Outcomes of Patients with Mutant Advanced NSCLC in a Developing Country in Southeast Asia.

Background: Although first- and second-generation EGFR TKIs are considered first-line treatment in EGFRm+ NSCLC, most patients develop resistance and progress, commonly, EGFR mutation. The third-generation EGFR-TKI has demonstrated efficacy in patients with progressive disease harboring the mutation and in the first-line setting, bypassing this mode of resistance. The primary objectives of this study are to describe the proportion of m+ NSCLC patients treated with first-, second- and third-generation EGFR TKIs, and cytotoxic chemotherapy in the first-line setting, and the time on treatment for each category.

Programmed death-ligand 1 expression and use of immune checkpoint inhibitors among patients with advanced non-small-cell lung cancer in a resource-limited country.

Introduction: Immune checkpoint inhibitor (ICI) therapy is an established treatment for advanced non-small-cell lung cancer (NSCLC) and programmed death ligand-1 (PD-L1) expression is a recognized biomarker to determine response to therapy. We retrospectively analyzed NSCLC patients in the Malaysia Lung Cancer Registry (MLCR) and report on the clinical characteristics associated with PD-L1 expression and ICI use in Malaysia, a low- to middle-income country.

Methods: All 901 NSCLC patients in the MLCR who were diagnosed from January 1, 2017 to December 31, 2020 from 14 hospitals across the country were analyzed.

Successful resection of a giant thoracic myxoid liposarcoma.

Primary liposarcoma is an extremely rare disease. We report a case of giant thoracic myxoid liposarcoma that occupied the whole left hemithorax and was successfully resected. We discuss the surgical considerations and difficulties encountered, and how we overcome these challenges.

Results of surgery for chronic pulmonary Aspergillosis, optimal antifungal therapy and proposed high risk factors for recurrence--a National Centre's experience.

Background: Surgery for pulmonary aspergillosis is infrequent and often challenging. Risk assessment is imprecise and new antifungals may ameliorate some surgical risks. We evaluated the medical and surgical management of these patients, including perioperative and postoperative antifungal therapy.

Extraskeletal Ewing's sarcoma presenting as a mediastinal mass.

Ewing's sarcoma family of tumors is part of a rare group of malignant neoplasms with small blue, round-cell morphology on hematoxylin and eosin stain, expressing CD99, C-Kit, and Bcl2, and sharing the presence of the translocation t(11:22). Extraskeletal Ewing's sarcoma is a rare disease that typically involves the soft tissues of the trunk or extremities. We describe a case of extraskeletal Ewing's sarcoma presenting as a mediastinal mass in a 16-year-old boy.

Chylopericardium after cardiac surgery can be treated successfully by oral dietary manipulation: a case report.

We report a case of chylopericardium after ascending aorta and aortic valve replacement, which presented as late tamponade. We discuss the various treatment options in this rare condition which can result in serious morbidity or death.

Factors which influence the cardiac surgeon's decision not to operate on patients referred for consideration of surgery.

Background: The aim of this study was to document what proportion of patients referred for consideration of cardiac surgery are turned down, the reasons given for not operating and also to evaluate what happens to those patients who do not undergo surgery.

Methods: 382 elective patients referred for consideration of cardiac surgery to one of six consultant cardiac surgeons at Wythenshawe Hospital during a one year period from were included in the study. Data for those patients who underwent an operation were collected prospectively in a cardiac surgery database.

UK waiting time targets in lung cancer treatment: are they achievable? Results of a prospective tracking study.

Background: Recent guidelines have specified a number of waiting time targets to prevent delay in the treatment of lung cancer. This study was carried out to assess the quality of lung cancer services and compare with national recommendations.

Methods: All newly diagnosed cases of lung cancer presenting to our institution via general practitioner referral were entered into a prospective tracking study by a dedicated audit officer.

Long-term outcomes following VATS lobectomy for non-small cell bronchogenic carcinoma.

Objectives: Despite advantages regarding pain and muscle function, video-assisted thoracic surgery (VATS) lobectomy is infrequently performed and is particularly controversial in bronchogenic carcinoma. We have, therefore, reviewed our experience with VATS lobectomy for non-small cell lung cancer (NSCLC) in an attempt to define the long-term results of VATS lobectomy in this setting.

Methods: Patients were selected for surgery on the basis of clinical Stage I or II disease with routine use of thoracic/upper abdominal CT scanning and cervical mediastinoscopy.

Spontaneous rupture of the right hemidiaphragm after video-assisted lung volume reduction operation.

Lung volume reduction operation is an important therapeutic option in patients with advanced emphysema. We report a case of spontaneous rupture of the right diaphragm after a video-assisted thoracoscopic surgical procedure for emphysema. The pathophysiology of this complication is also discussed, along with practical points for perioperative management of emphysematous patients.