Lucas Voltolini - Academia.edu (original) (raw)
Papers by Lucas Voltolini
European Journal of Cardio-thoracic Surgery, 2008
The aim of this study is to evaluate the long-term respiratory outcome of patients who underwent ... more The aim of this study is to evaluate the long-term respiratory outcome of patients who underwent pneumonectomy for non-small cell lung cancer (NSCLC), analysing functional tests. Materials and methods: Twenty-seven consecutive patients who were candidates for pneumonectomy performed spirometry before and at least 24 months after surgery in the same laboratory. Diffusion of carbon monoxide and the most common dynamic and static lung volumes were evaluated in percentage of predicted and compared. Results: A significant inverse correlation was observed between the preoperative FEV1 (%) and FVC (%) and their postoperative loss, respectively r = À641 ( p < 0.0001) and r = À789 ( p < 0.0001). Also the correlation between the RV/TLC ratio and the FEV1 loss confirmed a better postoperative outcome in patients with major airway obstruction ( p = 0.02). To investigate these data, the series were divided into two groups: group A included BPCO patients with a FEV1 lower than 80%, the others were considered group B. Group B showed a significant major postoperative FEV1 (%) and FVC (%) impairment, 31% versus 12%, p = 0.005, and FVC (%) loss, 37% versus 16% ( p = 0.02), meanwhile group A showed a significant major postoperative RV (%) reduction, 43% versus 17%, p = 0.03. Despite being significantly higher preoperatively in BPCO patients, the RV% becomes similar between the two groups in the postoperative. Conclusions: In our experience patients with major preoperative airway obstruction who underwent pneumonectomy had lower impairment in FEV1% at almost one year after surgery than those with normal respiratory function. The resection of a certain amount of non-functional parenchyma associated with the mediastinal shift, with an improvement of the chest cavity for the remaining lung, could give a reduction volume effect in BPCO/emphysematous patients. #
The aim of this study is to evaluate the long-term respiratory outcome of patients who underwent ... more The aim of this study is to evaluate the long-term respiratory outcome of patients who underwent pneumonectomy for non-small cell lung cancer (NSCLC), analysing functional tests. Materials and methods: Twenty-seven consecutive patients who were candidates for pneumonectomy performed spirometry before and at least 24 months after surgery in the same laboratory. Diffusion of carbon monoxide and the most common dynamic and static lung volumes were evaluated in percentage of predicted and compared. Results: A significant inverse correlation was observed between the preoperative FEV1 (%) and FVC (%) and their postoperative loss, respectively r = À641 ( p < 0.0001) and r = À789 ( p < 0.0001). Also the correlation between the RV/TLC ratio and the FEV1 loss confirmed a better postoperative outcome in patients with major airway obstruction ( p = 0.02). To investigate these data, the series were divided into two groups: group A included BPCO patients with a FEV1 lower than 80%, the others were considered group B. Group B showed a significant major postoperative FEV1 (%) and FVC (%) impairment, 31% versus 12%, p = 0.005, and FVC (%) loss, 37% versus 16% ( p = 0.02), meanwhile group A showed a significant major postoperative RV (%) reduction, 43% versus 17%, p = 0.03. Despite being significantly higher preoperatively in BPCO patients, the RV% becomes similar between the two groups in the postoperative. Conclusions: In our experience patients with major preoperative airway obstruction who underwent pneumonectomy had lower impairment in FEV1% at almost one year after surgery than those with normal respiratory function. The resection of a certain amount of non-functional parenchyma associated with the mediastinal shift, with an improvement of the chest cavity for the remaining lung, could give a reduction volume effect in BPCO/emphysematous patients. #
To analyze short-and long-term results of surgery in octogenarians, we reviewed data of 96 consec... more To analyze short-and long-term results of surgery in octogenarians, we reviewed data of 96 consecutive patients aged 80 years or more who were operated on for non-smallcell lung carcinoma from 1990 to 2005. Risk factors for complications, perioperative mortality, and long-term survival were assessed by univariate and multivariate analysis. Major complications developed in 17 (17.7%) patients, leading to death in 9 (9.4%) of them. Resection of more than 1 lobe, cardiorespiratory comorbidity, PaO 2 < 75 mm Hg, and CO diffusion capacity <60% were predictive of major complications; extended resection was also predictive of 30-day mortality. The overall 5-year survival rate was 38%, with a significant difference between stage I/II and stage III. In multivariate analysis only pathological stage was related to long-term survival. Surgery is feasible for octogenarians, and even patients in stage II can achieve remarkable survival.
