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Mediastinal staging

Daniël A Korevaar, Laurence M Crombag, Jérémie F Cohen, René Spijker, Patrick M Bossuyt, Jouke T Annema
BACKGROUND: Guidelines recommend endosonography with fine-needle aspiration for mediastinal nodal staging in non-small-cell lung cancer, but most do not specify whether this should be through endobronchial endoscopy (EBUS), oesophageal endoscopy (EUS), or both. We assessed the added value and diagnostic accuracy of the combined use of EBUS and EUS. METHODS: For this systematic review and random effects meta-analysis, we searched MEDLINE, Embase, BIOSIS Previews, and Web of Science, without language restrictions, for studies published between Jan 1, 2000, and Feb 25, 2016...
October 20, 2016: Lancet Respiratory Medicine
Raymond U Osarogiagbon
No abstract text is available yet for this article.
October 20, 2016: Lancet Respiratory Medicine
Jinbai Miao, Mei Li, Yili Fu, Xiaoxing Hu, Bin Hu, Hui Li
Video-assisted mediastinoscopy (VAM) is the most commonly used invasive method for the preoperative mediastinal staging of lung cancer and for the diagnosis of other mediastinal diseases. However, VAM has the risk of causing life-threatening bleeding consequent to the specific mediastinal anatomy. We adopted the ultrasonic technique for VAM biopsies that can easily distinguish the lymph nodes from the surrounding great vessels and thus makes the procedure easier and safer.
November 2016: Annals of Thoracic Surgery
Kemal Can Tertemiz, Aylin Ozgen Alpaydin, Volkan Karacam
INTRODUCTION: Many extrathoracic malignancies can metastasize to lungs and mediastinal lymph nodes. Whether mediastinal lesions are metastasis in these patients changes staging, prognosis, and treatment strategy. In this study, we aimed to find out the contribution of EBUS-TBNA to the diagnosis in cases with extrathoracic malignancy. MATERIALS AND METHODS: Patients who had been previously diagnosed as extrapulmonary solid organ malignancy and in whom mediastinal or hilar lymphadenopathy developed during their follow-up and EBUS-TBNA was applied for diagnostic purposes were retrospectively included in this study...
October 21, 2016: Surgical Endoscopy
Vidya Ramachandraiah, Wilbert Aronow, Dipak Chandy
Sarcoidosis is a multisystem disease characterized by the presence of noncaseating granulomas, the exact etiology of which is yet to be determined. Pulmonary involvement occurs in the majority of patients and its severity ranges from asymptomatic involvement of mediastinal lymph nodes to progressive pulmonary fibrosis and chronic respiratory failure that is insensitive to treatment. Diagnosis of pulmonary sarcoidosis requires a compatible clinical picture supported by radiologic and pathologic data. A recent development in establishing the diagnosis of pulmonary sarcoidosis is endobronchial ultrasound that increases the yield of transbronchial needle aspiration of hilar and/or mediastinal lymph nodes...
October 21, 2016: Postgraduate Medicine
Keiju Aokage, Junji Yoshida, Tomoyuki Hishida, Masahiro Tsuboi, Hisashi Saji, Morihito Okada, Kenji Suzuki, Syunichi Watanabe, Hisao Asamura
Since 'radical lobectomy' was reported by Cahan in 1960, the standard surgical care for lung cancer has been lobectomy, in which units of the lobe are excised with their specific regional hilar and mediastinal lymphatics. However, pulmonary function-preserving limited resection for lung cancer has gradually become more prevalent in the late 20th century. In 1995, Ginsberg et al. conducted a randomized controlled trial in which limited resection (segmentectomy and wide-wedge resection) and lobectomy for stage I lung cancer were compared and reported that limited resection should not be applied to healthy patients with clinical stage IA lung cancer...
October 20, 2016: Japanese Journal of Clinical Oncology
Takahiro Wakasaki, Hirofumi Omori, Shintaro Sueyoshi, Fumihide Rikimaru, Satoshi Toh, Kenichi Taguchi, Yuichiro Higaki, Masaru Morita, Muneyuki Masuda
BACKGROUND: Advanced head and neck squamous cell carcinomas frequently develop distant metastases to limited organs, including the lungs, bone, mediastinal lymph nodes, brain, and liver. Peritoneal carcinomatosis as an initial distant metastasis from hypopharyngeal squamous cell carcinoma is quite rare. CASE PRESENTATION: A 75-year-old man diagnosed with hypopharyngeal squamous cell carcinoma and his clinical stage was determined as T2N2cM0. Notably, the right retropharyngeal lymph node surrounded more than half of the right internal carotid artery...
