Thoracic and Cardiovascular Surgeon最新文献

{"title":"Hypothermic Circulatory Arrest and Early Outcomes in Open Distal Aortic Repair.","authors":"Sedat Karaca, Anil Ziya Apaydin, Dilek Erdinli, Ahmet Daylan, Kapkin Aysen Yaprak, Emrah Oguz, Hakan Posacioglu","doi":"10.1055/a-2955-1902","DOIUrl":"https://doi.org/10.1055/a-2955-1902","url":null,"abstract":"<p><strong>Objectives: </strong>The optimal perfusion strategy for open repair of descending and thoracoabdominal aortic pathologies remains controversial. Although hypothermic circulatory arrest (HCA) is established in arch surgery, concerns about neurologic and systemic complications limit its use. This study aimed to evaluate whether HCA adversely affects early outcomes in distal aortic repair.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 90 patients who underwent open repair of descending and thoracoabdominal aortic pathologies between January 2005 and June 2024. Patients were grouped by perfusion strategy as HCA (<i>n</i> = 35) or non-HCA (<i>n</i> = 55). Preoperative, intraoperative, and postoperative variables were compared for 30-day mortality and major postoperative morbidity, including neurological, cardiac, renal, respiratory, and infectious complications. Incremental mortality risk factors were assessed using univariate analysis only.</p><p><strong>Results: </strong>Thirty-day mortality did not differ significantly between the HCA and non-HCA groups (11.4% vs. 7.3%, <i>p</i> = 0.387). Transient cerebral neurologic dysfunction was more frequent in the HCA group (11.4% vs. 0%, <i>p</i> = 0.003), whereas permanent neurologic injury was infrequent. Renal, respiratory, infectious, and cardiac complications were not statistically different between groups. Intensive care unit (ICU) and hospital stay were similar, while postoperative packed red blood cell (PRBC) transfusion requirements were higher in the HCA group (<i>p</i> = 0.016). In univariate analysis, early mortality was associated with urgent/emergent surgery, postoperative cardiac complications, and higher PRBC transfusion requirements.</p><p><strong>Conclusion: </strong>In this single-center, retrospective experience, HCA was used mainly in anatomically challenging distal aortic repairs requiring proximal control. Although the study does not establish equivalence or superiority between perfusion strategies, HCA remains an important surgical adjunct when safe proximal clamping or distal perfusion is not feasible.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"German Heart Surgery Report 2025: The Annual Updated Registry of the German Society for Thoracic and Cardiovascular Surgery.","authors":"Andreas Beckmann, Renate Meyer, Inge König, Jan Gummert, Torsten Doenst","doi":"10.1055/a-2939-3829","DOIUrl":"https://doi.org/10.1055/a-2939-3829","url":null,"abstract":"<p><strong>Abstract: </strong>Based on a voluntary registry, founded by the German Society for Thoracic and Cardiovascular Surgery (DGTHG) in 1980, well-defined but limited datasets of all cardiac and vascular surgery procedures performed in 78 German heart surgery departments are reported annually. For the year 2025, nearly all departments submitted a total of 181,988 procedures to the registry. Of these operations, 107,546 are defined as heart surgery procedures in a classical sense. The unadjusted in-hospital survival rate for the 29,267 isolated coronary artery bypass grafting (CABG) procedures (relationship on-/off-pump 2.4:1) was 97.7%, 97.4% for the 48,167 isolated heart valve procedures (26,896 transcatheter interventions included) and 99.3% for 19,528 pacemaker/implantable cardioverter defibrillator (ICD) procedures, respectively. Concerning short- and long-term mechanical circulatory support, a total of 3,109 ECLS/ECMO implantations and 867 ventricular assist device implantations (L-/R-/BVAD, TAH) were reported. In 2025, 358 isolated heart transplantations, 310 isolated lung transplantations, and 6 combined heart-lung transplantations were performed. This annually updated registry of the DGTHG represents non-risk adjusted voluntary public reporting, encompassing actual data for nearly all heart surgical procedures in Germany, indicating trends in heart medicine, and representing a basis for quality management (e.g., benchmark) for all participating institutions.