Lung Cancer, 2006
Multimodal management of lung cancer extending to chest wall and type of surgical procedure to be... more Multimodal management of lung cancer extending to chest wall and type of surgical procedure to be performed are still debated. The aim of this retrospective analysis was to analyze the predictive factors of long-term survival after surgery, focusing on depth of infiltration, type of surgical intervention and possible role of preoperative therapies, comparing survival of these patients with that of a group of patients affected by a Pancoast tumour and surgical treated in the same period. We reviewed records of 83 consecutive patients with NSCLC in stage T3 (owing to direct extension to chest wall), who underwent surgical resection in our Thoracic Surgery Unit between January 1994 and December 2003. Patients were classified in two groups: pancoast tumours (PT) or chest wall extending tumours (CW): survival and prognostic factors of each category were analyzed. In the CW group we had 68 patients: 45 were in stage IIB (pT3N0), 23 in stage IIIA (pT3-N1-2). Histology revealed adenocarcinoma in 23 cases, squamous cell carcinoma in 34, large cells anaplastic carcinoma in 8, adenosquamous carcinoma in 3. An involvement of chest wall tissues beyond the endothoracic fascia was found in 21 patients, while in the remaining 47 the invasion of chest wall tissues was confined to the parietal pleura. An extrapleural dissection was performed in 48 patients while combined pulmonary and chest wall en bloc resection was required in 20 patients. Resection was incomplete in three cases. In the PT group we had 15 patients: 11 were in stage IIB and 4 in stage IIIA. Histological type was adenocarcinoma in 10 cases, squamous cell carcinoma in 4 and adenosquamous carcinoma in 1. A univariate analysis performed in the CW group showed that survival was significantly affected by nodal status, stage, extension of chest wall invasion, type of lung resection and residual disease. In a multivariate analysis we found that nodal status, completeness of resection and extension of chest wall involvement maintained a significant prognostic value. There was no difference between the survival curve of CW and PT group: considering the two subset of CW patients, on the basis of depth of infiltration, survival of PT patients was significantly better than that of CW patients with involvement of muscular tissues and ribs (p=0.02). Nodal status, radical resection and depth of chest wall infiltration are the main predictive factors affecting long-term survival, while surgical procedure does not impact on it if margins of resection are free from disease. The better survival observed in PT patients let us to hypothesize that an induction chemo-radiation therapy, as routinely administered to PT patients, could have a potential benefit in survival of patients with CW tumour extending beyond parietal pleura.
International Journal of Neuropsychopharmacology, 2008
International Journal of Neuropsychopharmacology, 2008
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
European Journal of Cardio-thoracic Surgery, 1999
Objective: The aim of this study is a retrospective evaluation of survival in patients who had un... more Objective: The aim of this study is a retrospective evaluation of survival in patients who had undergone lung resection for non-small cell lung cancer and in whose microscopic residual disease at the bronchial resection margin was found, according to the type of in®ltration, histology, lymph node involvement and postoperative treatment. Methods: A total of 1384 patients underwent lung resection for non-small cell lung cancer at the Thoracic Surgery Unit of the University of Siena from 1983 through 1998. All patients underwent complete mediastinal lymphadenectomy and this guaranteed an accurate stadiation. Staging was done according to the TNM and UICC classi®cations. Residual microscopic disease at the bronchial resection margin was divided in mucosal microscopic residual disease and extramucosal microscopic residual disease. Patients dying within 30 days from operation were excluded from survival analyses. Survival was analysed by the product limit method of Kaplan and Meier and curves were compared using the log-rank test. Results: Microscopic residual disease was found postoperatively at the bronchial margin in 3.39% (47/1384) of all patients undergoing lung resection for non-small cell lung cancer. Thirty patients (2.16%) had extramucosal microscopic residual disease and 17 (1.22%) had mucosal microscopic residual disease. Seventeen patients received adjuvant radiotherapy after operation, two patients underwent completion pneumonectomy; no chemotherapy was given. Median survival for the whole group was 22 months. The probability of survival was not signi®cantly (P . 