Publications by authors named "Paul E VAN Schil"

Introduction: The EORTC-Lung Cancer Group initiated a Delphi consensus process to establish a consensual definition of resectable stage III non-small cell lung cancer (NSCLC) for the use in clinical trials, including a systematic review, survey, and review of clinical cases. Here, the survey results are presented, aimed to identify areas of controversy.

Methods: A survey was distributed among the members of six international organizations related to lung cancer.

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  • The study surveyed pathologists and thoracic surgeons from the IASLC to evaluate their views on the R classification for lung cancer, with a response rate of 72% from 447 professionals.
  • Findings revealed geographic differences in R classification usage, with Europe and Asia often reporting R status, while 70% of North American pathologists rarely do, and varied practices regarding who assigns R categories between regions.
  • The "uncertain resection" category (R(un)) is largely unused globally, highlighting the need for more evidence and standardization in reporting surgical margins and R categories in pathology.
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  • Thymic epithelial tumors (TETs) are rare tumors found in the chest and include types like thymomas and thymic carcinomas.
  • The best way to treat these tumors is usually through surgery, but there's disagreement about the best method to perform the surgery.
  • New techniques like video-assisted and robotic surgeries are becoming popular, especially for early-stage TETs, but more research is needed to see how they compare in the long term to traditional surgery methods.
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Introduction: The TNM classification of lung cancer is periodically revised. The International Association for the Study of Lung Cancer collected and analyzed a new database to inform the forthcoming ninth edition of the TNM classification. The results are herewith presented.

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Introduction: An international database was created by the International Association for the Study of Lung Cancer to inform on the ninth edition of the TNM classification of lung cancer. The present analyses concern its T component.

Methods: Data on 124,581 patients diagnosed with lung cancer from January 1, 2011 to December 31, 2019 were submitted to the International Association for the Study of Lung Cancer database.

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Angiogenesis significantly influences the carcinogenesis of thymic epithelial tumors (TET). Both thymomas and thymic carcinoma (TC) overexpress VEGF-A and VEGFR-1 and -2. This review aims to provide an appraisal of the use of anti-angiogenics in the treatment of TET.

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Small airway disease is an important pathophysiological feature of chronic obstructive pulmonary disease (COPD). Recently, "pre-COPD" has been put forward as a potential precursor stage of COPD that is defined by abnormal spirometry findings or significant emphysema on computed tomography (CT) in the absence of airflow obstruction. To determine the degree and nature of (small) airway disease in pre-COPD using microCT in a cohort of explant lobes/lungs.

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Patients with unforeseen N2 (uN2) disease are traditionally considered to have an unfavorable prognosis. As preoperative and intraoperative mediastinal staging improved over time, the prevalence of uN2 changed. In this review, the current evidence on uN2 disease and its prevalence will be evaluated.

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Surgical resection is still the standard treatment for early-stage lung cancer. A multimodal treatment consisting of chemotherapy, radiotherapy and/or immunotherapy is advised for more advanced disease stages (stages IIb, III and IV). The role of surgery in these stages is limited to very specific indications.

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Background: Good's syndrome (GS) is an adult-onset acquired immunodeficiency, in which patients present with thymoma and hypogammaglobulinemia (HGG). GS is characterized by low to absent peripheral B cells and impaired T-cell mediated immunity, often resulting in various (opportunistic) infections and concurrent autoimmune disorders. In this case report, we present a case of a patient with GS and coronavirus disease 2019 (COVID-19) infection after surgical removal of a thymoma.

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The tumor microenvironment (TME) is a complex and constantly changing entity. The TME consists of stromal cells, fibroblasts, endothelial cells, and innate and adaptive immune cells. Cancer development and progression occurs through this interplay between the tumor and the adjacent stroma.

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Thymic epithelial tumors (TET) are a group of rare neoplasms of the anterior mediastinum comprising thymomas and thymic carcinomas. The carcinogenesis of TET is mostly unknown. Many studies, mostly retrospective case series, have tried to establish prognostic factors in TET.

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  • Cancer is a major cause of death in Europe, and there's a big need to improve how we diagnose and treat it.
  • New science is helping, but not all countries are using these new techniques equally, and some life-saving practices aren't widespread yet.
  • This paper talks about ways to improve cancer care in Europe, taking into account the different challenges faced by each country and the goal of giving everyone better access to healthcare.
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Background: Tracheal cancer is a rare malignancy of which previous reports are mostly case reports or small series. Herein, we sought to evaluate the clinical characteristics, surgical treatments, and prognosis of surgically treated primary tracheal cancer patients.

Methods: Patients with primary tracheal cancer who had received surgery in our center between January 2000 and December 2020 were enrolled.

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  • Multimodal treatment is recommended for patients with advanced non-small cell lung cancer (NSCLC) and positive lymph nodes, but the best approach for those with positive mediastinal nodes (N2 disease) remains unclear.
  • *Recent advancements include the introduction of immunotherapy and targeted therapies, which are changing the role of surgery in treatment plans.
  • *Current studies indicate that performing surgery after initial immunotherapy or targeted therapy can be safe and effective, leading to positive short-term outcomes.
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Pathology and radiology are complimentary tools, and their joint application is often crucial in obtaining an accurate diagnosis in non-neoplastic pulmonary diseases. However, both come with significant limitations of their own: Computed Tomography (CT) can only visualize larger structures due to its inherent-relatively-poor resolution, while (histo) pathology is often limited due to small sample size and sampling error and only allows for a 2D investigation. An innovative approach of inflating whole lung specimens and subjecting these subsequently to CT and whole lung microCT allows for an accurate matching of CT-imaging and histopathology data of exactly the same areas.

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The current coronavirus disease 2019 (COVID-19) pandemic has forced healthcare providers worldwide to adapt their practices. Our understanding of the effects of COVID-19 has increased exponentially since the beginning of the pandemic. Data from large-scale, international registries has provided more insight regarding risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and has allowed us to delineate specific subgroups of patients that have higher risks for severe complications.

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En bloc resection of the thoracic duct compartment enhances adequate lymph node removal and may improve oncologic outcomes in esophagectomy for malignant esophageal diseases. However, it also increases the risk of postoperative chylothorax, with a reported incidence of 5% to 20%. This report describes a technique that facilitates intraoperative identification of the thoracic duct, as well as proximal and distal ligation, during robot-assisted esophagectomy by lymphangiography-guided injection of indocyanine green in the right groin in a patient in the left lateral position.

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Objective: In this review, we aim to summarize the most recent data on the surgical management of oligometastatic non-small cell lung cancer (NSCLC).

Background: Approximately 60-70% of all patients with NSCLC initially present with advanced stages of cancer at time of diagnosis. These patients are generally treated with chemotherapy, radiation therapy, or a combination of these modalities.

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