Thoracic surgery clinics
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Thoracic surgery clinics · May 2013
Review Historical ArticleTobacco smoking: the leading cause of preventable disease worldwide.
Tobacco smoking is the world's leading cause of avoidable premature mortality, reflecting the potent toxicity of tobacco smoke inhaled by smokers for decades. In the twentieth century, lung cancer was an early sentinel of the emergence of the still persisting epidemic of tobacco-caused disease. Smoking has declined in many countries, particularly the high-income countries, but low- and middle-income countries remain at risk because of the aggressive tactics of tobacco multinationals. The World Health Organization treaty, the Framework Convention on Tobacco Control, is a critical factor in countering these tactics and precipitating the end of the global epidemic of tobacco smoking.
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Thoracic surgery clinics · May 2013
ReviewShould all cases of lung cancer be presented at Tumor Board Conferences?
Tumor Board Conferences (TBCs) have been associated with higher adherence of staging and treatment to guidelines. The influence of TBCs on the rate of curative treatments has been established. Patients with lung nodules and tumors of unknown histology should not be presented before surgery, but every patient with malignant histology should be declared to the TBC coordinator and registered at the time of histologic confirmation. This approach allows physicians to deal rapidly with simple cases on a systematic basis, to give more attention to the most complicated situations, and to offer every patient the benefit of a multidisciplinary approach.
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Thoracic surgery clinics · May 2013
ReviewThe changing epidemic of lung cancer and occupational and environmental risk factors.
The epidemiology of lung cancer continues to evolve. Since the invention of a machine that could rapidly manufacture cigarettes in the 1880s, tobacco smoking has progressively been the major causative agent for the lung cancer epidemic. ⋯ There are other causes of lung cancer in people who never smoke, which include environmental and occupational. Enough is now known to implement strong policies that could eliminate most lung cancers.
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Thoracic surgery clinics · May 2013
ReviewPerformance of integrated positron emission tomography/computed tomography for mediastinal nodal staging in non-small cell lung carcinoma.
Integrated positron emission tomography (PET)/CT is routinely used for mediastinal nodal staging of non-small cell lung carcinoma in centers throughout the world. This modality is the most accurate noninvasive means by which to identify metastatic disease in mediastinal lymph nodes. This article reviews the evidence supporting the use of PET/CT and discusses the clinical applicability of this modality.
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Thoracic surgery clinics · May 2013
ReviewRelevance of endoscopic ultrasonography and endobronchial ultrasonography to thoracic surgeons.
Although cervical mediastinoscopy has been considered the gold standard for mediastinal staging in non-small cell lung cancer, new minimally invasive endoscopic ultrasound technology, such as endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound fine-needle aspiration, have changed the practice of invasive staging. Based on the current evidence, minimally invasive endoscopic staging is the recommended choice in patients with high pretest probability of lymph node metastasis; however, all negative results should be verified by mediastinoscopy, especially in centers with low expertise. In patients with low pretest probability, mediastinoscopy may be omitted when adequate sampling is achieved with endoscopic modalities.