0:05) correlated with the type of in®ltration, nor with lymph node disease, neither with histology, although patients with squamous cell carcinoma had a median survival of 30 versus 12 months of patients with adenocarcinoma. The probability of survival could not be correlated with the administration of adjuvant radiotherapy. Conclusions: A frozen-section analysis of the bronchial resection margin and peribronchial tissue should be made in all patients with endobronchial tumour. We suggest that patients with microscopic residual tumour and stage I or II disease should undergo reoperation, if possible. In patients with documented N2 disease we don't recommend re-operation; extending the magnitude of the resection is unlikely to alter their outcome. Choice treatment for these patients is radiotherapy. q
European Surgical Research, 2010
Talc poudrage is considered a safe pleurodesis technique to improve the results of video-assisted... more Talc poudrage is considered a safe pleurodesis technique to improve the results of video-assisted thoracoscopic surgery in cases of primary spontaneous pneumothorax (PSP). We report the case of a patient with left pleural pseudo-nodular plaque and a high metabolic rate upon PET scan suspected for malignancy, occurring 42 years after slurry talc injection for conservative treatment of PSP. The patient presented with coughing, chest pain and weight loss. Thoracotomy was required to obtain a diagnosis and perform a complete pleurectomy. Histology was conclusive for pleural talc granuloma. Indications and possible complications of talc use in young patients with PSP, and the management of possible consequent pleural lesions suspected for malignancy, need to be investigated.
Objective: The aim of this study is a retrospective evaluation of survival in patients who had un... more Objective: The aim of this study is a retrospective evaluation of survival in patients who had undergone lung resection for non-small cell lung cancer and in whose microscopic residual disease at the bronchial resection margin was found, according to the type of in®ltration, histology, lymph node involvement and postoperative treatment. Methods: A total of 1384 patients underwent lung resection for non-small cell lung cancer at the Thoracic Surgery Unit of the University of Siena from 1983 through 1998. All patients underwent complete mediastinal lymphadenectomy and this guaranteed an accurate stadiation. Staging was done according to the TNM and UICC classi®cations. Residual microscopic disease at the bronchial resection margin was divided in mucosal microscopic residual disease and extramucosal microscopic residual disease. Patients dying within 30 days from operation were excluded from survival analyses. Survival was analysed by the product limit method of Kaplan and Meier and curves were compared using the log-rank test. Results: Microscopic residual disease was found postoperatively at the bronchial margin in 3.39% (47/1384) of all patients undergoing lung resection for non-small cell lung cancer. Thirty patients (2.16%) had extramucosal microscopic residual disease and 17 (1.22%) had mucosal microscopic residual disease. Seventeen patients received adjuvant radiotherapy after operation, two patients underwent completion pneumonectomy; no chemotherapy was given. Median survival for the whole group was 22 months. The probability of survival was not signi®cantly (P . 0:05) correlated with the type of in®ltration, nor with lymph node disease, neither with histology, although patients with squamous cell carcinoma had a median survival of 30 versus 12 months of patients with adenocarcinoma. The probability of survival could not be correlated with the administration of adjuvant radiotherapy. Conclusions: A frozen-section analysis of the bronchial resection margin and peribronchial tissue should be made in all patients with endobronchial tumour. We suggest that patients with microscopic residual tumour and stage I or II disease should undergo reoperation, if possible. In patients with documented N2 disease we don't recommend re-operation; extending the magnitude of the resection is unlikely to alter their outcome. Choice treatment for these patients is radiotherapy. q
Journal of Heart and Lung Transplantation, 2004
Lung tumors are the most frequent solid tumor in the heart transplant population. Unfortunately, ... more Lung tumors are the most frequent solid tumor in the heart transplant population. Unfortunately, most of these patients are in an advanced stage of disease at the time of presentation, which carries a poor prognosis. We present a heart transplant patient with histologically proven. Stage IIIA-N2 bronchogenic adenocarcinoma who had complete lymph-node downstaging after induction chemotherapy and underwent a complete tumor resection by right pneumonectomy.
