Publications by authors named "Manjit S Bains"
Objective: Evaluate an electronic platform for remote symptom monitoring to enhance postdischarge care in thoracic surgery using patient reporting of symptoms.
Summary Background Data: Owing to the increased use of enhanced recovery after surgery protocols, patients are spending a larger portion of their postoperative course at home. For patients undergoing complex operations, this represents an opportunity for early identification of abnormal symptoms at home before deterioration.
Article Synopsis
- The study aimed to create a prediction model to help decide between stereotactic body radiotherapy (SBRT) and minimally invasive surgery (MIS) for treating early-stage non-small cell lung cancer (NSCLC).
- Researchers analyzed data from 1,291 patients to develop the model using logistic regression, which produced three risk categories for patient treatment based on several health factors.
- The model showed strong predictive power and suggested that the decision on treatment modality does not significantly impact overall survival, highlighting the importance of assessing intermediate-risk patients through a multidisciplinary approach.
Article Synopsis
- The latest Commission on Cancer guidelines suggest specific lymph node sampling during lung cancer resections, but its effect on patient outcomes is not well-explored.
- In a study of 9,289 lung resections, 33% followed the guidelines, showing higher rates of nodal upstaging and complications, yet similar rates of adjuvant therapy and recurrence.
- While survival rates were similar in stages I and II, guideline adherence in stage III resulted in improved survival, indicating a need for further research on optimal lymph node sampling in diverse lung cancer cases.*
Article Synopsis
- The study examined the relationship between preoperative frailty and outcomes in older patients (65+) undergoing esophagectomy, rather than just focusing on age.
- Using a frailty scoring system called MSK-FI, researchers analyzed 447 patients and found that higher frailty scores were linked to increased risks of major complications, readmissions, and being discharged to a facility after surgery.
- Although frailty was a strong indicator of short-term morbidity, it did not correlate with 90-day mortality, suggesting it can help identify patients at higher risk for complications during surgery decision-making.
Article Synopsis
- Minimally invasive surgery (MIS) is becoming the standard for early-stage non-small cell lung cancer (NSCLC), but its effectiveness in more advanced stages (IB-IIIB) after neoadjuvant therapy is not well understood.
- A study analyzed 627 patients from 2013-2022 who underwent surgery after neoadjuvant treatment, comparing outcomes between open surgery and MIS, with successful MIS defined by specific criteria.
- Results showed a 77% success rate for MIS, with the clinical N stage being a key factor in determining success, while the T stage and type of neoadjuvant therapy did not significantly impact outcomes.
Background: Results of recent clinical trials suggest that segmentectomy may be an acceptable alternative to lobectomy for selected patients with early-stage non-small cell lung cancer (NSCLC). Increased use of segmentectomy may result in a concomitant increase in occult node-positive (N+) disease on surgical pathology examination. The optimal management for such patients remains unknown.
View Article and Find Full Text PDFIntroduction: Electronic nose (E-nose) technology has reported excellent sensitivity and specificity in the setting of lung cancer screening. However, the performance of E-nose specifically for early-stage tumors remains unclear. Therefore, the aim of our study was to assess the diagnostic performance of E-nose technology in clinical stage I lung cancer.
View Article and Find Full Text PDFObjective: To assess the performance of a lower predicted postoperative (ppo) forced expiratory volume in 1 second (FEV 1 ) or diffusion capacity of the lung for carbon monoxide (DLCO) (ppoFEV 1 /ppoDLCO) threshold to predict cardiopulmonary complications after minimally invasive surgery (MIS) lobectomy.
Background: Although MIS is associated with better postoperative outcomes than open surgery, MIS uses risk-assessment algorithms developed for open surgery. Moreover, several different definitions of cardiopulmonary complications are used for assessment.
Article Synopsis
- * 19 patients who underwent EAC resection post-bariatric surgery were analyzed, revealing that most were obese at diagnosis and that sleeve gastrectomy was common among the patients.
- * The findings suggest that endoscopy should be standard practice before and after bariatric surgery for better treatment outcomes, and that EAC resection post-surgery can be conducted safely with tailored approaches.
Objectives: The study objectives were to assess the outcomes of lung resection in patients with non-small cell lung cancer previously treated with nonoperative treatment and to identify prognostic factors associated with survival.
Methods: Patients who underwent surgery (2010-2022) after initial nonoperative treatment at a single institution were identified from a prospectively maintained database. Exclusion criteria included metachronous cancer, planned neoadjuvant therapy, and surgery for diagnostic or palliative indications.
Biologic versus synthetic prosthesis for chest wall reconstruction: a matched analysis.
Eur J Cardiothorac Surg
December 2023
Objectives: The aim of this study was to compare postoperative outcomes between biologic and synthetic reconstructions after chest wall resection in a matched cohort.
Methods: All patients who underwent reconstruction after full-thickness chest wall resection from 2000 to 2022 were reviewed and stratified by prosthesis type (biologic or synthetic). Biologic prostheses were of biologic origin or were fully absorbable and incorporable.
