To investigate the relationships between tumor heterogeneity, assessed by texture analysis of 18Ffluorodeoxyglucose–positron emission tomography (FDG-PET) images, metabolic parameters, and pathologic ...staging in patients with non-small cell lung carcinoma (NSCLC). A retrospective analysis of 38 patients with histologically confirmed NSCLC who underwent staging FDG-PET/computed tomography was performed. Tumor images were segmented using a standardized uptake value (SUV) cutoff of 2.5. Five textural features, related to the heterogeneity of gray-level distribution, were computed (energy, entropy, contrast, homogeneity, and correlation). Additionally, metabolic parameters such as SUVmax, SUVmean, metabolic tumor volume (MTV), and total lesion glycolysis (TLG), as well as pathologic staging, histologic subtype, and tumor diameter, were obtained. Finally, a correlation analysis was carried out. Of 38 tumors, 63.2% were epidermoid and 36.8% were adenocarcinomas. The mean ± standard deviation values of MTV and TLG were 30.47 ± 25.17 mL and 197.81 ± 251.11 g, respectively. There was a positive relationship of all metabolic parameters (SUVmax, SUVmean, MTV, and TLG) with entropy, correlation, and homogeneity and a negative relationship with energy and contrast. The T component of the pathologic TNM staging (pT) was similarly correlated with these textural parameters. Textural features associated with tumor heterogeneity were shown to be related to global metabolic parameters and pathologic staging.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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In the more than 2 years since its emergence, the SARS-CoV-2 pandemic has prompted important changes in healthcare systems and their organization. The aim of this study is to ...determine the implications in specialized thoracic surgery training as well as the repercussions on thoracic surgery residents. With this objective, the Spanish Society of Thoracic Surgery has conducted a survey among all its trainees and those who had finished their residency during the last 3 years. It consisted of 24 multiple-answer closed questions about the impact of the pandemic on their services, their training, and their personal experience. The response rate was 42% (52 out of a target population of 120). The effect of the pandemic on thoracic surgery services was high or extreme according to 78.8% of the participants. Academic activities were completely cancelled in 42.3% of the cases, and 57.7% of the respondents were required to treat hospitalized COVID patients (25% part-time, and 32.7% full-time). More than 80% of the survey participants believed that changes during the pandemic negatively affected their training, and 36.5% would prefer to extend their training period. In sum, we observe how the pandemic has had deep negative effects on specialized training in thoracic surgery in Spain.
Tras más de dos años desde su aparición, la pandemia por SARS-CoV-2 ha generado importantes cambios en la sanidad y su organización. El presente trabajo trata de dilucidar las implicaciones de estos en la formación especializada de la cirugía torácica y sus repercusiones en los profesionales en formación. Para ello, desde la Sociedad Española de Cirugía Torácica se distribuye una encuesta entre los residentes en activo y aquellos que han terminado su formación en los últimos 3 años. Esta consta de 24 preguntas cerradas de respuesta múltiple sobre el impacto de la pandemia en sus servicios, su formación y su vivencia. La tasa de respuesta de la encuesta fue del 42% (52 de una población objetivo de 120). El efecto de la pandemia en el funcionamiento de los servicios de cirugía torácica fue considerado alto o extremo según 78.8% de los participantes. Las actividades académicas fueron completamente suspendidas en 42.3% de los casos, mientras que el 57.7% de los participantes tuvieron que prestar atención asistencial a pacientes ingresados por COVID, de los cuales el 25% fue a tiempo parcial y 32,7% a tiempo completo. De los encuestados, el 80% consideró que los cambios sufridos durante la pandemia afectaron su formación como residente y 36.5% opinó que debería ofrecerse una prolongación del periodo de formación para quienes se hayan visto afectados. Así pues, observamos cómo la pandemia ha afectado profundamente de forma negativa la formación especializada en cirugía torácica en España.
