in group B (5.1% local and 8.3% distant; P = .73).

Conclusions

There was no significant difference in oncological outcomes in stage I non–small cell lung cancer resections that included 2 N2 stations compared with at least 3 N2 stations examined.
目标:2022年,ACS癌症委员会(CoC)发布了标准5.8质量指标,用于需要从3个N2站进行淋巴结切除的癌症治疗切除。在本报告中,我们比较了I期非小细胞肺癌切除3个N2站和2个N2站后的肿瘤学结果。方法:从2011-2020年对单一机构数据库进行回顾性审查,以确定临床I期非大细胞肺癌患者。有癌症、类癌、磨玻璃病变病史的患者。结果:581例患者被识别,并根据检查的N2站数分为两组;A组检查了2个N2站(364名患者),B组检查了3个以上的N2站(217名患者)。两组之间的基线人口统计学和临床特征相似。在A组中,8.2%(30/364)和5.2%(19/364)的患者存在N1和N2阳性淋巴结,而B组分别为7.4%(16/217)和5.5%(12/217)。5年OS和DFS在A组分别为89%和74%,而在B组则分别为88%和78%。复发发生在A组56例(15.4%)(6.6%局部和8.8%远处)和B组29例(13.4%)(5.1%局部和8.3%远处;p=0.73)。
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引用次数: 0
Optimal timing of Ross operation in children: A moving target? 儿童实施 Ross 手术的最佳时机:一个移动的目标?
IF 4.9 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 DOI: 10.1016/j.jtcvs.2024.02.012
Igor E. Konstantinov MD, PhD, FRACS , Emile Bacha MD , David Barron MD, FRCS , Tirone David MD , Joseph Dearani MD , Yves d’Udekem MD, PhD, FRACS , Ismail El-Hamamsy MD, PhD , Hani K. Najm MD, MSc , Pedro J. del Nido MD , Christian Pizarro MD , Peter Skillington MBBS, FRACS , Vaughn A. Starnes MD , David Winlaw MBBS, FRACS
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引用次数: 0
Information for readers 读者须知
IF 4.9 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 DOI: 10.1016/S0022-5223(24)00879-1
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引用次数: 0
Discussion to: Volume–failure to rescue relationship in acute type A aortic dissections: An analysis of The Society of Thoracic Surgeons Database 讨论:急性A型主动脉夹层容量与抢救失败的关系:胸外科学会数据库分析。
IF 4.9 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 DOI: 10.1016/j.jtcvs.2023.11.007
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引用次数: 0
Truncal valve surgery during repair of truncus arteriosus and interrupted aortic arch 修复动脉导管未闭和主动脉弓中断时的截流瓣手术
IF 4.9 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 DOI: 10.1016/j.jtcvs.2024.01.027
Aybala Tongut MD, Mahmut Ozturk MD, Manan Desai MD, Sofia Hanabergh MSc, Can Yerebakan MD, PhD, Yves d’Udekem MD, PhD
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引用次数: 0
Video-assisted mediastinoscopic lymphadenectomy (VAMLA): Mature results for staging non–small cell lung cancer with normal mediastinum 视频辅助纵隔镜淋巴腺切除术(VAMLA):对纵隔正常的非小细胞肺癌进行分期的成熟结果。
IF 4.9 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 DOI: 10.1016/j.jtcvs.2024.01.040
Sergi Call MD, PhD, FETCS , Nina Reig-Oussedik MD , Carme Obiols MD, PhD, FEBTS , José Sanz-Santos MD, PhD , Juan Manuel Ochoa-Alba MD , Lucía Reyes Cabanillas MD , Mireia Serra-Mitjans MD , Ramón Rami-Porta MD, PhD, FETCS

Objectives

The aim of this study is to analyze the accuracy of video-assisted mediastinoscopic lymphadenectomy (VAMLA) and the unsuspected (u) N2/3 rates in patients with non–small cell lung cancer (NSCLC) and normal mediastinum by integrated positron emission tomography-computed tomography.