Background: Residual tumor at the proximal or distal margin after esophagectomy is associated with worse survival outcomes; however, the significance of the circumferential resection margin (CRM) remains controversial. In this study, we sought to evaluate the prognostic significance of the CRM in patients with esophageal cancer undergoing resection.
Materials And Methods: We identified patients who underwent esophagectomy for pathologic T3 esophageal cancer from 2000 to 2019.
The contribution of microvascular free flaps and pedicled flaps to successful chest wall surgery.
J Thorac Cardiovasc Surg
October 2023
Objective: Pedicled flaps (PFs) have historically served as the preferred option for reconstruction of large chest wall defects. More recently, the indications for microvascular-free flaps (MVFFs) have increased, particularly for defects in which PFs are inadequate or unavailable. We sought to compare oncologic and surgical outcomes between MVFFs and PFs in reconstructions of full-thickness chest wall defects.
View Article and Find Full Text PDFObjective: To investigate the utility of serum soluble mesothelin-related peptide (SMRP) and tumor mesothelin expression in the management of esophageal adenocarcinoma (ADC).
Background: Clinical management of esophageal ADC is limited by a lack of accurate evaluation of tumor burden, treatment response, and disease recurrence. Our retrospective data showed that tumor mesothelin and its serum correlate, SMRP, are overexpressed and associated with poor outcomes in patients with esophageal ADC.
Objective: To assess postoperative morbidity, disease-free survival (DFS), and overall survival (OS) in patients treated with salvage esophagectomy (SE).
Background Data: A shift toward a "surgery as needed" approach for esophageal cancer has emerged, potentially resulting in delayed esophagectomy.
Methods: We identified patients with clinical stage I-III esophageal adenocarcinoma or squamous cell carcinoma who underwent chemoradiation followed by esophagectomy from 2001 to 2019.
Article Synopsis
- Research identified key factors predicting isolated regional recurrence, such as less radiation therapy before surgery and positive lymph nodes, while older age and more removed lymph nodes reduced again the risk of recurrence.
- Patients receiving a mix of local and systemic therapies had significantly better survival rates compared to those who only underwent systemic treatment, suggesting salvage options may be effective for regional recurrences.
Objective: Targeted therapy improves outcomes in patients with advanced-stage non-small cell lung cancer (NSCLC) and in the adjuvant setting, but data on its use before surgery are limited. We sought to investigate the safety and feasibility of preoperative targeted therapy in patients with operable NSCLC.
Methods: We retrospectively reviewed 51 patients with clinical stage I to III NSCLC who received targeted therapy, alone or in combination with chemotherapy, before surgical resection with curative intent, treated from 2004 to 2021.
Objective: To investigate the association between operative time and postoperative outcomes.
Background: The association between operative time and morbidity after pulmonary lobectomy has not been characterized fully.
Methods: Patients who underwent pulmonary lobectomy for primary lung cancer at our institution from 2010 to 2018 were reviewed.
Introduction: Anatomical resection-often by lobectomy-is the standard of care for patients with early stage NSCLC. With increased diagnosis, survival, and prevalence of persons with early stage NSCLC, the incidence of second primary NSCLC, and consequently, the need for contralateral lobectomy for a metachronous cancer, is increasing. Perioperative outcomes after contralateral lobectomy are unknown.
View Article and Find Full Text PDFObjective: The objective is to determine how the COVID-19 pandemic affected care for patients undergoing thoracic surgery for cancer.
Background: The COVID-19 pandemic accelerated the adoption of telemedicine.
Methods: Characteristics and outcomes of new patients seen between March 1 and June 30, 2019, and the same period in 2020 were compared.
Article Synopsis
- This study aimed to understand the patterns of lymph node metastases in esophageal adenocarcinoma patients who received neoadjuvant chemoradiation and had surgery, to see how these patterns relate to prognosis.
- Out of 537 patients analyzed, 36% had lymph node metastases at surgery, with the majority having either single or multiple affected nodal stations, predominantly in the paraesophageal and left gastric areas.
- The research found that as the number of affected nodal stations increased, especially in the paraesophageal and subcarinal regions, the risk of disease recurrence significantly increased.
Background: Unintentional weight loss and malnutrition are associated with poorer prognosis in patients with cancer. Risk of cancer-associated malnutrition is highest among patients with esophageal cancer (EC) and has been repeatedly shown to be an independent risk factor for worse survival in these patients. Implementation of nutrition protocols may reduce postoperative weight loss and enhance recovery in these patients.
View Article and Find Full Text PDFObjective: We sought to compare gastroesophageal junction (GEJ) cancer and gastric cancer (GC) and identify clinicopathological and oncological differences.
Summary Background Data: GEJ cancer and GC are frequently studied together. Although the treatment approach for each often differs, clinico-pathological and oncological differences between the 2 have not been fully evaluated.
Background: Isolated local recurrence after curative esophagectomy for esophageal cancer is a rare event. Although it is potentially curable, management can be challenging.
Methods: We retrospectively reviewed all patients undergoing esophagectomy for esophageal adenocarcinoma (EAC) from 2000 to 2019.