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recoarctation after Neonatal Hypoplastic Aortic Arch Repair: Impact of Patch Material.","authors":"Thibault Schaeffer, Marina Huhnke, Doris Kienmoser, Maria von Stumm, Paul Philipp Heinisch, Masamichi Ono, Cordula Wolf, Jürgen Hörer, Julie Cleuziou","doi":"10.1055/a-2942-3381","DOIUrl":"10.1055/a-2942-3381","url":null,"abstract":"<p><strong>Background: </strong>Recoarctation remains a frequent complication after neonatal aortic arch repair. This study aimed to identify risk factors for recoarctation, with particular emphasis on the patch material used for aortic enlargement.</p><p><strong>Methods: </strong>All neonates who underwent aortic arch repair with patch augmentation through median sternotomy at our institution between 2000 and 2024 were reviewed retrospectively. The primary endpoint was recoarctation, defined as any catheter-based or surgical reintervention on the reconstructed distal aortic arch. Risk factors were assessed using multivariable cause-specific Cox regression, and cumulative incidences of recoarctation and death were estimated using competing-risk methods.</p><p><strong>Results: </strong>A total of 597 patients were included (38% female; 61% with single-ventricle physiology; median age and weight at surgery, 8 days and 3.2 kg, respectively). The cumulative incidence of recoarctation was 23% at 1 year. Smaller preoperative aortic arch dimensions (cause-specific hazard ratio [csHR], 0.84 per mm; 95% confidence interval [CI], 0.73-0.97), younger age at surgery (csHR, 0.96 per day; 95% CI, 0.93-0.99), and patch material were independently associated with recoarctation. Compared with glutaraldehyde-fixed autologous pericardium, bovine pericardium (csHR, 2.94; 95% CI, 2.01-4.65) and equine pericardium (csHR, 2.18; 95% CI, 1.36-3.24) were associated with higher recoarctation risk, whereas cryopreserved pulmonary homograft was associated with lower risk (csHR, 0.27; 95% CI, 0.16-0.48).</p><p><strong>Conclusion: </strong>Cryopreserved pulmonary homograft and glutaraldehyde-fixed autologous pericardium were associated with a lower incidence of recoarctation and should therefore be preferred over xenograft patches for neonatal aortic arch repair.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Cystatin C Predicts Postsurgical Acute Kidney Injury in Aortic Dissection.","authors":"Qu-Bo Huang, Jia-Xin Zhang, Li-Wen Wang, Zeng-Rong Luo","doi":"10.1055/a-2945-9260","DOIUrl":"https://doi.org/10.1055/a-2945-9260","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND:  Studies reported a strong relationship between cystatin C and postsurgical acute kidney injury (AKI) following cardiac surgery. This study aims to establish the above relationship in acute type A aortic dissection (ATAAD) patients.</p><p><strong>Abstract: </strong>METHODS:  ATAAD patients receiving hemiarch replacement in combination with modified triple-branched stent-graft (MTBSG) implantation were recruited. The relationship between cystatin C and AKI, as well as in-hospital mortality, was analyzed.</p><p><strong>Abstract: </strong>RESULTS:  About 459 patients were enrolled. A total of 223 (48.6%) exhibited AKI and 71 (15.5%) exhibited severe AKI. AKI patients displayed elevated perioperative cystatin C levels. Upon adjustment of known AKI hazards, the logarithmically transformed presurgical cystatin C (odds ratio = 1.66 [95% confidence interval, 1.20-2.30], <i>p</i> = 0.010), postsurgical day 1 cystatin C (odds ratio = 2.61 [95% confidence interval, 1.70-4.13], <i>p</i> = 0.002), postsurgical day 2 cystatin C (odds ratio = 3.01 [95% confidence interval, 2.22-4.07], <i>p</i> = 0.001), and postsurgical day 3 cystatin C (odds ratio = 2.89 [95% confidence interval, 1.99-3.86], <i>p</i> = 0.009) were intricately linked to severe AKI. Moreover, these relationships remained even after adjusting for filtration reduction via alterations in serum creatinine (Δcreatinine) and urea nitrogen (Δurea nitrogen). Relative to the clinical model, cystatin C enhanced the risk discrimination and restratification of AKI.</p><p><strong>Abstract: </strong>CONCLUSION:  For ATAAD patients, cystatin C greatly enhanced postsurgical AKI risk stratification. When dynamic cystatin C levels indicate a high risk of severe AKI, more aggressive monitoring should be performed to assess whether more intensive stent intervention is warranted to improve renal artery perfusion.