Guidance document for the triage of operations for thoracic malignancies produced by the Thoracic Outcomes Research Network. Their recommendations emphasize the importance of shared decision making, transparency and adherence to ethical principals.
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COVID-19 Guidance for Triage of Operations for Thoracic Malignancies: A Consensus Statement From Thoracic Surgery Outcomes Research Network
April 14, 2020
March 18, 2020
The authors describe a thoughtful process for resource utilization in the setting of competing needs that optimizes survival for a popultion. Examples of existing guidelines are provided.
February 1, 2020
Individuals at high risk for lung cancer were randomized to low dose CT screening (years 0, 1, 3, and 5.5) or observation. At 10 years the cumulative rate ratio for lung cancer death was 0.76 in the screened population of men (p=0.01) and 0.67 in the screened population of women, demonstrating a strong benefit for screening.
January 10, 2020
Benign-appearing lung nodules identified on screening CTs are associated with an increased risk of lung cancer diagnosis 4 to 8 and 8 to 11 years after the scan (RRs 1.9 and 1.6, respectively).
County-Level Variations in Receipt of Surgery for Early-Stage Non-Small Cell Lung Cancer in the United States
December 18, 2019
Performance of curative surgery for early stage cancer varied considerably among counties in the US, and was related to socioeconomic factors, availability of surgeons, and non-metropolitan status.
December 4, 2019
Well-presented Canadian prospective study juxtaposing a combination of Wells scoring and dimers to the imaging gold standard. It was particularly fascinating to read the referenced assertion that:
November 7, 2019
This brief overview of recently presented improvements in lung cancer therapy highlights the substantial benefits of newer chemotherapy and immunotherapy regimens that are transforming the outlooks of many patients with advanced lung cancer.
Evaluation of the INSPIRE Trial and Its Implications for Lung Transplantation With Normothermic Portable Ex Vivo Lung Perfusion
October 30, 2019
A balanced appraisal of last year's manuscript from the Lancet Group on a relatively novel portable Organ Care System for donor lungs. The analysis of the technical complications, especially organ damage from overenthusiastic revving of the pump, is particularly sobering.
Incidence, Management, and Outcomes of Intraoperative Catastrophes During Robotic Pulmonary Resection
October 24, 2019
This multiinstitutional study including advocates of robotic lung resection identified a 1.9% incidence of intraoperative castrophes, most commonly pulmonary arterial bleeding. Patients at risk had lower FEV1%, higher clinical stage, and more frequent preoperative radiation therapy.
October 9, 2019
Ex vivo lung perfusion was used in 25% of transplanted lungs in the Toronto program since 2008. This resulted in an increase in the number of transplanted patients without any degradation of long-term outcomes, including survival and freedom from chronic dysfunction.