David Rice

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..Preoperative chemotherapy and radiation therapy are often administered to patients with esophageal cancer. Despite an aging population, little data exist regarding feasibility of preoperative therapy in elderly patients...

..The overall effect of SPLC on survival after resection of stage I NSCLC is unknown. Here we report the incidence, management, and outcome of SPLC in a large prospective cohort of patients who underwent careful follow-up...

..To improve local control, we have used intensity-modulated radiation therapy (IMRT) as it allows better dose distribution to regions at risk of recurrence as well as reduced radiation to surrounding organs...

..To determine the incidence of fatal pulmonary events after extrapleural pneumonectomy and hemithoracic intensity-modulated radiotherapy (IMRT) for malignant pleural mesothelioma...

..If cytoreductive surgery does have a beneficial effect on long-term survival, it will most likely be realized in patients with epithelioid tumors without nodal metastases...

..We explored mesothelioma surgeons' concepts of P/D with the aim of unifying surgical nomenclature...

..We evaluated the role of extended surgical staging procedures, which generally includes a combination of laparoscopy, peritoneal lavage, and mediastinoscopy, to more precisely stage patients with MPM...

..The patient underwent surgical repair with polytetrafluoroethylene chest wall reconstruction. Postoperative recovery was complicated by respiratory insufficiency due to underlying pulmonary contusion and multiple rib fractures...

..Recurrent laryngeal nerve palsy is an unusual complication of bronchogenic cysts. This case highlights the need for complete excision of these cysts and the lack of efficacy of cyst aspiration...

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..An uncontained thoracic anastomotic leak may cause severe morbidity or mortality. Thoracic transposition of an omental flap along with the gastric conduit may decrease leak incidence, severity, or need for reoperations after esophagectomy...

..As local control improves, systemic metastases become more common, and it may be appropriate to add novel agents to further improve the therapeutic ratio...

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..Our preliminary data suggest that the proportion of patients with significant pathologic response can be increased by using the three-step strategy...

..Previous reports of salvage esophagectomy in patients with recurrent adenocarcinoma after definitive CRT are limited by small numbers and high morbidity and mortality rates...

..Future investigations should focus on reducing the proportion of residual carcinoma and metastatic disease progression in patients with esophageal carcinoma...

..We aimed to determine the frequency and significance of a close (<1 mm) or involved CRM in patients undergoing esophagectomy after CRT...

..The purpose of this study was to examine the effect of aprotinin on blood loss in extrapleural pneumonectomy and to identify potential treatment-related complications...

..EUS and EUS-guided FNA can be helpful in identifying residual tumor in the lymph nodes after preoperative chemoXRT to select patients who benefit maximally from surgery...

..For this study, the authors explored their institution's large surgical experience to examine the impact of age on long-term patient survival and surgical complications...

..The increased use of preoperative chemoradiation, better preoperative staging, and other time-dependent factors may have contributed to the observed increase in survival...

..Our study confirms that in many cases, final histopathologic typing of MPM is influenced by complete surgical resection and that initial biopsy should be carefully weighed in the treatment stratification...

..Other treatment planning systems are also IMRT-capable. Treatment plans from several systems were compared to determine the feasibility of using IMRT in a multi-institution trial...

..Chemoradiotherapy as primary therapy for patients with Stage I esophageal carcinoma warrants investigation as a means to preserve their esophagus...

..Overall survival and disease-free survival were increased in patients who received CCRT, especially in the subset of patients who had more advanced disease...

..These patients should be stratified in future multimodality trials. The investigation of induction chemotherapy before concurrent chemoradiotherapy might be warranted in this high-risk group of patients...

..We hypothesized that these patients would have similar survival to patients with incomplete response to therapy...

..We therefore reviewed sequential phase II/III trials performed at a single institution to assess the impact of preoperative chemotherapy versus preoperative C/RT strategies...

..Although CT is the modality most often used for follow-up imaging, PET or MR imaging may be helpful in cases in which the CT findings are questionable...

..Recent reports suggest that the number of lymph nodes involved is also an important factor. We reviewed our esophageal experience to propose an improved nodal staging system...

..In this prospective, randomized, placebo-controlled, double-blind trial, the authors investigated whether aprotinin decreased blood loss in patients who underwent this operation...

..It was hypothesized that chemoradiotherapy with fluoropyrimidine, taxane, and camptothecin would have preserved or improved efficacy with no compromise in safety...

..Frequent presence of malignant nodes in the resected specimens of ACA patients resulted in a shorter time-to-metastases suggesting that ACA patients need better systemic control...

