The Society of Thoracic Surgeons 2024 Member Practice Survey.

Background: The Society of Thoracic Surgeons (STS) has conducted a practice survey every five years since 1974 to guide decision-making and resource allocation.

Methods: The 2024 Practice Survey, conducted online between January 25 to March 14, 2024, included a 72-question survey distributed to 4,692 active STS members from the Senior, Surgeon, and Resident/Fellow member categories. A total of 1,027 responses (22%) were received and interpreted.

Minimally Invasive Total Versus Partial Thymectomy for Early-Stage Thymoma.

: Total thymectomy is currently the gold standard operation for treating thymoma. However, recent studies have suggested the potential health consequences of thymus removal in adults, including possible increased autoimmune disease and all-cause mortality. In this context, we assess oncologic outcomes following total vs.

Cost-Effectiveness of Adjuvant Osimertinib With and Without Chemotherapy for Surgically Resected NSCLC.

Introduction: Osimertinib is now approved as adjuvant therapy for stage IB to III NSCLC with mutations. Nevertheless, this treatment is lengthy and expensive. Its cost-effectiveness profile as monotherapy versus combination with chemotherapy is unknown.

Are Access Costs and Income Associated With Treatment Decision-Making and Clinical Outcomes in Rural Patients Presenting With Upper Gastrointestinal Malignancy?

Background And Objective(s): Few studies evaluate the price elasticity of demand or the relationships between costs of access, patient income, treatment decision making and outcome in rural patients with upper gastrointestinal malignancy.

Methods: We queried the National Cancer Database to identify rural patients presenting with clinical stages I-III esophagus, stomach, pancreas, hepatocellular (HCC) and cholangiocarcinoma between 2004 and 2020. Access cost was defined as (distance to treating center) × (regional gas price)/(regional vehicle fuel efficiency).

Robotic resection of a bronchogenic cyst.

We present the case of the robotic resection of a bronchogenic cyst in a 25-year-old man. The mass, which was 3.5 x 2.

Robotic resection of a mediastinal liposarcoma.

A 76-year-old man presented with new onset atrial fibrillation. During his workup, he underwent a computed tomography angiogram of his coronary arteries that revealed multivessel disease and an incidental heterogeneous fat and complex fluid density in the posterior aortopulmonary window space. The mass was further characterized with the use of magnetic resonance imaging and a dedicated computed tomography scan of the chest showing a complex fat-containing tumour most consistent with either an atypical lipomatous tumour or a well-differentiated liposarcoma.

Implementation and Validation of Decision-Aid Tool to Reduce Unnecessary Testing Before Thoracic Surgery.

Background: The aim of this study was to implement and prospectively validate a previously published decision-aid tool to guide ordering of preoperative type and screen (preT&S) tests.

Study Design: In this interrupted time-series quasi-experimental study, we implemented a decision-aid tool for patients undergoing elective thoracic surgery at a single academic institution. Data were collected 6 months before and prospectively after implementation.

Lung resection from wedge to pneumonectomy as surgical options for pulmonary mucormycosis.

Pulmonary mucormycosis (PM) is a rare and life-threatening condition, most prevalent in immunocompromised patients. Early signs and symptoms are often nonspecific. A high index of suspicion in at risk patients should prompt early infectious work-up, including bronchoscopy, followed by aggressive antifungal therapy and early surgical resection when indicated.

En bloc chest wall resection in locally advanced cT3N2 (stage IIIB) lung cancer involving the chest wall: Revisiting guidelines.

Objectives: Current National Comprehensive Cancer Network guidelines recommend definitive chemoradiation rather than surgery for patients with locally advanced clinical stage T3 and N2 (stage IIIB) lung cancer involving the chest wall. The data supporting this recommendation are controversial. We studied whether surgery confers a survival advantage over definitive chemoradiation in the National Cancer Database.

Tackling complex thoracic surgical operations with robotic solutions: a narrative review.

Background And Objective: The adoption of robotic surgery for general thoracic surgery has rapidly progressed over the last two decades from its application in basic operations to complex pathologies. As such, the purpose of this narrative review is to highlight the collective experience of tackling complex thoracic surgical operations with minimally invasive robotic solutions.

Methods: Electronic searches of PubMed were conducted for each subtopic, using specific keywords and inclusion criteria.

Does commission on cancer (CoC) accreditation mitigate the effect of care fragmentation on clinical outcome in localized rectal cancer?

Background: Studies of fragmented care (FC) in rectal cancer have not adjusted for indicators of hospital quality and may misrepresent the effects of FC.