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-Port Robotic Thoracic Surgery via Intercostal Approach: First Series from Turkey.","authors":"Serhan Tanju, Kadir B Özer, Özgür Güzey, Ezgi Cesur, Suat Erus, Şükrü Dilege","doi":"10.1055/a-2948-5012","DOIUrl":"https://doi.org/10.1055/a-2948-5012","url":null,"abstract":"<p><strong>Background: </strong>Single-port (SP) robotic platforms aim to reduce surgical trauma by allowing all instruments through a single incision. In thoracic surgery, SP experience has been reported mainly via subxiphoid or subcostal routes, whereas the intercostal approach and heterogeneous case series remain scarce. We report an initial technical feasibility experience with intercostal SP robotic thoracic surgery, the first reported from Turkey.</p><p><strong>Methods: </strong>This single-center retrospective review included the first 10 consecutive patients who underwent thoracic surgery with the da Vinci SP Surgical System via a standardized intercostal approach (single 2-4 cm incision at the midaxillary line, approximately the sixth intercostal space; March 13-April 28, 2026). Procedures comprised anatomic and wedge lung resections, esophageal surgery, and mediastinal/paraesophageal mass excision. This is presented as an initial technical experience rather than a comparative outcomes study; the primary endpoint was technical feasibility.</p><p><strong>Results: </strong>Ten patients (seven women and three men; mean age: 57 years, range: 44-68) underwent pulmonary resection (<i>n</i> = 5), esophageal surgery (<i>n</i> = 3), and mediastinal/paraesophageal mass excision (<i>n</i> = 2). All procedures were completed through a single intercostal incision, with no additional incision, no conversion, and no instrument clash. Mean operative time was 48.6 minutes (pulmonary/mediastinal) and 67 minutes (thoracic phase and esophageal); mean docking time was 4.4 minutes. Mean blood loss was 68 ± 32 mL, mean chest tube duration was 2.2 ± 1.3 days, and mean length of stay was 2.8 ± 1.4 days. Four patients underwent synchronous SP abdominal procedures. No complications, reinterventions, or 30-day mortality occurred.</p><p><strong>Conclusion: </strong>In this small, highly selected initial series performed by an experienced team, intercostal SP robotic thoracic surgery appeared technically feasible across a range of thoracic procedures. Given the limited sample size and retrospective design, these findings should be regarded as hypothesis-generating; larger prospective studies are needed before conclusions regarding safety or comparative outcomes can be drawn.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Surgery 2025 Reviewed.","authors":"Hristo Kirov, Tulio Caldonazo, Murat Mukharyamov, Angelique Runkel, Philine Fleckenstein, Sebastian Freiburger, Thierry Siemeni, Torsten Doenst","doi":"10.1055/a-2835-1473","DOIUrl":"10.1055/a-2835-1473","url":null,"abstract":"<p><strong>Abstract: </strong>For the 12th consecutive time, we systematically reviewed the cardio-surgical literature for the past year, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach for a results-oriented summary. In 2025, the discussion on the value of randomized and observational evidence continued, showing converging results in the treatment of coronary artery disease and further diverging results in the field of invasive aortic valve therapies. Across randomized trials, meta-analyses, and registries, coronary artery bypass grafting (CABG) consistently provides superior long-term outcomes compared with percutaneous coronary intervention in complex coronary artery disease, driven primarily by sustained reductions in future myocardial infarctions. In addition, atrial fibrillation after CABG was shown to be more frequent than expected, but its long-term burden was negligible, while prolonged dual antiplatelet therapy after CABG for acute coronary syndrome offered no benefit but increased bleeding risk. The \"valve treatment arena\" in 2025 was heavily affected by the new guidelines, which clarified many aspects in mitral and tricuspid valve treatment but generated great controversy for aortic stenosis treatment. The latter was based on a reduction of the age cut-off for transcatheter aortic valve implantation to 70 years (unsupported by new data) and the selective reliance on only randomized studies (despite contradictory risk-adjusted registry evidence). Across mitral and tricuspid valve disease, publications showed improvements in symptoms and quality of life without survival benefits with transcatheter therapies and the most consistent long-term outcomes with surgery, particularly when appropriately timed and performed in experienced centers. This article summarizes publications perceived as important by us. It cannot be complete nor free of individual interpretation, but it provides up-to-date information for patient-specific decision-making.