..CONCLUSIONS: The results of the current study suggest that the clinical biology of SCC and ACA is different after CTRT. An investigation of molecular and patient genetics is needed to improve therapy...

..To determine the impact of pathologic response following preoperative chemoradiation (CRT) on the AJCC esophageal cancer staging system...

..The C. curvus cases are likely the first reported infections by this organism, and the C. rectus case represents the second such reported extraoral infection...

..Preliminary reports suggest that FDG-PET may be predictive of the response of esophageal carcinoma patients to preoperative CRT...

..The purpose of this study was to identify risk factors associated with the onset of atrial fibrillation after thoracic surgery to allow more targeted interventions in patients with the highest risk...

..We used a single institution experience to validate the hypothesis that the WECC system more accurately predicts survival in GEJA patients than both the American Joint Commission on Cancer 6th edition esophageal and gastric systems...

..Age does not impact on survival rate in patients with acute presentation, and surgery should not be restricted to only younger patients...

..Our results were examined to assess the risks and benefits of such radical therapy...

..We have previously documented a 2-year survival of 54% in patients treated with a multimodality approach. This work builds on our previous experience and examines the long-term outcomes...

..The impact of esophageal tumor length on pT1 esophageal adenocarcinoma has not been well evaluated...

..We evaluate the use of integrated computed tomography-positron emission tomography in patients with malignant pleural mesothelioma who are being considered for extrapleural pneumonectomy...

..The thyroid transcription factor 1 (TITF-1) gene functions as a lineage survival gene abnormally expressed in a significant fraction of non-small cell lung cancers (NSCLC), in particular lung adenocarcinomas...

..Primary cardiac sarcomas are rare tumors carrying poor prognosis. Resection remains the primary therapy. Especially in recent years, chemotherapy and radiation have been used adjunctively...

..To the authors' knowledge the impact of esophageal tumor length on long-term outcome and the esophageal cancer staging system has not been fully evaluated in the current era...

..The mean survival for all patients with sarcoma is 22 months.Cardiac autotransplantation enables complete resection and accurate reconstruction in many primary malignant and complex benign left-heart tumors...

..23-2.04; P < .001) were independent predictors of poor survival. CONCLUSIONS: The use of multimodality therapy appears to contribute to improved outcomes over time in patients with resected stage IIIA (N2) non-small cell lung cancer...

..Functional outcomes are excellent, despite the severity of disease and technical challenges in this patient population...

..Clinical decisions regarding the use of intrathoracic anastomoses should not be affected by concerns of increased mortality from leak...

..We evaluated our experience with this novel technique in intrathoracic anastomoses and compared the outcome with circular-stapled or hand-sewn techniques...

..Although believed to be associated with poor prognosis, its effect on survival and recurrence has not been well defined. Our goal was to determine the prognostic significance of SARC histology in patients undergoing pulmonary resection...

..In this study, we retrospectively compared the outcome of patients treated with wedge resection or three-dimensional (3-D) conformal radiation therapy, the most common treatment modalities used for such high-risk patients...

..Evaluation of swallowing function to identify aspiration is indicated in HNC patients before pulmonary resection to avoid the morbidity and prolonged hospitalization associated with aspiration pneumonia...

..It is unknown if these patients are at higher risk of dying from pulmonary resection due to lymphoma or if they have reasonable long-term survival...

..Cephalad advancement and autotransplantation of the lower lobe were then accomplished. These procedures allowed enough mobilization for direct bronchial and arterial reconstruction...

..We, therefore, reviewed our experience with resection of pulmonary metastases in patients who had documented extrapulmonary metastases to determine long-term outcome...

..Limited locally recurrent esophageal carcinoma is rare, and little is known regarding effectiveness of re-resection...

..The dissection itself can be somewhat tedious, but it became easier with experience, making this an excellent training model for learning proper technique in the elevation of any true perforator flap...

..102). The clinical implication is that arterial division is critical for TRAM flap delay and that arbitrary venous interruption is unnecessary...

..Venous supercharging can be accomplished by inclusion of the ipsilateral dominant deep vein, and should be a consideration in the clinical planning of delay maneuvers and for treatment of the compromised TRAM flap...

..These findings corroborate the clinical observation that only a unilateral TRAM flap would be reliable in the presence of a vertical midline abdominal scar...

..On an empiric basis, their salvage has been accomplished by augmenting venous drainage through alternative outflow tracts. The validity of this clinical maneuver can now best be tested in a rat DIEP flap model...

..This would allow the other vascular system to be retained intact for later potential salvage maneuvers as needed...

..183). In summary, relative flow to these rat ventral abdomen models was directly proportional to the number of retained musculocutaneous perforators, but a single perforator only could routinely allow near-total survival...