The following is a collection of
featured thoracic articles from the Journal of Thoracic and Cardiovascular
Surgery (JTCVS). To read the latest issue, or
browse the feature video library and other journal
highlights, please visit www.jtcvs.org.
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analysis of readmission and mortality during the first
year after pneumonectomy
Gregory D. Jones, MD, Kay See Tan,
PhD, Raul Caso, MD, Joseph Dycoco, BA, Bernard J. Park,
MD, Matthew J. Bott, MD, Daniela Molena, MD, James
Huang, MD, James M. Isbell, MD, Manjit S. Bains, MD,
David R. Jones, MD, Gaetano Rocco, MD
of readmission and death varies during the first year
after pneumonectomy. Nononcologic causes predominate in
the first 90 days, after which oncologic causes
Are we home yet?
A. D'Amico, MD
Readmission after pneumonectomy
confers significant risk of mortality until 90 days
after surgery. Failure to rescue is a result of
delayed readmission or ineffective care after
John Snow, pneumonectomy, and complication epidemiology
Wakeam, MD, MPH
John Snow used epidemiology to solve
a cholera outbreak in London in 1856. We need
similar efforts to solve a difficult problem in
2020—that of complications after pneumonectomy.
What's past is prologue: The story of pneumonectomy
Pneumonectomy remains a high-risk
procedure in general thoracic surgery. Outcomes
from postoperative day 90 and onwards suggest
additional targets for quality improvement.
guideline-concordant treatment for node-positive,
non–small cell lung cancer following surgery
Norma E. Farrow, MD, Selena J. An,
MD, MSPH, MA, Paul J. Speicher, MD, MHS, David H.
Harpole Jr., MD, Thomas A. D'Amico, MD, Jacob A.
Klapper, MD, Matthew G. Hartwig, MD, Betty C. Tong, MD,
factors, including lack of insurance and geographic
region, are associated with disparities in adjuvant
therapy use for node-positive non–small cell lung
cancer. These disparities have significant impact on
outcomes and survival.
The majority of minorities
C. Salazar, MD, Daniel J. Boffa, MD
Some sociodemographic strata were
more likely to receive nonguideline-concordant
care; however, many strata classically at risk to
be undertreated were not.
Chemo if you can—disparities in receipt of
guideline-concordant adjuvant therapy in patients with
locoregional non–small cell lung cancer
Chidi, MD, PhD, MSPH, Stephen R. Broderick, MD, MPHS
Within the limitations of the
National Cancer Database, the study identifies
inequities in care of patients with locoregional
NSCLC and presents opportunities for further study
and practice change.
Despair and disparity
Hammoud, MD, FACS
Insurance status is a leading factor
in guideline discordant therapy for completely
resected pN1 and pN2 non–small cell lung cancer.
The effect of
age on survival after endoscopic resection versus surgery
for T1a esophageal cancer
Vignesh Raman, MD, Oliver K.
Jawitz, MD, Soraya L. Voigt, MD, Chi-Fu J. Yang, MD,
David H. Harpole, MD, Thomas A. D'Amico, MD, Matthew G.
associated with comparable survival to surgery in
patients with cT1a esophageal cancer regardless of age.
Endoscopic resection versus surgery for superficial
esophageal cancer: Ageless or timeless?
Endoscopic resection is an option
across all ages for T1a cancer, but esophagectomy
remains important in patients with a greater risk of
Age is just a number: Let's give endoscopy a chance in
the treatment of early esophageal cancer
Rappaport, MD, Siva Raja, MD, PhD
Endoscopic resection for very early
esophageal cancer may be the right first-line
choice for all patients, especially elderly
patients, who may be at greater risk for
transplantation on intraoperative extracorporeal membrane
oxygenator: An observational study
Konrad Hoetzenecker, MD, PhD,
Alberto Benazzo, MD, Theresa Stork, MD, Katharina Sinn,
MD, Stefan Schwarz, MD, Thomas Schweiger, MD, PhD,
Walter Klepetko, MD, the Vienna Lung Transplant Group
transplantation should be routinely performed on
intraoperative ECMO support. VA-ECMO provides optimal
reperfusion conditions that translate into superior
primary graft function.
Adding fuel to the fire for mechanical support during
lung transplantation—More might be better
Najmeh, MD, Matthew G. Hartwig, MD, MHS
Routine VA ECMO in lung transplant
is safe and demonstrates excellent short-term
outcomes, including low PGD. Additional studies are
needed before advocating this approach as a new
standard of care.
Taking matters into your own hands: Venoarterial
extracorporeal membrane oxygenation for controlled
reperfusion during lung transplantation
Many times, less is more. In this
case, using venoarterial extracorporeal membrane
oxygenation to alter reperfusion can significantly
improve primary graft dysfunction rates and overall
Central defense on trial
Dhamija, MD, Heather K. Hayanga, MD, MPH, Kelsey
Musgrove, MD, J.W. Awori Hayanga, MD, MPH
Extracorporeal support is a growing
strategy of choice for intraoperative support in
TRANSPLANT FEATURED VIDEO
How to achieve controlled
LUNG CANCER: PERIOPERATIVE MANAGEMENT
nutritional index and postoperative complications after
curative lung cancer resection: A retrospective cohort
Sukhee Park, MD, Hyun Joo Ahn, MD,
PhD, Mikyung Yang, MD, PhD, Jie Ae Kim, MD, PhD, Jin
Kyoung Kim, MD, PhD, Soo Jung Park, MD
preoperative prognostic nutritional index was
associated with postoperative complications and
long-term outcomes after curative resection of
non–small cell lung cancer.
Beyond the eyeball test
D. Cornwell, MD, R. Taylor Ripley, MD
Although surgeons use the “eyeball
test” to advise patients about surgical risk,
nutritional indices such as the PNI may help
quantify risks beyond the VASQIP, performance
status, and frailty scoring.
Soft prognosticators following radical treatment of
lung cancer: The time has come for a more integrated
TNM staging system should be
integrated by cancer- and patient-related biologic,
immunologic, and metabolic characteristics to allow
a targeted and personalized cancer treatment.