European Journal of Cardio-thoracic Surgery, 2008
The aim of this study is to evaluate the long-term respiratory outcome of patients who underwent ... more The aim of this study is to evaluate the long-term respiratory outcome of patients who underwent pneumonectomy for non-small cell lung cancer (NSCLC), analysing functional tests. Materials and methods: Twenty-seven consecutive patients who were candidates for pneumonectomy performed spirometry before and at least 24 months after surgery in the same laboratory. Diffusion of carbon monoxide and the most common dynamic and static lung volumes were evaluated in percentage of predicted and compared. Results: A significant inverse correlation was observed between the preoperative FEV1 (%) and FVC (%) and their postoperative loss, respectively r = À641 ( p < 0.0001) and r = À789 ( p < 0.0001). Also the correlation between the RV/TLC ratio and the FEV1 loss confirmed a better postoperative outcome in patients with major airway obstruction ( p = 0.02). To investigate these data, the series were divided into two groups: group A included BPCO patients with a FEV1 lower than 80%, the others were considered group B. Group B showed a significant major postoperative FEV1 (%) and FVC (%) impairment, 31% versus 12%, p = 0.005, and FVC (%) loss, 37% versus 16% ( p = 0.02), meanwhile group A showed a significant major postoperative RV (%) reduction, 43% versus 17%, p = 0.03. Despite being significantly higher preoperatively in BPCO patients, the RV% becomes similar between the two groups in the postoperative. Conclusions: In our experience patients with major preoperative airway obstruction who underwent pneumonectomy had lower impairment in FEV1% at almost one year after surgery than those with normal respiratory function. The resection of a certain amount of non-functional parenchyma associated with the mediastinal shift, with an improvement of the chest cavity for the remaining lung, could give a reduction volume effect in BPCO/emphysematous patients. #
The aim of this study is to evaluate the long-term respiratory outcome of patients who underwent ... more The aim of this study is to evaluate the long-term respiratory outcome of patients who underwent pneumonectomy for non-small cell lung cancer (NSCLC), analysing functional tests. Materials and methods: Twenty-seven consecutive patients who were candidates for pneumonectomy performed spirometry before and at least 24 months after surgery in the same laboratory. Diffusion of carbon monoxide and the most common dynamic and static lung volumes were evaluated in percentage of predicted and compared. Results: A significant inverse correlation was observed between the preoperative FEV1 (%) and FVC (%) and their postoperative loss, respectively r = À641 ( p < 0.0001) and r = À789 ( p < 0.0001). Also the correlation between the RV/TLC ratio and the FEV1 loss confirmed a better postoperative outcome in patients with major airway obstruction ( p = 0.02). To investigate these data, the series were divided into two groups: group A included BPCO patients with a FEV1 lower than 80%, the others were considered group B. Group B showed a significant major postoperative FEV1 (%) and FVC (%) impairment, 31% versus 12%, p = 0.005, and FVC (%) loss, 37% versus 16% ( p = 0.02), meanwhile group A showed a significant major postoperative RV (%) reduction, 43% versus 17%, p = 0.03. Despite being significantly higher preoperatively in BPCO patients, the RV% becomes similar between the two groups in the postoperative. Conclusions: In our experience patients with major preoperative airway obstruction who underwent pneumonectomy had lower impairment in FEV1% at almost one year after surgery than those with normal respiratory function. The resection of a certain amount of non-functional parenchyma associated with the mediastinal shift, with an improvement of the chest cavity for the remaining lung, could give a reduction volume effect in BPCO/emphysematous patients. #
To analyze short-and long-term results of surgery in octogenarians, we reviewed data of 96 consec... more To analyze short-and long-term results of surgery in octogenarians, we reviewed data of 96 consecutive patients aged 80 years or more who were operated on for non-smallcell lung carcinoma from 1990 to 2005. Risk factors for complications, perioperative mortality, and long-term survival were assessed by univariate and multivariate analysis. Major complications developed in 17 (17.7%) patients, leading to death in 9 (9.4%) of them. Resection of more than 1 lobe, cardiorespiratory comorbidity, PaO 2 < 75 mm Hg, and CO diffusion capacity <60% were predictive of major complications; extended resection was also predictive of 30-day mortality. The overall 5-year survival rate was 38%, with a significant difference between stage I/II and stage III. In multivariate analysis only pathological stage was related to long-term survival. Surgery is feasible for octogenarians, and even patients in stage II can achieve remarkable survival.