Methods

Prospective observational single-center study of 603 consecutive VAMLAs from 2010 to 2022. Exclusion criteria: other indications (n = 32), tumors different from NSCLC (n = 91), and clinical (c) N2/3 tumors by positron emission tomography-computed tomography (n = 46). Systematic nodal dissection was the gold standard to validate negative VAMLAs. Those patients with negative VAMLA and missing reference standard test were excluded. uN2/3 rates were analyzed in the global series and in the subgroups of tumors according to their clinical nodal and tumor categories. Pathologic findings were reviewed, and staging values were calculated.

Results

Three hundred eighty-three patients with cN0/1 NSCLC underwent VAMLA. Staging values of VAMLA were: sensitivity, 0.98 (95% CI, 0.92-0.99); negative predictive value, 0.99 (95% CI, 0.98-1); and diagnostic accuracy, 0.99 (95% CI, 0.98-1). The uN2/3 rate for the whole series (N = 383) was 18.8%. The uN2/3 rates according to presurgical nodal and tumor categories determined by positron emission tomography computed tomography were: 3.6% (4 out of 111) in cT1N0; 16.3% (18 out of 110) in cT2N0; 10.25% (4 out of 39) in cT3N0; and 32% (7 out of 22) in cT4N0. Forty-two percent (39 out of 93) in cN1; complication rate was 7%.

Conclusions

This series of NSCLC with normal mediastinum staged by VAMLA demonstrates a high accuracy of this technique and a high rate of uN2/3 disease (specially in cN1 and cT4N0). VAMLA could be considered the reference staging procedure for staging cN0/1 NSCLC.
研究目的本研究旨在通过正电子发射断层扫描(PET)-计算机断层扫描(CT)综合分析视频辅助纵隔镜淋巴腺切除术(VAMLA)的准确性以及非小细胞肺癌(NSCLC)和正常纵隔患者的未怀疑(u)N2-3率:排除标准:其他适应症(32例);不同于NSCLC的肿瘤(91例);PET-CT显示的cN2-3肿瘤(46例)。系统性结节解剖是验证 VAMLA 阴性的金标准。根据临床结节和肿瘤类别,分析了总体系列和亚组肿瘤的 uN2-3 率。对病理结果进行复查,并计算分期值:结果:383例临床(c) N0-1 NSCLC患者接受了VAMLA。VAMLA的分期值为:敏感性0.98(95% CI:0.92- 0.99);阴性预测值0.99(95% CI:0.98-1);诊断准确性0.99(95% CI:0.98-1)。整个系列(n=383)的uN2-3率为18.8%。根据 PET-CT 确定的手术前结节和肿瘤类别,uN2-3 率为cT1N0为3.6%(4/111);cT2N0为16.3%(18/110);cT3N0为10.25%(4/39);cT4N0为32%(7/22)。cN1为42%(39/93);并发症发生率为7%:7%:这组纵隔正常的NSCLC患者采用VAMLA分期显示了该技术的高准确性和uN2-3疾病的高发生率(尤其是cN1和cT4N0)。VAMLA可被视为对cN0-1 NSCLC进行分期的参考分期程序。
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引用次数: 0
Commentary: SWIFT-ly demonstrating benefits of minimally invasive cardiac surgery 评论:SWIFT 展示微创心脏手术的优势
IF 4.9 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 DOI: 10.1016/j.jtcvs.2024.04.001
Bryan A. Whitson MD, PhD
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引用次数: 0
Reply: Redefining the durability of bioprostheses in the era of a “biological lifelong strategy”: Is it time to reach a consensus? 答复:在 "生物终身战略 "时代重新定义生物假体的耐用性:现在是达成共识的时候了吗?
IF 4.9 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 DOI: 10.1016/j.jtcvs.2024.05.028
Alessandra Francica MD, Francesco Onorati MD, PhD, Giovanni Battista Luciani MD
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引用次数: 0
Update Your AATS Profile 更新您的 AATS 简介
IF 4.9 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 DOI: 10.1016/S0022-5223(24)00884-5
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引用次数: 0
Congenital Articles in AATS Journals AATS 期刊上的先天性文章
IF 4.9 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-01 DOI: 10.1016/S0022-5223(24)00843-2
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引用次数: 0
期刊
Journal of Thoracic and Cardiovascular Surgery
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