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Journal and News Scan

Source: Journal of the National Cancer Institute
Author(s): Kurt A. Schalper, Jason Brown, Daniel Carvajal-Hausdorf, Joseph McLaughlin, Vamsidhar Velcheti, Konstantinos N. Syrigos, Roy S. Herbst and David L. Rimm

Samples from tissue microarrays of 552 NSCLC patients were analyzed to measure the levels of 3 different tumor-infiltrating lymphocytes (TILs): CD3, CD8, and CD20. An elevated level of CD3 or CD8 was associated with longer survival. This finding might be useful to evaluate response or assess the local immune effect of anticancer immune inhibitors.

Source: Journal of Clinical Oncology
Author(s): Cliff G. Robinson, Aalok P. Patel, Jeffrey D. Bradley, Todd DeWees, Saiama N. Waqar, Danieal Morgensztern, Maria Q. Baggstrom, Ramaswamy Govindan, Jennifer M. Bell, Tracay J. Guthrie, Graham A. Colditz, Traves D. Crabtree, Daniel Kreisel, Alexander S. Krupnick, G. Alexander Patterson, Bryan F. Meyers, and Varun Puri

A review of the National Cancer Data Base was undertaken to determine the impact of postoperative radiation therapy on survival for patients with pathologic stage IIIA NSCLC in the setting of adjuvant chemotherapy. The authors point out that some prior analyses demonstrated a decrease in survival with postoperative radiation therapy likely due to the inclusion of patients with N0 or N1 disease and toxicity associated with outdated radiation treatment regimens. The main results of this study were that in patients with completely resected stage IIIA NSCLC, there was an improvement in median overall survival and 5-year overall survival with postoperative radiation therapy (45.2 months and 39.3%) over adjuvant chemotherapy alone (40.7 months and 34.8%). Furthermore, when other factors associated with overall survival were controlled for, the survival benefit of postoperative radiation therapy, although modest, continued to be significant.

Source: VuMedi
Author(s): Anthony Panos

This video demonstrates a transaortic approach for TAVR, through the second intercostal space. Illustrations, photos, 3D CAT scan images, and rotating fluoroscopic images are used to demonstrate this approach. 

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Shehada S-E, Öztürk Ö, Wottke M, Lange R

This propensity matched single institution study compared conventional aortic valve replacement via a full sternotomy (CAVR) to minimal access aortic valve replacement (MAAVR) via an upper hemisternotomy. Over the eleven year study period a total of 2103 patients underwent isolated aortic valve replacement. After propensity matching, 585 patients were included in each group. Patient characteristics were well balanced between the two groups. There was no difference between the groups with respect to cross-clamp time although the MAAVR group had a longer average bypass time. The MAAVR group had a lower average volume of autologous blood transfusion, intubation time, post-operative renal complications and rate of respiratory insufficiency. There was no difference between the groups with regards to re-exploration for bleeding, ICU or hospital length of stay, early mortality of survival. The authors conclude that MAAVR is their procedure of choice for isolated aortic valve replacement.  

Source: JAMA
Author(s): Justin M. Schaffer; Steve K. Singh; Bruce A. Reitz; Roham T. Zamanian; Hari R. Mallidi

The impact of the new Lung Allocation Score (implemented in 2005) on outcomes of single and double lung transplants for IPF and COPD was explored.  After controlling for confounders with propensity score techniques, DLT was associated with better graft survival for IPF but there was no difference in graft survival between DLT and SLT for COPD patients.

Source: EJCTS
Author(s): Zongli Ren, Zhiwei Wang, Rui Hu, Hongbing Wu, Hongping Deng, Zhen Zhou, Xiaoping Hu, and Wanli Jiang

This meta-analysis compares short-term mortality, neurological dysfunction and malperfusion in patients who underwent acute type A aortic dissection (AAD) repair with axillary artery cannulation (AXC) compared to femoral artery cannulation (FAC).

Source: EJCTS
Author(s): Barbara Oberwallner, Andreja Brodarac, Petra Anić, Tomo Šarić, Katharina Wassilew, Klaus Neef, Yeong-Hoon Choi, and Christof Stamm

In in-vitro experiments, human cardiac extracellular matrix supported proliferation and cardiomyocyte differentiation of murine embryonic stem cells and induced pluripotent stem cells. Artificial matrices did not promote differentiation.

Source: EJCTS
Author(s): Hideo Ohuchi, Kenji Yasuda, Aya Miyazaki, Shin Ono, Yosuke Hayama, Jun Negishi, Kanae Noritake, Masanori Mizuno, and Osamu Yamada

412 Fontan patients were evaluated retrospectively for long-term correlations between postoperative haemodynamics and anticoagulant regimens with haemostatic events. Thrombo-embolic events were observed in 2.7% and haemorrhagic events in 4.4% of patients. Risk factors are analysed for both short- and long-term complications.

Source: Annals of Thoracic Surgery
Author(s): Shinji Otani, Bronwyn J. Levvey, Glen P. Westall, Miranda Paraskeva, Helen Whitford, Trevor Williams, David C. McGiffin, Rowan Walker, Solomon Menahem, Gregory I. Snell

This study evaluated outcomes of synchronous or delayed kidney Tx in patients with lung or heart-lung transplant.  Delayed living-donor kidney Tx was associated with favorable outcomes.  Synchronous cadaver kidney transplant at the time of heart-lung or lung transplant was clinically challenging.

Source: Annals of Thoracic Surgery
Author(s): Sara K. Pasquali, Xia He, Jeffrey P. Jacobs, Marshall L. Jacobs, Michael G. Gaies, Samir S. Shah, Matthew Hall, J. William Gaynor, Eric D. Peterson, John E. Mayer, Jennifer C. Hirsch-Romano

This study examined the utility/accuracy of an administrative database compared to the STS Congenital Database for the outcome of mortality, which is used to rank quality.  The administrative database had substantially lower volume and mortality numbers than the STS Database, resulting in ranking differences of 5 or more places for 24% of hospitals.