Nomogram prediction of overall survival for patients with non-small-cell lung cancer incorporating pretreatment peripheral blood markers.

Objectives: The objective of this study is to build a novel prognostic nomogram in non-small-cell lung cancer (NSCLC) incorporating pre-treatment peripheral blood markers beyond known pathoclinical predictors.

Methods: We analysed 7158 patients with NSCLC diagnosed between 1 January 1997 and 31 December 2012 from a single institution with a uniform medical record and routine follow-up information. Besides common clinicopathological factors, we investigated the prognostic value of the neutrophil to lymphocyte ratio, monocytes and haemoglobin level in peripheral blood before treatment.

Using an Electronic Perioperative Documentation Tool to Identify Returns to Operating Room (ROR) in a Tertiary Care Academic Medical Center.

Background: The metric "Unplanned returns to operating room (ROR)" is being tracked in surgical quality dashboards; 70% of unplanned RORs may be related to surgical complications. With increasing regionalization of trauma and complex surgical care at tertiary care academic centers, it is unclear if a simple ROR metric is a valid assessment of surgical quality at such centers.

Method: A real-time electronic tool was used to identify all RORs-planned and unplanned-in a high-volume, high-complexity academic surgical practice at Mayo Clinic-Rochester within 45 days of the index operation.

Pulmonary Artery Agenesis Associated With Emphysema and Multiple Invasive Non-Small Cell Lung Cancers.

Pulmonary artery (PA) agenesis in the absence of associated cardiac abnormalities is a rare congenital abnormality. It may remain undiagnosed until adulthood when patients present with respiratory symptoms such as hemoptysis, dyspnea, repeated respiratory infections, or pulmonary hypertension. Herein we present a case of a 50-year-old woman who was found to have multiple, morphologically distinct non-small cell lung cancers in association with agenesis of the PA.

Bilobectomy Versus Lobectomy for Non-Small Cell Lung Cancer: A Comparative Study of Outcomes, Long-Term Survival, and Quality of Life.

Background: We aimed to compare long-term survival and quality of life (QOL) outcomes after bilobectomy and lobectomy for non-small cell lung cancer patients.

Methods: A cohort of 951 consecutive patients was identified from a single treatment institution, of whom 128 underwent bilobectomy and 823, lobectomy. Propensity score matching (1:3) was applied to balance known confounders between the two surgical groups and resulted in 512 patients (matched cohort).

External validation of the Ferguson pulmonary risk score for predicting major pulmonary complications after oesophagectomy†.

Objectives: Pulmonary complications remain a frequent cause of morbidity in patients undergoing oesophagectomy. Risk screening tools assist in patient stratification. Ferguson proposed a risk score system to predict major pulmonary complications after oesophagectomy.

A meta-analysis of the impact of bronchial stump coverage on the risk of bronchopleural fistula after pneumonectomy.

The occurrence of bronchopleural fistula (BPF) after pneumonectomy is associated with high morbidity and mortality. The incidence of BPF in historical patients not subjected to bronchial stump coverage (BSC) was between 6 and 12% after pneumonectomy for lung cancer surgery or benign disease. BSC is considered an important prophylactic measure against BPF and is widely used, but its efficacy remains unknown.

Do the number and volume of surgical lung biopsies influence the diagnostic yield in interstitial lung disease? A propensity score analysis.

Introduction: Our objective was to evaluate whether the number and volume of surgical lung biopsies (SLB) influence the diagnosis of diffuse interstitial lung disease (ILD).

Methods: Retrospective study of SLB for suspected ILD in patients from the Mayo Clinic from January 2002 to January 2010. Data were collected in the institution and analyzed.

Laparoscopic repair for failed antireflux procedures.

Background: Minimally invasive procedures have become common, and more reoperations for failed antireflux procedures are performed laparoscopically. We wanted to study the outcomes of laparoscopic reoperations for reflux.

Methods: Medical records of all patients who underwent reoperation without esophageal resection after previous antireflux procedures between January 2000 and October 2012 were reviewed.

The prognosis of pulmonary metastasectomy depends on the location of the primary colorectal cancer.

Background: Rectal cancer has a higher risk of developing lung metastasis compared with colon cancer. It is unclear whether the prognosis after pulmonary metastasectomy for these distinct tumors is different.

Methods: Patients who underwent pulmonary metastasectomy for colorectal carcinoma were analyzed for survival and patterns of recurrence depending on the location of the primary colorectal cancer.

Prior thoracoscopic surgery may improve reoperative pulmonary resection.

Objectives: although video-assisted thoracoscopic surgery for pulmonary resection appears to be associated with more favorable postoperative outcomes than thoracotomy, no reports have discussed its benefit at subsequent reoperative pulmonary resection.

Methods: between January 2000 and December 2009, 144 patients underwent reoperative pulmonary resections for benign and malignant nodules at the Mayo Clinic, Rochester. Their data were evaluated retrospectively.

Outcomes in patients requiring mechanical ventilation following pneumonectomy.

Objectives: The aim of this study was to clarify the outcomes of patients who require post-pneumonectomy mechanical ventilation (PPMV).

Methods: The medical records of all 548 patients who underwent pneumonectomy between January 1994 and December 2009 were reviewed. PPMV was defined as mechanical ventilation via an endotracheal tube following thoracotomy (continued PPMV) or reintubated and started within 30 days of the pneumonectomy (reintubated PPMV) and continued for longer than 24 h.

