The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Dissecting the clinicopathological, genomic, and prognostic significance of ALK rearrangement in resected lung adenocarcinoma.
The ALINA trial introduced anaplastic lymphoma kinase (ALK) inhibitors in an early-stage context, generating notable interest. This study aims to investigate the characteristics and prognostic implications of ALK rearrangement in patients with resected lung adenocarcinoma (LUAD). ⋯ ALK positivity was associated with specific aggressive pathological features and inferior RFS in stage I LUAD. ALK-positive patients seemed to benefit more from adjuvant chemotherapy. Active treatment with ALK inhibitors or chemotherapy should be considered for ALK-positive LUAD, although further evidence is warranted to expand their utility in early-stage disease management.
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Late diagnosis of Marfan syndrome is associated with unplanned aortic surgery and cardiovascular death.
Marfan syndrome (MFS) guidelines recommend optimal pharmacological therapy (OPT) and replacement of the ascending aorta (RAA) at 5.0cm diameters to prevent acute type A aortic dissection (ATAAD) and death. The effect of early MFS diagnosis and initiation of therapy on outcomes is not known. ⋯ Late diagnosis of Marfan syndrome is associated with delayed surgery and death.
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J. Thorac. Cardiovasc. Surg. · Sep 2024
Enhanced machine learning models for predicting one-year mortality in individuals suffering from type A aortic dissection.
Develop and validate an interpretable machine learning model to predict one-year mortality in Type A aortic dissection (TAAD) patients, improving risk classification and aiding clinical decision-making. ⋯ The Treebag ML model effectively predicts one-year mortality in TAAD patients, stratifying risk profiles. Key factors for enhancing survival include surgical intervention, β-blocker administration, and management of SBP, Lym, CO2-Bp, Eos, and WBC levels, offering a valuable tool for improving patient outcomes.