Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
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Comparative Study Clinical Trial
Screening-detected lung cancers: is systematic nodal dissection always essential?
To address whether systematic lymph node dissection is always necessary in early lung cancer, we identified factors predicting nodal involvement in a screening series and applied them to nonscreening-detected cancers. ⋯ This limited experience suggests that in early-stage clinically N0 lung cancers with maxSUV <2.0 or pathological nodule size ≤10 mm, systematic nodal dissection can be avoided as the risk of nodal involvement is very low.
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In recent years, there have been significant advances in the management of patients with lung cancer. This progress is associated with increased use of medical intensive care units (ICUs) for the management of a variety of complications related to cancer, its treatment, or comorbid illnesses. At the same time, there are advances in the care of critically ill patients in general. ⋯ However, it is clear that not all lung cancer patients will benefit from this aggressive care. Although there are no absolute predictors, the current evidence suggests that advanced refractory cancer, poor baseline performance status, the need for mechanical ventilation, and multiple organ system failures are factors associated with worse ICU outcome. Further studies are needed to better triage patients who are going to benefit from ICU care; determine the optimal duration of this care; and assess the impact of this therapy on the long-term survival, cancer treatment, and quality of life of these patients.
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Comparative Study
Spontaneous smoking cessation before lung cancer diagnosis.
We have observed that many patients with lung cancer stop smoking before diagnosis, usually before clinical symptoms, and often without difficulty. This led us to speculate that spontaneous smoking cessation may be a presenting symptom of lung cancer. ⋯ These results challenge the notion that patients with lung cancer usually quit smoking because of disease symptoms. The hypothesis that spontaneous smoking cessation may be a presenting symptom of lung cancer warrants further investigation.
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Clinical Trial
Management of thymic tumors: a survey of current practice among members of the European Society of Thoracic Surgeons.
Management of thymoma has largely been based on single-institution retrospective, observational studies. The European Society of Thoracic Surgeons (ESTS) Thymic Working Group has investigated the current practice among ESTS members. ⋯ The survey provides a large, multiinstitutional overview of the clinical practice in the management of thymic tumors by ESTS members. Responses show some areas of agreement along with several areas of controversy. It is conceivable that a consequent step forward will be the creation of a collaborative effort within the ESTS and with other organizations for the creation of standard recommendations and guidelines for the management of thymic malignancies.