Methods: We queried the National Cancer Database to identify patients undergoing care for clinical stage II and III rectal adenocarcinoma between 2006 and 2019. Those undergoing FC were sub-categorized based on whether (FC CoC) or not (FC non-CoC) they received systemic therapy at CoC accredited facilities.

Robotic chest wall resection for primary benign chest wall tumors and locally advanced lung cancer: an institutional case series and national report.

Background: Limited data exists for robotic chest wall resection; we report institutional and national experience of robotic chest wall resection.

Methods: In this comparative retrospective case series we describe patients who underwent robotic chest wall resection at our institution and enrich this case series with data from the National Cancer Database (NCDB). We describe our preoperative workup, operative technique, and postoperative care.

Fragmented care in localized pancreatic cancer: Is commission on cancer accreditation associated with improved overall survival?

Background: Prior studies of fragmentation of care in pancreatic cancer have not adjusted for indicators of hospital quality such as Commission on Cancer accreditation. The effect of fragmentation of care has not been well defined.

Methods: We queried the National Cancer Database to identify patients undergoing pancreaticoduodenectomy and distal pancreatectomy with perioperative systemic therapy for clinical stages I-III pancreatic cancer between 2006 and 2019.

Fragmented care, Commission on Cancer accreditation, and overall survival in patients receiving surgery and chemotherapy for esophageal cancer.

Background: Increasing regionalization for esophagectomy for cancer may lead patients to travel for surgery at one institution and receive chemotherapy at another closer to home. We explore the effects on survival for care fragmentation, the Commission on Cancer status of secondary institutions providing chemotherapy, and the type of institution performing surgery.

Methods: We queried the National Cancer Database to identify all patients who underwent esophagectomy for esophageal cancer and received perioperative chemotherapy between 2006 and 2019.

Prognosis of Unresected vs Resected Small Pulmonary Carcinoid Tumors.

Background: Previous studies have shown that overall survival after lung resection for pulmonary carcinoid tumors is favorable. It is unclear what the prognosis is for observation rather than resection for small carcinoid tumors.

Methods: We queried the National Cancer Database to identify patients presenting with primary pulmonary carcinoid tumors between 2004 and 2017.

Answer to January 2023 Photo Quiz.

Read the full article for the answer.

Use of a national registry to define a composite quality metric for rectal cancer.

Background: Quality assessment in oncologic surgery has traditionally involved reporting discrete metrics that may be difficult for patients and referring providers to interpret. We define a composite quality metric (CQM) for resection in rectal cancer.

Methods: We queried the National Cancer Database to identify patients undergoing low anterior resection for clinical stage II-III rectal adenocarcinoma between 2010 and 2017.

Impact of Federal Lung Cancer Screening Policy on the Incidence of Early-stage Lung Cancer.

Background: In December 2013 the US Preventative Services Task Force (USPSTF) recommended annual lung cancer screening for high-risk patients. The Centers for Medicare & Medicaid Services (CMS) later announced coverage in 2015. The impact of these federal decisions at the population level is unknown.

Increased social media utilization and content creation by cardiothoracic surgery programs during the coronavirus disease 2019 pandemic.

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has changed the landscape of professional activities, emphasizing virtual meetings and social media (SoMe) presence. Whether cardiothoracic programs increased their SoMe presence is unknown. We examined SoMe use and content creation by cardiothoracic surgery programs during the COVID-19 pandemic.

Comparative effectiveness of stereotactic body radiation therapy versus surgery for stage I lung cancer in otherwise healthy patients: An instrumental variable analysis.

Objectives: Stereotactic body radiation therapy (SBRT) is an established primary treatment modality in patients with lung cancer who have multiple comorbidities and/or advanced-stage disease. However, its role in otherwise healthy patients with stage I lung cancer is unclear. In this context, we compared the effectiveness of SBRT versus surgery on overall survival using a national database.

Inflammatory cytokines in robot-assisted thoracic surgery versus video-assisted thoracic surgery.

Background: Cytokines play a crucial role in the inflammatory response and are essential modulators of injury repair mechanisms. While minimally invasive operations have been shown to induce lower levels of cytokines compared to open thoracotomy, the inflammatory cytokine profile difference between video-assisted (VATS) and robotic-assisted thoracic surgery (RATS) techniques has yet to be elucidated.

Methods: In this prospective observational study of 45 patients undergoing RATS (n=30) or VATS (n=15) lung resection for malignancy, plasma levels of interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, vascular endothelial growth factor (VEGF), interferon (IFN)-γ, tumor necrosis factor (TNF)-α, monocyte chemo-attractant protein (MCP)-1, and endothelial growth factor (EGF) were measured before and after surgery via immunoassay.