Primary and prosthetic repair of acquired chest wall hernias: a 20-year experience.

Background: Chest wall herniation has been described after thoracotomy, trauma, and violent coughing episodes. Few studies have examined risk factors associated with chest wall herniation or predictors of complications after surgical repair.

Methods: A divisional database identified all patients who underwent chest wall herniorrhaphy between 1992 and 2011.

Clinical outcomes and changes in lung function after segmentectomy versus lobectomy for lung cancer cases.

Objective: We compared the clinical outcomes and changes in pulmonary function test (PFT) results after segmentectomy or lobectomy for non-small cell lung cancer.

Methods: The retrospective study included 212 patients who had undergone segmentectomy (group S) and 2336 patients who had undergone lobectomy (group L) from 1997 to 2012. The follow-up and medical record data were collected.

Feasibility and safety of outpatient medical thoracoscopy at a large tertiary medical center: a collaborative medical-surgical initiative.

Background: Medical thoracoscopy (MT) is performed by relatively few pulmonologists in the United States. Recognizing that an outpatient minimally invasive procedure such as MT could provide a suitable alternative to hospitalization and surgery in patients with undiagnosed exudative pleural effusions, we initiated the Mayo Clinic outpatient MT program and herein report preliminary data on safety, feasibility, and outcomes.

Methods: All consecutive patients referred for outpatient MT from October 2011 to August 2013 were included in this study.

Modified Robicsek procedure for pectus excavatum in adult patients.

Objectives: The aim of this study was to clarify the short-term and mid-term outcomes of the modified Robicsek procedure using polypropylene mesh for adult pectus excavatum patients.

Methods: Retrospective chart review was performed. Between 2001 and 2012, 46 consecutive adult patients underwent modified Ravitch repair using polypropylene mesh for pectus excavatum at our institution.

Bullectomy for symptomatic or complicated giant lung bullae.

Background: Giant bullae of the lung are rare. Little is known about functional results after surgical treatment.

Methods: This study retrospectively reviewed all patients who underwent surgical treatment for giant bullae between December 1988 and December 2010.

The outcome of pulmonary resection for invasive fungal infection complicating haematological malignancy.

Objectives: The aim of this study was to clarify clinical outcomes of pulmonary resection of invasive fungal infection (IFI) complicating haematological malignancy.

Methods: Between 1985 and 2010, 28 patients underwent 31 pulmonary procedures for IFI complicating haematological malignancy. Retrospective chart review was performed.

Long-term outcome after laparoscopic myotomy for achalasia.

Objectives: Achalasia has a variety of therapeutic options. We sought to determine the long-term outcome of laparoscopic myotomy in a large group of patients.

Methods: We conducted a retrospective record review of 500 patients who underwent laparoscopic myotomy and follow-up with a standardized dysphagia questionnaire.

Functional recovery in the elderly after major surgery: assessment of mobility recovery using wireless technology.

Purpose: Hospitalization and surgery in older patients often leads to a loss of strength, mobility, and functional capacity. We tested the hypothesis that wireless accelerometry could be used to measure mobility during hospital recovery after cardiac surgery.

Description: We used an off-the-shelf fitness monitor to measure daily mobility in patients after surgery.

Minimally invasive resection for mediastinal ectopic parathyroid glands.

Background: We reviewed our experience with ectopic mediastinal parathyroidectomy.

Methods: Between March 1980 and September 2010, mediastinal parathyroidectomy was performed in 33 patients with hypercalcemia secondary to hyperparathyroidism.

Results: Primary hyperparathyroidism was the main diagnosis in 32 patients (97%).

Patient engagement and reported outcomes in surgical recovery: effectiveness of an e-health platform.

Background: Electronic health information platforms have the potential to support standardized care delivery models, engage patients, and deliver patient self-assessment tools.

Study Design: We tested whether an e-health platform could support the delivery and acquisition of patient-reported outcomes (PROs) during hospitalization after cardiac surgery. Secondarily, we tested if patient reported data were predictive of resource use (length of stay) or outcomes (discharge disposition).

Genome-wide association study of genetic predictors of overall survival for non-small cell lung cancer in never smokers.

To identify the genetic factors that influence overall survival in never smokers who have non-small cell lung carcinoma (NSCLC), we conducted a consistency meta-analysis study using genome-wide association approaches for overall survival in 327 never smoker patients with NSCLC from The University of Texas MD Anderson Cancer Center (Houston, TX) and 293 cases from the Mayo Clinic (Rochester, MN). We then conducted a two-pronged validation of the top 25 variants that included additional validation in 1,256 patients with NSCLC from Taiwan and assessment of expression quantitative trait loci (eQTL) and differential expression of genes surrounding the top loci in 70 tumors and matched normal tissues. A total of 94 loci were significant for overall survival in both MD Anderson and Mayo studies in the consistency meta-analysis phase, with the top 25 variants reaching a P value of 10(-6).

Stage IIIA non-small cell lung cancer: morbidity and mortality of three distinct multimodality regimens.

Background: Although concurrent chemoradiation therapy can cure stage IIIA non-small cell lung cancer (NSCLC), studies have demonstrated that anatomic resection following high-dose or standard-dose chemoradiation may benefit selected patients. We examined morbidity and mortality associated with 3 multimodality treatment regimens for stage IIIA disease.

Methods: Institutional databases identified patients with stage IIIA (N2) NSCLC who underwent concurrent platinum-based chemoradiotherapy with or without pulmonary resection between 1998 and 2011.