Higher serum 25-hydroxyvitamin D (25(OH)D) levels are reportedly associated with better survival in early-stage non-small cell lung cancer (NSCLC). Therefore, whether vitamin D supplementation can improve the prognosis of patients with NSCLC was examined (UMIN000001869). A randomized, double-blind trial comparing vitamin D supplements (1,200 IU/day) with placebo for 1 year after operation was conducted. The primary and secondary outcomes were relapse-free survival (RFS) and overall survival (OS), respectively. Prespecified subgroup analyses were performed with stratification by stage (early vs. advanced), pathology (adenocarcinoma vs. others), and 25(OH)D levels (low, <20 ng/mL vs. high, ≥20 ng/mL). Polymorphisms of vitamin D receptor (VDR) and vitamin D-binding protein (DBP) and survival were also examined. Patients with NSCLC ( = 155) were randomly assigned to receive vitamin D ( = 77) or placebo ( = 78) and followed for a median of 3.3 years. Relapse and death occurred in 40 (28%) and 24 (17%) patients, respectively. In the total study population, no significant difference in either RFS or OS was seen with vitamin D compared with the placebo group. However, by restricting the analysis to the subgroup with early-stage adenocarcinoma with low 25(OH)D, the vitamin D group showed significantly better 5-year RFS (86% vs. 50%, = 0.04) and OS (91% vs. 48%, = 0.02) than the placebo group. Among the examined polymorphisms, DBP1 (rs7041) TT and CDX2 (rs11568820) AA/AG genotypes were markers of better prognosis, even with multivariate adjustment. In patients with NSCLC, vitamin D supplementation may improve survival of patients with early-stage lung adenocarcinoma with lower 25(OH)D levels. .

3D-MDCT imaging is useful for preoperatively understanding the individual thoracic anatomy in lung cancer surgery. This modality can therefore contribute to safer anatomical pulmonary operations, especially in VATS.

Lung surgeries in patients with bronchial variations have rarely been reported. Here, we describe the case of a patient along with lung cancer with variant anatomy of the right upper lobe bronchus. This variation was evaluated by three-dimensional multi-detector computed tomography angiography with bronchography and a three-dimensional printing model using rapid prototyping. The variant anterior segment bronchus (S3) of the right upper lobe arising from the middle lobe bronchus was confirmed before surgery using the printing model, which helped to determine the extent of resection required and facilitated the understanding of the patient's anatomy during surgery. A thoracoscopic anterior segmentectomy and middle lobectomy were performed. The printing model was useful for detecting and evaluating the variant bronchi.

We observed common ostia more frequently on the left side than on the right. The middle lobe variations were frequent, and the right inferior pulmonary vein often divided at the root. Preoperative 3D-MDCT presented correct pulmonary vein anatomy of the patients.

Patients with pancreatic ductal adenocarcinoma (PDA) typically succumb to mortality early, even following surgical resection. Therefore, prognostic factors associated with early mortality are required to improve the survival of patients with PDA following surgical resection. Carbohydrate sulfotransferase 15 (CHST15) is responsible for the biosynthesis of sulfated chondroitin sulfate E (CS-E), which serves a pivotal function in cancer progression by cleaving CD44. CHST15 and CD44 expression in PDA tissue were assessed as a prognostic factor in patients with PDA following surgical resection. A total of 36 consecutive patients with PDA were enrolled following surgical resection between January 2008 and December 2014. The intensities of CHST15 and CD44 expression were analyzed by immunohistochemical staining. The recurrence period was significantly earlier in the strong CHST15 expression group compared with the negative-to-moderate CHST15 expression group. Overall survival (OS) was also significantly decreased in the strong CHST15 expression group compared with the negative-to-moderate CHST15 expression group. Multivariate analysis also indicated significant associations between CHST15 overexpression and disease-free survival (DFS) and OS. However, expression of CD44 in PDA tissue was not associated with DFS or OS. The present study has demonstrated for the first time that high CHST15 expression in PDA tissue may represent a potential predictive marker of DFS and OS in patients with PDA following surgical resection.

Few clinicians are familiar with the anatomy of anomalous pulmonary veins, and studies reporting patients who required right lower lobectomy for lung cancer and who had anomalies of the middle and lower pulmonary veins are even rarer. This report describes the case of a lung cancer patient who had an anomalous lateral part of the middle lobe vein (V4) draining into the right inferior pulmonary vein, which was confirmed by three-dimensional 64-row multidetector computed axial tomography (3D-MDCT) angiography. She was then successfully treated with video-assisted thoracic surgery. The preoperative 3D imaging of the pulmonary vein and artery allowed us to comprehend fully the patient's vascular anatomy before the operation. Thus, we recommend preoperative 3D-MDCT angiography for patients with lung cancer undergoing thoracic surgery, especially video-assisted thoracic surgery.

Thymic haemangiomas and innominate vein aneurysms are rare with only 7 and 19 previous cases, respectively, reported in the medical literature. The aetiology of an innominate vein aneurysm remains unclear and there is no previous report of tumour involvement. We present the case of a 27-year old male with concomitant mediastinal tumour and innominate vein aneurysm who underwent surgical treatment. The tumour intruded into the lower section of the innominate vein, thus causing aneurysmal dilation. Pathologically, the tumour was diagnosed as a thymic cavernous haemangioma involving the left innominate vein. This is the first case of a thymic haemangioma presenting with an innominate vein aneurysm, and suggests that tumours may be involved in the aetiology of innominate vein aneurysms.

Here we report a case of thymic cavernous haemangioma with the left innominate vein aneurysm. A 43-year-old man presented with chest pain. Enhanced chest computed tomography revealed an anterior mediastinal tumor measuring 60 × 52 × 38 mm with multiple venous lakes and focal specks of calcification, composed of a low-density soft tissue mass along with a left innominate vein aneurysm. We preoperatively diagnosed the mass as a thymic hemangioma and subsequently performed surgical resection. Pathologic diagnosis was a thymic cavernous hemangioma with a left innominate vein aneurysm, which is very rare.