The objective of this study was to analyze the clinical respiratory and spirometric effects of video-assisted minithoracotomy diaphragmatic plication (VAM-T DP) in the treatment of diaphragmatic ...eventration.
A retrospective longitudinal study of 18 patients who underwent a VAM-T DP in our service between February 2005 and July 2011 was performed. Data of patient characteristics, preoperative clinical variables, and postoperative results (3, 6, and 12 months) were collected for statistical analysis using the software package SPSS 13.0 for Windows (Wilcoxon test, Friedman test, and
-test).
The main clinical respiratory and spirometric variables improved significantly and remained stable over 1 year.
VAM-T DP is a viable and safe procedure that improves the spirometry values and offers stable results during the first year. To our knowledge, the present series is the second largest published report in English relating to this procedure in adults.
Surgical treatment of thoracic inlet tumors represents a challenge to the surgeon due to its location and anatomical elements contained in that region. Several surgical approaches have been proposed, ...each of them showing some advantages but drawbacks as well. In our opinion, the anterior transmanubrial approach described in 1997 is one of the most convenient. The objective of this paper is to describe and comment on some technical aspects of the procedure in order to aid surgeons who intend to perform this surgical approach. Moreover, we show our results in five patients and also comment on other approaches in this pathology.
Abstract Surgical treatment of thoracic inlet tumors represents a challenge to the surgeon due to its location and anatomical elements contained in that region. Several surgical approaches have been ...proposed, each of them showing some advantages but drawbacks as well. In our opinion, the anterior transmanubrial approach described in 1997 is one of the most convenient approaches. The objective of this paper is to describe and comment on some technical aspects of the procedure in order to aid surgeons who intend to perform this surgical approach. Moreover, we show our results in five patients and also comment on other approaches in this pathology.
INTRODUCTIONThe new 2009 TNM classification introduced important modifications in lung cancer staging. The aim of this study is to validate our series of patients with pathologic stage I ...non-small-cell lung cancer according to the 7th edition of the TNM classification of malignant tumors and to the factors related with prognosis.PATIENTS AND METHODSA multicenter retrospective study was performed. Survival rates were calculated by the Kaplan-Meier method, and for multivariate analyses, Cox proportional hazards regression model was used. The following variables were analyzed: age, sex, pathologic stage, T category, histology, type of resection and tumor size.RESULTSA total of 402 patients were included. Mean follow-up was 70.18 months. Overall 5-year survival was 68%. Males and patients over 70 had lower survival. Prognosis worsened with increasing pathologic stage, T category and tumor size. We found no statistically significant differences in prognosis for histology or type of resection. Multivariate analysis showed age, sex and pathologic stage to be independent prognostic factors.CONCLUSIONSSurvival results and the analysis of prognostic factors in our series are similar to those published in the new 2009 TNM classification. The most important prognostic factor is pathologic stage. Other adverse prognostic factors include male sex and age over 70.
Diaphragmatic plication is the most accepted treatment for symptomatic diaphragmatic hernia in adults. The fact that this pathology is infrequent and this procedure not been widespread means that ...this is an exceptional technique in our field. To estimate its use in the literature, we carried out a review in English and Spanish, to which we added our series. We found only six series that contribute 59 video-assisted mini-thoractomy for diaphragmatic plications in adults, and none in Spanish. Our series will be the second largest with 18 cases. Finally, we conducted a survey in all the Spanish Thoracic Surgery units in Spain: none reported more than 10 cases operated by thoracoscopy in the last 8 years (except our series) and most continue employing thoracotomy as the main approach. We believe that many patients with symptomatic diaphragmatic hernia could benefit from the use of such techniques.
![Heterogeneity in [18F]Fluor...](http://api.summon.serialssolutions.com/2.0.0/image/issn/XR4PS5YY4K/1536-0121_1535-3508/small "Heterogeneity in [18F]Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography of Non–Small Cell Lung Carcinoma and Its Relationship to Metabolic Parameters and Pathologic Staging")
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