October 18, 2016: World Journal of Surgical Oncology
Hyejin Cheon, Hye Jung Kim, Sang-Woo Lee, Do-Hoon Kim, Chang-Hee Lee, Seung Hyun Cho, Kyung Min Shin, So Mi Lee, Gab Chul Kim, Won Hwa Kim
PURPOSE: To evaluate the prevalence of and factors associated with internal mammary node (IMN) adenopathy on MRI and PET/CT used for initial staging in patients with operable breast cancer. METHODS: A total of 1320 patients diagnosed with invasive breast carcinoma between January 2011 and December 2015 underwent MRI and PET/CT for initial staging. The patients were considered to have IMN adenopathy when MRI revealed IMNs with the longest diameter of 5 mm or greater and a standardized uptake value greater than that of the mediastinal blood pool/contralateral parasternal area on PET/CT...
October 17, 2016: Breast Cancer Research and Treatment
Jia-Ming Chang, Kam-Hong Kam, Yi-Ting Yen, Wei-Li Huang, Wei Chen, Yau-Lin Tseng, Ming-Ho Wu, Wu-Wei Lai, Diego Gonzalez-Rivas
Our study sought to review our experience from biportal to uniportal video-assisted thoracoscopic surgery (VATS) major lung resection. Lessons we learned from the evolution regarding technical aspects were also discussed.We retrospectively reviewed patients who underwent VATS lobectomy or segmentectomies in Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan, during January 2012 and December 2014. Patient clinical profiles, surgical indications and procedures, postoperative course, and oncological parameters were analyzed and compared between the biportal and uniportal groups...
October 2016: Medicine (Baltimore)
Qing-Hua Liu, Sixto Arias, Ko-Pen Wang
The invaluable role of transbronchial needle aspiration (TBNA) in the diagnosis and staging of mediastinal adenopathy and lung cancer has been well established. Different lymph nodes regional nomenclatures and maps had been described over the years. The international association for the study of lung cancer (IASLC) and Wang's maps complement each other benefiting patients with lung cancer. In this article we briefly reviewed the roles of IALSC, Wang's maps and ROSE in TBNA.
September 2016: Journal of Thoracic Disease
Frank O Velez-Cubian, Kathryn L Rodriguez, Matthew R Thau, Carla C Moodie, Joseph R Garrett, Jacques P Fontaine, Eric M Toloza
BACKGROUND: We investigated whether robotic-assisted surgery improves mediastinal lymph node dissection (MLND). METHODS: We analyzed patients (pts) who underwent robotic-assisted video-assisted thoracoscopic surgery (R-VATS) lobectomy for non-small cell lung cancer (NSCLC) over 36 months. Perioperative outcomes, tumor histology, numbers, locations, and status of all lymph nodes (LNs), and TNM (tumor, nodal, and metastasis) stage changes were analyzed. RESULTS: One hundred fifty-nine pts had mean tumor size 3...
September 2016: Journal of Thoracic Disease
Ahmed Ali Elsayed, Akira Satou, Ahmed E Eladl, Seiichi Kato, Shigeo Nakamura, Naoko Asano
AIMS: To report the clinicopathologic features of EBV-positive (EBV(+) ) grey zone lymphoma (GZL) with features intermediate between diffuse large B-cell lymphoma (DLBCL) and classical Hodgkin lymphoma (CHL). METHODS AND RESULTS: We report the clinicopathologic features of 14 cases of EBV(+) GZL in Japan. The control group included 173 cases of EBV(+) CHL and 64 cases of EBV(+) DLBCL of the elderly (polymorphous type). Patients included 10 men and 4 women with a median age of 62 years...
October 13, 2016: Histopathology
Eric Goudie, Mehdi Tahiri, Moishe Liberman
VATS lobectomy is a safe and effective treatment strategy for operable stage I and II lung cancer. It has a similar five-year survival compared to open lobectomy (thoracotomy). VATS lobectomy is associated with less postoperative complications and shorter hospital length of stay when compared to lobectomy by thoracotomy. VATS lobectomy has not been widely adopted by the thoracic surgical community, in part, due to technical reasons. Pulmonary artery branch manipulation in VATS lobectomy is one of the most critical parts of the procedure, especially when endostaplers are used for ligation and division of the vessel...
October 6, 2016: Surgical Technology International
Hiroyuki Matsuzaki, Soichiro Ishihara, Kazushige Kawai, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Hiroaki Nozawa, Shigeru Yamada, Toshiaki Watanabe
BACKGROUND: The need for surveillance of rare late recurrence of rectal cancer has not yet been established. Local control of unresectable skeletal metastasis is important for palliation of symptoms and support for systemic chemotherapy. CASE PRESENTATION: A Japanese man underwent preoperative pelvic irradiation (50.4 Gy/28 Fr) and low anterior resection at the age of 57 years. The pathological stage was II (T3N0M0). Nine years after the surgery, his carcinoembryonic antigen (CEA) level showed rapid elevation, although he had no symptoms...
