Quality Gaps and Comparative Effectiveness in Lung Cancer Staging and Diagnosis.

Quality Gaps and Comparative Effectiveness in Lung Cancer Staging and Diagnosis. Chest. 2019 Oct 11;: Authors: Ost DE, Niu J, Zhao H, Grosu H, Giordano SH Abstract BACKGROUND: Guidelines recommend mediastinal sampling first for patients with mediastinal lymphadenopathy with suspected lung cancer. Our objective was to describe practice patterns and outcomes of diagnostic strategies in patients with lung cancer. METHODS: Retrospective cohort of 15,914 lung cancer patients with T1-3/N1-3/M0 disease diagnosed from 2004 to 2013 in the SEER or Texas Cancer Registry Medicare-linked databases. We classified patients who had mediastinal sampling as their first invasive test as guideline-consistent; all others were guideline-inconsistent. We used propensity matching to compare the number of tests performed and multivariable logistic regression to compare incidence of complications. RESULTS: Guideline-consistent care increased from 23% to 34% of patients from 2004 to 2013 (p
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research

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CONCLUSIONS: In general, imaging and rates of procedures after screening LDCT was low in this commercially insured population. PMID: 31521671 [PubMed - as supplied by publisher]
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
Valliappan Muthu, Inderpaul Singh Sehgal, Sahajal Dhooria, Kuruswamy T Prasad, Nalini Gupta, Ashutosh N Aggarwal, Ritesh AgarwalJournal of Cytology 2019 36(1):65-70 Intrathoracic lymphadenopathy is a common problem encountered in clinical practice and is caused by a wide variety of diseases. Traditionally, the mediastinal lymph nodes were sampled using conventional transbronchial needle aspiration (TBNA), or surgical methods such as mediastinoscopy, and thoracotomy (open or video-assisted thoracoscopy). However, surgical modalities including mediastinoscopy are invasive, expensive, and not universally available. Moreover,...
Source: Journal of Cytology - Category: Cytology Authors: Source Type: research
Conclusions: In our initial series of 35 cases, ENB-guided TBLB showed an acceptable diagnostic yield. PMID: 30034825 [PubMed]
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
Publication date: Available online 28 March 2017 Source:Surgery (Oxford) Author(s): Herbert J. Witzke, Vladimir Anikin Lung abscess remains a common complication of pneumonia and aspiration, particularly in immunosuppressed patients and must be differentiated from a cavitary form of lung cancer. The conservative treatment with antibiotics is still the main therapeutic approach; however, percutaneous drainage may be employed in selected cases. Inhaled foreign bodies require a prompt diagnosis with rigid or a combination of rigid and flexible bronchoscopies to remove the foreign body avoiding complications and the need for ...
Source: Surgery (Oxford) - Category: Surgery Source Type: research
CONCLUSIONS The number of lymph node stations examined during VATS resections is similar to open resections for cStage-I NSCLC. Almost one-third of the patients with a central cStage-I NSCLC were upstaged to pN1. Tumour location was the only independent variable for pN1 upstaging in logistic regression analysis. It is a potential bias in retrospective studies and should therefore be accounted for when comparing different surgical resection techniques for cStage-I NSCLC.
Source: European Journal of Cardio-Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Lung - transplantation, Mediastinum THORACIC Source Type: research
Conclusions In patients undergoing lobectomy with en bloc chest wall resection for non-small cell lung cancer, the number of ribs resected is directly associated with incidence of postoperative respiratory complications.
Source: Lung - Category: Respiratory Medicine Source Type: research
CONCLUSIONS Data from the ESTS database confirmed that lobectomy performed through VATS is associated with a lower incidence of complications compared with thoracotomy.
Source: European Journal of Cardio-Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Mediastinum, Cardiac - physiology THORACIC Source Type: research
Abstract A 24 year old male presented with a history of recurrent bronchopulmonal infections. Chest computed tomography was performed, revealing a right central mass. In the following bronchoscopy and ultrasound guided needle aspiration of the tumour no specific diagnosis could be obtained. Due to the central location of the tumour thoracotomy and middle lobe resection was performed. Histopathological analysis revealed an intrapulmonary, subpleural located Morbus Castleman of the hyaline-vascular type.Castleman's disease is a very rare disorder of the lymphatic tissue that is differentiated into two clinical subty...
Source: Annals of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Cardiovasc Surg Source Type: research
Evaluation of mediastinal lymphadenopathy in children is challenging and surgical procedures (mediastinoscopy/thoracotomy) are usually performed wherever tissue sampling is required. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a widely utilized and minimally invasive modality for evaluation of mediastinum (lymphadenopathy, masses, and nodal staging in patients with lung cancer) in adults. Smaller size of pediatric trachea potentially limits the use of EBUS. The EBUS bronchoscope can also be introduced into the esophagus for mediastinal evaluation and sampling, a technique described as tr...
Source: Journal of Bronchology and Interventional Pulmonology - Category: Respiratory Medicine Tags: Case Reports Source Type: research
Publication date: 2015 Source:Respiratory Medicine Case Reports, Volume 16 Author(s): I. Hammen Tuberculosis (TB) is well known as a diagnostic chameleon and can resemble malignancy. In thorax TB can be manifested as pulmonary infiltrates and/or mediastinal lymphadenopathy. In low incident countries with high incidence of lung cancer and varying clinical presentations, TB often gets misdiagnosed with the result of delayed treatment start and unnecessary diagnostic procedures. Our case report presents two patients, who were referred to the Thorax diagnostic centre at the Department of Respiratory Medicine, Odense Univers...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
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