Lung Cancer, 2006
Multimodal management of lung cancer extending to chest wall and type of surgical procedure to be... more Multimodal management of lung cancer extending to chest wall and type of surgical procedure to be performed are still debated. The aim of this retrospective analysis was to analyze the predictive factors of long-term survival after surgery, focusing on depth of infiltration, type of surgical intervention and possible role of preoperative therapies, comparing survival of these patients with that of a group of patients affected by a Pancoast tumour and surgical treated in the same period. We reviewed records of 83 consecutive patients with NSCLC in stage T3 (owing to direct extension to chest wall), who underwent surgical resection in our Thoracic Surgery Unit between January 1994 and December 2003. Patients were classified in two groups: pancoast tumours (PT) or chest wall extending tumours (CW): survival and prognostic factors of each category were analyzed. In the CW group we had 68 patients: 45 were in stage IIB (pT3N0), 23 in stage IIIA (pT3-N1-2). Histology revealed adenocarcinoma in 23 cases, squamous cell carcinoma in 34, large cells anaplastic carcinoma in 8, adenosquamous carcinoma in 3. An involvement of chest wall tissues beyond the endothoracic fascia was found in 21 patients, while in the remaining 47 the invasion of chest wall tissues was confined to the parietal pleura. An extrapleural dissection was performed in 48 patients while combined pulmonary and chest wall en bloc resection was required in 20 patients. Resection was incomplete in three cases. In the PT group we had 15 patients: 11 were in stage IIB and 4 in stage IIIA. Histological type was adenocarcinoma in 10 cases, squamous cell carcinoma in 4 and adenosquamous carcinoma in 1. A univariate analysis performed in the CW group showed that survival was significantly affected by nodal status, stage, extension of chest wall invasion, type of lung resection and residual disease. In a multivariate analysis we found that nodal status, completeness of resection and extension of chest wall involvement maintained a significant prognostic value. There was no difference between the survival curve of CW and PT group: considering the two subset of CW patients, on the basis of depth of infiltration, survival of PT patients was significantly better than that of CW patients with involvement of muscular tissues and ribs (p=0.02). Nodal status, radical resection and depth of chest wall infiltration are the main predictive factors affecting long-term survival, while surgical procedure does not impact on it if margins of resection are free from disease. The better survival observed in PT patients let us to hypothesize that an induction chemo-radiation therapy, as routinely administered to PT patients, could have a potential benefit in survival of patients with CW tumour extending beyond parietal pleura.
International Journal of Neuropsychopharmacology, 2008
International Journal of Neuropsychopharmacology, 2008
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
Critical Care, 2008
all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed... more all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40%
European Journal of Cardio-thoracic Surgery, 1999
Objective: The aim of this study is a retrospective evaluation of survival in patients who had un... more Objective: The aim of this study is a retrospective evaluation of survival in patients who had undergone lung resection for non-small cell lung cancer and in whose microscopic residual disease at the bronchial resection margin was found, according to the type of in®ltration, histology, lymph node involvement and postoperative treatment. Methods: A total of 1384 patients underwent lung resection for non-small cell lung cancer at the Thoracic Surgery Unit of the University of Siena from 1983 through 1998. All patients underwent complete mediastinal lymphadenectomy and this guaranteed an accurate stadiation. Staging was done according to the TNM and UICC classi®cations. Residual microscopic disease at the bronchial resection margin was divided in mucosal microscopic residual disease and extramucosal microscopic residual disease. Patients dying within 30 days from operation were excluded from survival analyses. Survival was analysed by the product limit method of Kaplan and Meier and curves were compared using the log-rank test. Results: Microscopic residual disease was found postoperatively at the bronchial margin in 3.39% (47/1384) of all patients undergoing lung resection for non-small cell lung cancer. Thirty patients (2.16%) had extramucosal microscopic residual disease and 17 (1.22%) had mucosal microscopic residual disease. Seventeen patients received adjuvant radiotherapy after operation, two patients underwent completion pneumonectomy; no chemotherapy was given. Median survival for the whole group was 22 months. The probability of survival was not signi®cantly (P . 