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"433-444"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Preoperative Positron Emission Tomography - Computed Tomography for Mediastinal Lymph Node Staging in Non-Small Cell Lung Cancer.","authors":"Sarah Häufglöckner, Peter Kleine, André Althoff, Neelam Lingwal","doi":"10.1055/a-2855-2535","DOIUrl":"10.1055/a-2855-2535","url":null,"abstract":"<p><strong>Background: </strong>Accurate mediastinal lymph node staging is essential in non-small cell lung cancer (NSCLC) treatment. While 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is widely used for noninvasive staging, its diagnostic reliability, particularly for nodal assessment, remains debated.</p><p><strong>Methods: </strong>A retrospective multicenter analysis included 278 patients with histologically confirmed NSCLC who underwent FDG-PET/CT followed by surgery with systematic lymphadenectomy between 2015 and 2021. PET/CT-based nodal staging was compared with histopathology. Diagnostic performance was evaluated using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), and Cohen's κ. Logistic regression was performed to identify predictors of correct N staging. Patients receiving neoadjuvant therapy were excluded from subgroup analyses (<i>n</i> = 252).</p><p><strong>Results: </strong>Histopathology revealed nodal metastases in 112 patients (40.3%). PET/CT detected nodal involvement with sensitivity of 66.8% and specificity of 85.2%. PPV was 50.7% and NPV 85.5%, with an overall concordance of 43.3%. Sensitivity for N1 disease was 38.2%, whereas N2 and N3 metastases were detected with sensitivities of 55.3% and 100.0%. The false-negative rate was 25.2%, with intrapulmonary nodes (station 11) most frequently missed. False-positive findings occurred in 20.1%, predominantly in hilar nodes. Multivariable analysis identified lymph node involvement and tumor stage as independent predictors of staging accuracy, whereas extracapsular extension showed a non-significant trend.</p><p><strong>Conclusion: </strong>FDG-PET/CT demonstrates high specificity and NPV but limited sensitivity for mediastinal nodal staging in NSCLC under real-world conditions. These findings are primarily driven by disease characteristics rather than methodological factors. A multimodal approach remains essential, with histopathological confirmation of PET-positive findings and selective invasive staging in PET-negative patients to ensure accurate treatment allocation.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"510-517"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitral Valve Procedures and Multivessel CABG through a Single Left Anterior Minithoracotomy.","authors":"Volodymyr Demianenko, Hilmar Dörge, Markus Schlömicher, Marius Grossmann, Ahmed Belmenai, Christian Sellin","doi":"10.1055/a-2765-7072","DOIUrl":"10.1055/a-2765-7072","url":null,"abstract":"<p><strong>Abstract: </strong>We describe a technique for concomitant coronary artery bypass grafting (CABG) and mitral valve (MV) replacement or annuloplasty with ring implantation performed through a single left anterior minithoracotomy (LAmT). Four patients underwent combined MV and CABG surgery using peripheral cardiopulmonary bypass, a transseptal approach to the MV, and complete coronary revascularization. MV exposure was successfully achieved in all cases without conversion to sternotomy. No major complications such as stroke, reoperation for bleeding, or early mortality occurred. Our initial results demonstrate that single LAmT is a feasible sternum-sparing approach for patients requiring simultaneous coronary and mitral procedures.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"500-502"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Gaps in Cardiothoracic Surgery: Are Patient Outcomes Shaped by Workforce Inequity?","authors":"Khaled Ebrahim Al-Ebrahim","doi":"10.1055/a-2867-5247","DOIUrl":"10.1055/a-2867-5247","url":null,"abstract":"<p><strong>Background: </strong>Gender disparities persist across cardiac and thoracic surgical care, influencing access, procedural selection, perioperative risk, and long-term outcomes. Despite major advances in operative technique and perioperative pathways, women continue to experience delayed diagnosis, lower procedural referral rates, and distinct complication profiles after high-risk procedures, including coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), surgical aortic valve replacement (SAVR), transcatheter aortic valve replacement (TAVR), and transcatheter edge-to-edge repair (TEER). These patient-level disparities parallel persistent inequities within the cardiothoracic surgery workforce, raising the possibility that structural workforce imbalances may influence clinical outcomes.