Impact of Video-Assisted Thoracoscopic Surgery on Benign Resections for Solitary Pulmonary Nodules

Kuo, Elbert; Bharat, Ankit; Bontumasi, Nicholas; Sanchez, Czarina; Zoole, Jennifer Bell; Patterson, G. Alexander; Meyers, Bryan F.

doi:10.1016/j.athoracsur.2011.08.035

Cited by 36 publications

(21 citation statements)

References 28 publications

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“…The availability of CT scanners has increased the incidence of solitary pulmonary nodule (SPN) findings as well as the use of thoracoscopy [58]. As mentioned above, changes in adenocarcinoma classification, with the new definitions of pre-invasive lesion, AIS, and MIA, may have been responsible for the 100%, or near 100%, 5-year survival after resection.…”

Section: Procedural Complications Of Screeningmentioning

confidence: 99%

Screening for lung cancer: time for large-scale screening by chest computed tomography

Shlomi

Ben-Avi

Balmor³

et al. 2014

European Respiratory Journal

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Lung cancer is the leading cause of cancer death worldwide. Age and smoking are the primary risk factors for lung cancer. Treatment based on surgical removal in the early stages of the disease results in better survival. Screening programmes for early detection that used chest radiography and sputum cytology failed to attain reduction of lung cancer mortality. Screening by low-dose computed tomography (CT) demonstrated high rates of early-stage lung cancer detection in a high-risk population. Nevertheless, no mortality advantage was manifested in small randomised control trials. A large randomised control trial in the USA, the National Lung Screening Trial (NLST), showed a significant relative reduction of 20% in lung cancer mortality and 6.7% reduction in total mortality, yet no reduction was evidenced in the late-stage prevalence. Screening for lung cancer by low-dose CT reveals a high level of false-positive lesions, which necessitates further noninvasive and invasive evaluations. Based primarily on the NLST eligible criteria, new guidelines have recently been developed by major relevant organisations. The overall recommendation coming out of this collective work calls for lung cancer screening by low-dose CT to be performed in medical centres manned by specialised multidisciplinary teams, as well as for a mandatory, pre-screening, comprehensive discussion with the patient about the risks and advantages involved in the process. Lung cancer screening is on the threshold of a new era, with ever more questions still left open to challenge future studies. @ERSpublications Lung cancer screening is on the threshold of a new era, with wider application of CT screening now recommended

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Section: Procedural Complications Of Screeningmentioning

confidence: 99%

Screening for lung cancer: time for large-scale screening by chest computed tomography

Shlomi

Ben-Avi

Balmor³

et al. 2014

European Respiratory Journal

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“…Importantly, the prevalence of pulmonary nodules in our patient population must be considered in the context of granulomatous disease from histoplasmosis, 25,26 which is endemic in the Missouri river valley that borders our institution. In a recent series of 1560 patients who underwent resection for pulmonary lesions at our institution, 140 cases (9%) were benign and 65% of these cases demonstrated granulomatous inflammation on pathology.…”

Section: Discussionmentioning

confidence: 98%

Natural History of Preoperative Subcentimeter Pulmonary Nodules in Patients With Resectable Pancreatic Adenocarcinoma

Chang¹,

Nguyen²,

Raptis³

et al. 2015

Annals of Surgery

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“…Other studies describing resection for known or suspected lung cancer report benign disease rates as high as 40%. 5–9 …”

Section: Introductionmentioning

confidence: 99%

Predicting Lung Cancer Prior to Surgical Resection in Patients with Lung Nodules

Deppen

Blume

Aldrich

et al. 2014

Journal of Thoracic Oncology

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Background Existing predictive models for lung cancer focus on improving screening or referral for biopsy in general medical populations. A predictive model calibrated for use during preoperative evaluation of suspicious lung lesions is needed to reduce unnecessary operations for benign disease. A clinical prediction model (TREAT) is proposed for this purpose. Methods We developed and internally validated a clinical prediction model for lung cancer in a prospective cohort evaluated at our institution. Best statistical practices were used to construct, evaluate and validate the logistic regression model in the presence of missing covariate data using bootstrap and optimism corrected techniques. The TREAT model was externally validated in a retrospectively collected Veteran Affairs population. The discrimination and calibration of the model was estimated and compared to the Mayo Clinic model in both populations. Results The TREAT model was developed in 492 patients from Vanderbilt whose lung cancer prevalence was 72% and validated among 226 Veteran Affairs patients with a lung cancer prevalence of 93%. In the development cohort the area under the receiver operating curve (AUC) and Brier score were 0.87 (95%CI: 0.83–0.92) and 0.12 respectively compared to the AUC 0.89 (95%CI: 0.79–0.98) and Brier score 0.13 in the validation dataset. The TREAT model had significantly higher accuracy (p<0.001) and better calibration than the Mayo Clinic model (AUC=0.80, 95%CI: 75–85; Brier score=0.17). Conclusion The validated TREAT model had better diagnostic accuracy than the Mayo Clinic model in preoperative assessment of suspicious lung lesions in a population being evaluated for lung resection.

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Impact of Video-Assisted Thoracoscopic Surgery on Benign Resections for Solitary Pulmonary Nodules

Cited by 36 publications

References 28 publications

Screening for lung cancer: time for large-scale screening by chest computed tomography

Screening for lung cancer: time for large-scale screening by chest computed tomography

Natural History of Preoperative Subcentimeter Pulmonary Nodules in Patients With Resectable Pancreatic Adenocarcinoma

Predicting Lung Cancer Prior to Surgical Resection in Patients with Lung Nodules

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