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Journal and News Scan

Source: VIMEO
Submitted by: Joel Dunning
July 28, 2014
Author(s): Devon Arbelo
Just a quick one and perhaps one to show patients, but a stark contrast between the best lungs and the worst.  Slightly sensationalist but might be effective for a patient that doesn't think that smoking makes a big difference !!     
Source: Interactive Journal of Cardiovascular and Thoracic Surgery
Submitted by: Joel Dunning
July 28, 2014
Author(s): Nisal K. Perera, Sean D. Galvin*, Siven Seevanayagam and George Matalanis
The authors deal with a dramatic complication of acute Type A aorticdissection - mesenteric malperfusion. They reviewed 309 papers on acuteaortic dissection and concluded that initial interventional management ofmesenteric malperfusion followed by delayed proximal aortic repair is areasonable strategy, since the prognosis of those immediately operated onthe ascending aorta was extremely poor.  
Source: Journal of Thoracic Oncology
Submitted by: Mark Ferguson
July 28, 2014
Author(s): Cuellar, Sonia L. Betancourt; Carter, Brett W.; Macapinlac, Homer A.; Ajani, Jaffer A.; Komaki, Ritsuko; Welsh, James W.; Lee, Jeffrey H.; Swisher, Stephen G.; Correa, Arlene M.; Erasmus, Jeremy J.; Hofstetter, Wayne L.
The authors queried whether PET has utility in clinically staging Tis or T1 esophageal cancers; this was a single institution retrospective study involving 79 pts.  The incidence of FDG uptake increased with increasing T status, as did the SUV.  Nodal staging was false positive in 3 pts and false negative all 13 pts with nodal involvement.  Metastatic staging was false positive in 5 pts.  PET is not recommended for pts with Tis or T1 disease on EUS.   
Source: Journal of Thoracic Oncology
Submitted by: Mark Ferguson
July 28, 2014
Author(s): Speicher, Paul J.; Ganapathi, Asvin M.; Englum, Brian R.; Hartwig, Matthew G.; Onaitis, Mark W.; D’Amico, Thomas A.; Berry, Mark F.
The efficacy of induction therapy for clinical T2 esophageal cancer was evaluated using the National Cancer Database.  Pretreatment staging was accurate in only 27% of pts.  42% of pts were upstaged and 32% were downstaged.  Induction therapy had no survival benefit.   
Source: Journal of the National Cancer Institute
Submitted by: Mark Ferguson
July 28, 2014
Author(s): Martin C. Tammemägi, Christine D. Berg, Thomas L. Riley, Christopher R. Cunningham and Kathryn L. Taylor
Participants in the Lung Cancer Screening Trial were evaluated for success in smoking cessation linked to findings in their screening CTs.  The odds ratios for continued smoking decreased with increasingly worrisome abnormalities on CTs: 0.81 for a major abnormality not suspicious for cancer, 0.79 for an abnormality suspicious for cancer but stable, and 0.66 for a finding suspicious for cancer that was new or changed from prior.  CT screening is an opportunity to aid patients with smoking cessation.
Source: Journal of the National Cancer Institute
Submitted by: Mark Ferguson
July 28, 2014
Author(s): Ryan P. Merkow, Karl Y. Bilimoria, Rajesh N. Keswani, Jeanette Chung, Karen L. Sherman, Lawrence M. Knab, Mitchell C. Posner and David J. Bentrem
This study tracked changes in management for and outcomes of T1a and T1b esophageal cancer using data from the National Cancer Data Base.  Endoscopic resection increased nearly 3-fold to 53% for T1a lesions during the interval, and increased nearly 3-fold to 21% for T1b cancers.  Nodal involvement was predicted by T status, tumor size >2cm, and tumor grade.  The rate of nodal involvement in resected pts was 5% for T1a and 17% for T1b.   Endoscopic therapy had a lower risk of procedure-related mortality (HR 0.33).  5-year survival was better after surgical resection (88% vs 77%).
Source: Journal of Clinical Oncology
Submitted by: Mark Ferguson
July 26, 2014
Author(s): J-J Hung, Y-C Yeh, W-J Jeng, K-J Wu, B-S Huang, Y-C Wu, T-Y Chou, W-H Hsu
Outcomes of lung adenocarcinoma classified according to the new IASLC/ATS/ERS system were evaluated in this retrospective single-institution study involving 573 pts who underwent surgical treatment.  Histologic patterns were associated with sex and tumor TNM factors.  Recurrence was higher in micropapillary and solid-predominant cancers.  These subtypes were also associated with poorer overall and disease-specific survival compared to other types.
Source: Annals of Oncology
Submitted by: Mark Ferguson
July 26, 2014
Author(s): B. Besse, A. Adjei, P. Baas, P. Meldgaard, M. Nicolson, L. Paz-Ares, M. Reck, E. F. Smit, K. Syrigos, R. Stahel, E. Felip, S. Peters, Panel Members
This article presents guidelines on the diagnosis and management of advanced stage lung cancer developed by the ESMO in 2013.
Source: Annals of Oncology
Submitted by: Mark Ferguson
July 26, 2014
Author(s): J. Vansteenkiste, L. Crinò, C. Dooms, J. Y. Douillard, C. Faivre-Finn, E. Lim, G. Rocco, S. Senan, P. Van Schil, G. Veronesi, R. Stahel, S. Peters, E. Felip, Panel Members
This article summarizes consensus guidelines for the diagnosis and management of early stage lung cancer developed by ESMO in 2013.
Source: JAMA surgery
Submitted by: Joel Dunning
July 15, 2014
Author(s): Harskamp RE, et al.
   – The aim of this study was to evaluate the effect of vein graft preservation solutions on vein graft failure (VGF) and clinical outcomes in patients undergoing coronary artery bypass graft (CABG) surgery. These researchers concluded that patients undergoing CABG whose vein grafts were preserved in a buffered saline solution had lower VGF rates and showed trends toward better long–term clinical outcomes compared with patients whose grafts were preserved in saline– or blood–based solutions. Methods Researchers used data from the Project of Ex–Vivo Vein Graft Engineering via Transfection IV (PREVENT IV) study, a phase 3, multicenter, randomized, double–blind, placebo–controlled trial that enrolled 3014 patients at 107 US sites from August 1, 2002, through October 22, 2003. Eligibility criteria for the trial included CABG surgery for coronary artery disease with at least 2 planned vein grafts. Interventions included preservation of vein grafts in saline, blood, or buffered saline solutions. Main outcomes measures included 1–year angiographic VGF and 5–year rates of death, myocardial infarction, and subsequent revascularization.   Results Most patients had grafts preserved in saline (1339 [44.4%]), followed by blood (971 [32.2%]) and buffered saline (507 [16.8%]). Baseline characteristics were similar among groups. Researchers found that 1–year VGF rates were much lower in the buffered saline group than in the saline group (patient–level odds ratio [OR], 0.59 [95% CI, 0.45–0.78; P<0.001]; graft–level OR, 0.63 [95% CI, 0.49–0.79; P<0.001]) or the blood group (patient–level OR, 0.62 [95% CI, 0.46–0.83; P=0.001]; graft–level OR, 0.63 [95% CI, 0.48–0.81; P<0.001]). Use of buffered saline solution also tended to be associated with a lower 5–year risk for death, myocardial infarction, or subsequent revascularization compared with saline (hazard ratio, 0.81 [95% CI, 0.64–1.02; P=0.08]) and blood (0.81 [0.63–1.03; P=0.09]) solutions.  

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