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المصدر: General Thoracic and Cardiovascular Surgery. 67:442-449
مصطلحات موضوعية: Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lung Neoplasms, Turkey, Comorbidity, 030204 cardiovascular system & hematology, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Risk Factors, Carcinoma, Non-Small-Cell Lung, Internal medicine, medicine, Humans, Lung cancer, Lymph node, Survival rate, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Radical Lymph Node Dissection, Mortality rate, General Medicine, medicine.disease, Cardiac surgery, Survival Rate, Dissection, medicine.anatomical_structure, 030228 respiratory system, Lymph Node Excision, Female, Surgery, Cardiology and Cardiovascular Medicine, Complication, business
الوصف: Lung cancer is a typical disease of elderly patients. While there are many publications in the literature on factors affecting survival, there is still no consensus on the survival impact of lymph node dissection. Our objective in this study was to evaluate prognostic factors influencing rates of complications, mortality, and survival in geriatric patients who underwent surgery for non-small cell lung cancer. Data obtained from the medical records of patients aged 70 years or older with early-stage non-small cell lung cancer who underwent surgery between January 01, 2008 and December 31, 2015 were evaluated retrospectively. Of the 72 patients included, 57 (79.2%) were male and 15 (20.8%) were female. Complications were observed in 42 patients (58.3%). Nineteen patients (26.4%) developed major complications. Percent predicted forced expiratory volume in 1 s (ppFEV1) and age was found to be risk factors for complications. Thirty days days mortality rate was 8.3%. Mortality was not significantly associated with low CCI, physical status, and ppFEV1 values. The 5-year survival rate was 40.5%. ppFEV1 were risk factors affecting survival, whereas radical lymph node dissection was not associated with survival. The main prognostic factors affecting long-term postoperative survival in the present study was a low postoperative ppFEV1 value. Radical lymph node dissection did not increase the risk of postoperative complications and it did not affect long-term survival in patients aged 70 years or older. A key finding was that comorbidities were not associated with postoperative complications or long-term survival.
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المؤلفون: Toru Nakano, Noriaki Ohuchi, Goh Miyata, Ko Onodera, Naoto Ujiie, Hirofumi Ichikawa, Takashi Kamei
المصدر: General Thoracic and Cardiovascular Surgery. 64:359-362
مصطلحات موضوعية: Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Supine position, Esophageal Neoplasms, 03 medical and health sciences, Imaging, Three-Dimensional, 0302 clinical medicine, Swallowing, medicine, Humans, Esophagus, business.industry, Thoracoscopy, Radical Lymph Node Dissection, General Medicine, Esophageal cancer, Situs Inversus, medicine.disease, Surgery, Cardiac surgery, Esophagectomy, Situs inversus, medicine.anatomical_structure, Cardiothoracic surgery, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Lymph Node Excision, Laparoscopy, 030211 gastroenterology & hepatology, Neoplasm Recurrence, Local, Tomography, X-Ray Computed, Cardiology and Cardiovascular Medicine, business
الوصف: A 63-year-old male visited our hospital, complaining of discomfort when swallowing. Upper gastrointestinal endoscopy revealed a type 2 tumor in the middle thoracic esophagus, which was diagnosed as squamous cell carcinoma by endoscopic biopsy. Computed tomography revealed situs inversus totalis (SIT). We assessed the relationship of the esophagus with neighboring organs using preoperative three-dimensional imaging. We performed thoracoscopic esophagectomy with radical lymph node dissection in the right decubitus position and hand-assisted laparoscopic gastric mobilization in the supine position. The definitive diagnosis was squamous cell carcinoma, pT2N1M0, pStage IIB according to the Union for International Cancer Control. The patient's postoperative course was uneventful, and 5 years post-operation, he is alive without recurrence. In SIT patients, surgical procedures are difficult because of anatomic transposition. Three-dimensional imaging effectively assesses the anatomical structure and contributes to safer thoracoscopic esophagectomy for esophageal cancer patients with SIT. Relevant literature is also discussed and reviewed.
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المؤلفون: Hiroya Takeuchi, Yuko Kitagawa
المصدر: General thoracic and cardiovascular surgery. 56(8)
مصطلحات موضوعية: Pulmonary and Respiratory Medicine, Oncology, medicine.medical_specialty, Esophageal Neoplasms, medicine.medical_treatment, Metastasis, Breast cancer, Japan, Internal medicine, medicine, Humans, Radionuclide Imaging, business.industry, Sentinel Lymph Node Biopsy, Radical Lymph Node Dissection, Cancer, Tin Compounds, General Medicine, Esophageal cancer, Sentinel node, medicine.disease, Surgery, Technetium Compounds, Esophagectomy, Lymphatic Metastasis, Lymphadenectomy, Radiopharmaceuticals, Cardiology and Cardiovascular Medicine, business
الوصف: Although sentinel node (SN) biopsy has been utilized to predict regional lymph node metastasis in patients with melanoma and breast cancer, the validity of the SN hypothesis is still controversial in regard to esophageal cancer. SN mapping for esophageal cancer is relatively complicated compared to that for gastric cancer, and the number of early-stage esophageal cancers is limited. Therefore, only a few studies have demonstrated the feasibility and validity of the SN concept for esophageal cancer. Nevertheless, our preliminary studies showed that SN mapping may be feasible in patients with early-stage esophageal cancer. Transthoracic extended esophagectomy with three-field radical lymph node dissection has been recognized as a curative procedure for thoracic esophageal cancer in Japan. However, uniform application of this highly invasive procedure might increase the morbidity and markedly reduce quality of life (QOL) after surgery. Although further accumulation of evidence based on multicenter clinical trials using standard protocol is required, SN mapping would provide significant information on individualized selective lymphadenectomy, which might reduce the morbidity and retain the patients' QOL.
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