0:05) correlated with the type of in®ltration, nor with lymph node disease, neither with histology, although patients with squamous cell carcinoma had a median survival of 30 versus 12 months of patients with adenocarcinoma. The probability of survival could not be correlated with the administration of adjuvant radiotherapy. Conclusions: A frozen-section analysis of the bronchial resection margin and peribronchial tissue should be made in all patients with endobronchial tumour. We suggest that patients with microscopic residual tumour and stage I or II disease should undergo reoperation, if possible. In patients with documented N2 disease we don't recommend re-operation; extending the magnitude of the resection is unlikely to alter their outcome. Choice treatment for these patients is radiotherapy. q
European Surgical Research, 2010
Talc poudrage is considered a safe pleurodesis technique to improve the results of video-assisted... more Talc poudrage is considered a safe pleurodesis technique to improve the results of video-assisted thoracoscopic surgery in cases of primary spontaneous pneumothorax (PSP). We report the case of a patient with left pleural pseudo-nodular plaque and a high metabolic rate upon PET scan suspected for malignancy, occurring 42 years after slurry talc injection for conservative treatment of PSP. The patient presented with coughing, chest pain and weight loss. Thoracotomy was required to obtain a diagnosis and perform a complete pleurectomy. Histology was conclusive for pleural talc granuloma. Indications and possible complications of talc use in young patients with PSP, and the management of possible consequent pleural lesions suspected for malignancy, need to be investigated.
Objective: The aim of this study is a retrospective evaluation of survival in patients who had un... more Objective: The aim of this study is a retrospective evaluation of survival in patients who had undergone lung resection for non-small cell lung cancer and in whose microscopic residual disease at the bronchial resection margin was found, according to the type of in®ltration, histology, lymph node involvement and postoperative treatment. Methods: A total of 1384 patients underwent lung resection for non-small cell lung cancer at the Thoracic Surgery Unit of the University of Siena from 1983 through 1998. All patients underwent complete mediastinal lymphadenectomy and this guaranteed an accurate stadiation. Staging was done according to the TNM and UICC classi®cations. Residual microscopic disease at the bronchial resection margin was divided in mucosal microscopic residual disease and extramucosal microscopic residual disease. Patients dying within 30 days from operation were excluded from survival analyses. Survival was analysed by the product limit method of Kaplan and Meier and curves were compared using the log-rank test. Results: Microscopic residual disease was found postoperatively at the bronchial margin in 3.39% (47/1384) of all patients undergoing lung resection for non-small cell lung cancer. Thirty patients (2.16%) had extramucosal microscopic residual disease and 17 (1.22%) had mucosal microscopic residual disease. Seventeen patients received adjuvant radiotherapy after operation, two patients underwent completion pneumonectomy; no chemotherapy was given. Median survival for the whole group was 22 months. The probability of survival was not signi®cantly (P . 0:05) correlated with the type of in®ltration, nor with lymph node disease, neither with histology, although patients with squamous cell carcinoma had a median survival of 30 versus 12 months of patients with adenocarcinoma. The probability of survival could not be correlated with the administration of adjuvant radiotherapy. Conclusions: A frozen-section analysis of the bronchial resection margin and peribronchial tissue should be made in all patients with endobronchial tumour. We suggest that patients with microscopic residual tumour and stage I or II disease should undergo reoperation, if possible. In patients with documented N2 disease we don't recommend re-operation; extending the magnitude of the resection is unlikely to alter their outcome. Choice treatment for these patients is radiotherapy. q
Journal of Heart and Lung Transplantation, 2004
Lung tumors are the most frequent solid tumor in the heart transplant population. Unfortunately, ... more Lung tumors are the most frequent solid tumor in the heart transplant population. Unfortunately, most of these patients are in an advanced stage of disease at the time of presentation, which carries a poor prognosis. We present a heart transplant patient with histologically proven. Stage IIIA-N2 bronchogenic adenocarcinoma who had complete lymph-node downstaging after induction chemotherapy and underwent a complete tumor resection by right pneumonectomy.