</p><p><strong>Objective: </strong>This study aimed to synthesize contemporary evidence (2020-2025) characterizing sex- and gender-based disparities across cardiac and thoracic surgery, identify interconnected root causes, and outline strategies and research priorities for reducing inequities.</p><p><strong>Methods: </strong>A narrative review (2020-2025) combined structured database searches of trials and registries with synthesis of mechanistic and health-system literature to interpret heterogeneous evidence.</p><p><strong>Results: </strong>Women undergoing cardiothoracic procedures often present at older age with greater frailty, smaller anatomical dimensions, and more atypical symptoms, increasing procedural complexity and perioperative risk. CABG and SAVR show higher early morbidity in women, while PCI disparities have narrowed but persist due to delayed recognition; TAVR demonstrates higher early complications yet better mid- and long-term survival. In thoracic surgery, women generally have lower perioperative mortality, but experience delayed diagnosis, lower screening rates, and reduced use of minimally invasive approaches. These outcome differences occur alongside persistent workforce inequities, including the underrepresentation of women in surgical practice, leadership, and academia.</p><p><strong>Conclusion: </strong>Gender disparities in cardiac and thoracic surgery are multifactorial and closely intertwined with systemic workforce inequities. Solutions require sex-aware risk assessment, equitable referral pathways, inclusive device development, mandated sex-stratified reporting, and targeted workforce reforms. Addressing both patient-level and structural contributors is essential to achieve durable gender equity in cardiothoracic surgical care.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"445-449"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147933674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Differences Among T3 Descriptor Subgroups in Resected Lung Cancer.","authors":"Canberk Heskiloğlu, Necati Citak, Serkan Yazgan, Ahmet Üçvet, Kenan C Ceylan","doi":"10.1055/a-2722-4702","DOIUrl":"10.1055/a-2722-4702","url":null,"abstract":"<p><strong>Objective: </strong>Prognostic heterogeneity may exist among T3 nonsmall cell lung cancers depending on specific T3 descriptors. Our study aimed to evaluate the survival differences among T3 subgroups in patients with resected lung cancer.</p><p><strong>Methods: </strong>This retrospective cohort study included 381 patients with pathologically confirmed (p)T3N0/1 nonsmall cell lung cancer. Patients with mediastinal lymph node metastases or superior sulcus tumors were excluded. Patients were classified into three subgroups; the T3-ordinary group (only tumor diameter >5 cm but ≤7 cm, or only an additional tumor nodule in the same lobe as the primary tumor, <i>n</i> = 246), the T3-invasion group (the primary tumor directly invades any of the structures; only the phernic nerve, pericardium, parietal pleura or the chest wall, <i>n</i> = 57), and the T3-multiple group (the tumor had at least two T3 descriptors, <i>n</i> = 78).</p><p><strong>Results: </strong>The 5-year overall survival rate was 52% (median survival time: 63 months; 95% CI: 53-72 months). A significant difference was observed between the three groups in terms of median survival time (T3-ordinary, 70 months; T3-invasion, 58 months; T3-multiple, 43 months; chi-square = 5.86, <i>p</i> = 0.04-log rank). Moreover, the 5-year survival rate was significantly higher in the T3 single group than in the T3 multiple group (54.5% vs. 40.4%, <i>p</i> = 0.03). Multivariate analysis showed that lymph node status (<i>p</i> = 0.007), adjuvant treatment (<i>p</i> < 0.001), major surgical complications (<i>p</i> < 0.001), and T3-subgroups (<i>p</i> = 0.02) were independent prognostic factors.</p><p><strong>Conclusion: </strong>Patients with two or more pT3 descriptors or tumors exhibiting invasion have the worst survival rates. Stage migration can be discussed in these patients.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"503-509"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}