Objective Primary neuroendocrine tumors of the thymus (TNET) are exceedingly rare. We studied a large series of TNET identified through the International Thymic Malignancy Interest Group and the ...European Society of Thoracic Surgeons databases. Methods This was a retrospective multicenter study of patients undergoing operation for TNET between 1984 and 2012. Outcome measures were: overall survival (OS) and cumulative incidence of recurrences (CIR). OS was analyzed using the Kaplan-Meier method and CIR was analyzed using competing risk analysis. Associations with clinical and prognostic factors for OS and CIR were evaluated using the log rank test and Gray test. Results Two hundred five patients with TNET were treated: 25 patients received induction therapy (19 chemotherapy CT and 6 radiotherapy RT). Data about resection status were available in 47% of cases: complete resection was performed in 52 patients (54%). Masaoka-Koga stages I, II, III, and IV were observed in 12, 33, 56, and 47 patients, respectively. Atypical carcinoid was the commonest histologic subtype (71 cases; 40%). One hundred one patients with TNET received adjuvant treatment; 52 patients died and 36 experienced a recurrence. The median OS was 7.5 years; 5-year OS was 68%, and 5-year CIR was 39%. OS was significantly influenced by Masaoka-Koga stage ( P = .02) and completeness of resection ( P = .03). CIR significantly increased in high Masaoka-Koga stages ( P = .04). Histologic subtype was not associated with either OS or CIR. Conclusions Our results confirm the high biologic aggressiveness of these rare neoplasms; pathologic stage and completeness of resection were demonstrated to be strong prognostic factors, whereas histology did not influence patients outcome.
Chest drain placement is one of the most common surgical procedures performed in routine clinical practice. Despite the many benefits, chest tube insertion is not always a harmless procedure, and ...potential significant morbidity and mortality may exist. The aim of this article was to highlight the correct chest tube placement procedure and to focus on errors and clinical complications following its incorrect insertion into the chest.
Immediately after lung resection, air tends to collect in the retrosternal part of the chest wall (in supine position), and fluids in its lower part (costodiaphragmatic sinus). Several general ...thoracic surgery textbooks currently recommend the placement of 2 chest tubes after major pulmonary resections, one anteriorly, to remove air, and another into the posterior and basilar region, to drain fluids. Recently, several authors advocated the placement of a single chest tube. In terms of air and fluid drainage, this technique demonstrated to be as effective as the conventional one after wedge resection or uncomplicated lobectomy.
Thymic neuroendocrine tumors Lausi, Paolo Olivo; Refai, Majed; Filosso, Pier Luigi ...
Thoracic surgery clinics,
08/2014, Letnik:
24, Številka:
3
Journal Article
Recenzirano
Thymic neuroendocrine tumors are rare and account for approximately 2% to 5% of all thymic tumors. Despite the suggestion of benign behavior implied by their name, thymic carcinoids have been noted ...to present a more aggressive biologic behavior than their counterparts in other sites. Because of the lack of data, adequate-sized prospective trials are required for validation, and the enrollment of patients with advanced disease into available clinical trials is encouraged.
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