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 pathologic features and inferior RFS in stage I LUAD. Patients positive for ALK seemed to benefit more from adjuvant chemotherapy. Active treatment with ALK inhibitors or chemotherapy should be considered for patients with 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 pharmacologic therapy (OPT) and replacement of the ascending aorta (RAA) at 5.0 cm in diameter 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. Therefore, we sought to evaluate the effect of age at MFS diagnosis and therapy initiation on delayed RAA and death. ⋯ Late diagnosis of MFS 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.
The study objective was to develop and validate an interpretable machine learning model to predict 1-year mortality in patients with type A aortic dissection, improving risk classification and aiding clinical decision-making. ⋯ The Treebag machine learning model effectively predicts 1-year mortality in patients with type A aortic dissection, stratifying risk profiles. Key factors for enhancing survival include surgical intervention, β-blocker administration, and management of systolic blood pressure, lymphocyte, carbon dioxide combining power, eosinophil, and white blood cell levels, offering a valuable tool for improving patient outcomes.