December 2016: Surgical Case Reports
Dawei Guo, Yiming Ni, Xiayi Lv, Zhihao Zhang, Peng Ye
BACKGROUND AND OBJECTIVE: With the popularity of minimally invasive techniques, preoperatively determining whether mediastinal lymph node dissection (MLD) is necessary for patients with cN1/2 nonsmall cell lung cancer (NSCLC) has sparked controversy once again. This study aims to analyze whether different primary sites are associated with the distribution of mediastinal lymph node metastases and to investigate the necessity of lymph node dissection and the factors influencing prognosis...
October 2016: Journal of Cancer Research and Therapeutics
Jennifer L Sullivan, Benny Weksler
BACKGROUND: Neuroendocrine tumors of the thymus (NETT) constitute less than 5% of all anterior mediastinal masses but are aggressive and lead to poor overall survival. This study was designed to evaluate factors that influence the prognosis of patients with NETT and the role of surgical intervention in survival. METHODS: We analyzed the Surveillance, Epidemiology, and End Results cancer database to identify patients with NETT. We performed univariate and multivariate analyses to identify prognostic factors among demographic, tumor, and treatment variables...
October 6, 2016: Annals of Thoracic Surgery
Yaxia Zhang, Michael Joyce, Jean Schils, Thomas W Bauer
Sarcoidosis is a systemic inflammatory disorder characterized by non-caseating granulomas, predominantly involving lung, mediastinal lymph nodes and other organs. Synovium involvement is infrequent, and as far as we know, involvement of a periprosthetic membrane has not been reported in the English literature. Intra-articular diffuse tenosynovial giant cell tumor ("conventional diffuse pigmented villonodular synovitis") is an uncommon, locally aggressive neoplasm with few previous case reports in which it arose in periprosthetic tissues after knee arthroplasty...
October 7, 2016: Skeletal Radiology
Naomi E Verstegen, Alexander P W M Maat, Frank J Lagerwaard, Marinus A Paul, Michel I Versteegh, Joris J Joosten, Willem Lastdrager, Egbert F Smit, Ben J Slotman, Joost J M E Nuyttens, Suresh Senan
INTRODUCTION: The literature on surgical salvage, i.e. lung resections in patients who develop a local recurrence following stereotactic ablative radiotherapy (SABR), is limited. We describe our experience with salvage surgery in nine patients who developed a local recurrence following SABR for early stage non-small cell lung cancer (NSCLC). METHODS: Patients who underwent surgical salvage for a local recurrence following SABR for NSCLC were identified from two Dutch institutional databases...
October 3, 2016: Radiation Oncology
Fumihiro Tanaka, Seiki Hasegawa, Nobuyuki Kondo, Ryo Miyahara, Hiroshi Date, Shinji Atagi, Masaaki Kawahara, Takeharu Yamanaka, Toshiaki Manabe, Hiromi Wada
BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard procedure for the pathological evaluation of the mediastinal nodal (N2) status of lung cancer; however, its feasibility in potentially operable patients with suspicion of minimal N2 disease remains unestablished. PATIENTS AND METHODS: A prospective multicenter study was conducted to assess the feasibility of EBUS-TBNA in this setting. Patients with clinical stage IIIA-N2 non-small cell lung cancer (NSCLC) and mediastinal nodal enlargement on computed tomography (CT) were eligible; patients were ineligible when CT revealed bulky (> 3 cm in the long-axis diameter) N2 or multiple (≥ 3) station N2...
2016: Oncology Research and Treatment
Faten Fedhila, Samar Rhayem, Habiba Hafsi, Wiem Douira, Raoudha Doghri, Monia Khemiri, Karima Mrad, Ibtissem Bellagha, Bechir Zouari, Sihem Barsaoui
Background Extracranial Germ cell tumors (GCT) are a rare and a heterogeneous group of pediatric cancers but highly curable. Aim We aimed to review management, outcome and prognostic factors that influence overall survival (OS) in a pediatric Tunisian oncologic unit. Methods We retrospectively evaluated between January 1998 and December 2012, 33 patients affected by extracranial germ cell tumors and treated according to TGM95 protocol established by the SFOPin a pediatric Tunisian oncologic unit. Results Patients had a mean age of 57 months (ranges: 1 day-13 years)...
April 2016: La Tunisie Médicale
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