Seminars in Thoracic and Cardiovascular Surgery

Our medical research library holds 12 studies published in Seminars in Thoracic and Cardiovascular Surgery (2000–2016). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 11 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it.

About the journal

• Publisher: W.B. Saunders
• Published: 1989 to the present, United States
• Language: English
• ISSN: 1043-0679 (print), 1532-9488 (electronic)
• Its record in the NLM Catalog

2010s

• The Next Generation of Mesothelioma Surgeons Roundtable Discussion. H. Pass, D. Rice, A. Wolf, et al. 2016;28(1):203-20. PubMed · Publisher

• Induction Therapy for Mesothelioma. I. Opitz, W. Weder. 2015;27(2):240-9. Review PubMed · Publisher

  Abstract

  One particular approach of multimodality treatment for mesothelioma is induction therapy followed by surgery. Among its several advantages, the most important is downstaging of the tumor into a resectable stage, although morbidity and mortality might be increased. In this article we review the principles and outcome of different modalities for induction treatment of mesothelioma.

  Copyright © 2015 Elsevier Inc. All rights reserved.

• Surgical Management of Malignant Pleural Mesothelioma: An Update of Clinical Evidence. C. Cao, Z. Akhunji, B. Fu, et al. 2015;27(1):6-8. PubMed · Publisher

  Abstract

  To investigate the surgical management of malignant pleural mesothelioma, 2 randomized controlled trials have been completed. We discuss the findings from these trials and the current evidence of various surgical techniques to treat this challenging disease.

  Copyright © 2015 Elsevier Inc. All rights reserved.

• The Thoracic Surgery Service at Memorial Sloan Kettering Cancer Center. V.W. Rusch. 2015;27(4):403-9. Historical article PubMed · Publisher

  Abstract

  The development of the Thoracic Surgery Service at Memorial Sloan Kettering Cancer Center paralleled the emergence of Thoracic Surgery as a specialty, but with the unique focus on oncology and multidisciplinary cancer care characteristic of the institution. From the early post-war years treating lung cancer with new surgical techniques, through early definitive work in malignant mesothelioma, to today's translational research in cancer biology, the Thoracic Surgery Service continues to be an international leader in educating surgeons in thoracic surgical oncology, conducting clinical trials, and developing innovative therapies to treat thoracic cancers.

  Copyright © 2015 Elsevier Inc. All rights reserved.

• Current readings: Window-of-opportunity trials for thoracic malignancies. A.S. Tsao. 2014;26(4):323-30. Review PubMed · Publisher

  Abstract

  Recent major advances in metastatic non-small cell lung cancer have occurred with the identification of molecular biomarker targets and administration of novel agents with resulting improvement in clinical outcomes. In the early-stage setting, personalized therapy with novel agents and molecular profiling are being incorporated into neoadjuvant "window-of-opportunity" trials. These important studies enable biomarker research and an expedited analysis of the efficacy of the targeted agent. However, there are significant limitations to window-of-opportunity trials. The aim of this article is to review the current window-of-opportunity trials of neoadjuvant targeted agents for thoracic malignancies, discuss the benefits and limitations of these trials, and propose more optimal alternative trial end points. Neoadjuvant trials of resectable non-small cell lung cancer and mesothelioma that are ongoing or under development and relevant to thoracic surgeons are also discussed. The success of these trials will depend on a collaborative multidisciplinary effort, especially from the field of thoracic surgery.

  Copyright © 2014 Elsevier Inc. All rights reserved.

• Novel induction therapies for pleural mesothelioma. L. Donahoe, J. Cho, M. de Perrot. 2014;26(3):192-200. Review PubMed · Publisher

  Abstract

  Malignant mesothelioma is becoming increasingly common, and rates of diagnosis are expected to continue to increase in the coming years because of the extensive use of asbestos in industrialized countries and the long time interval between exposure and onset of disease. Although much research has been done on the optimal treatment for this disease, the overall prognosis remains grim. The main components of therapy are surgery, chemotherapy, and radiation therapy, but there is controversy in the literature about the optimal inclusion and sequencing of these treatments, as each has unique risk profiles. We have developed a new Surgery for Mesothelioma After Radiation Therapy protocol consisting of induction-accelerated hemithoracic radiation followed by extrapleural pneumonectomy. The rationale behind this protocol is to maximize both the tumoricidal and immunogenic potential of the radiotherapy while minimizing the radiation toxicity to the ipsilateral lung. Our initial trial demonstrated the feasibility of this approach and has shown encouraging results in patients with epithelial histology. In this article, we reviewed the current literature on induction chemotherapy for mesothelioma as well as described the Surgery for Mesothelioma After Radiation Therapy protocol and upcoming studies of novel induction therapies for mesothelioma.

  Copyright © 2014 Elsevier Inc. All rights reserved.

• Current readings: improvements in intensity-modulated radiation therapy for malignant pleural mesothelioma. K.E. Rosenzweig. 2013;25(3):245-50. Review PubMed · Publisher

  Abstract

  The treatment of malignant pleural mesothelioma with radiation therapy has always been a technical challenge. Early experience with intensity-modulated radiation therapy demonstrated troubling toxicity. Recent reports from institutions have demonstrated that with greater experience, intensity-modulated radiation therapy can be delivered safely, both in the setting of pneumonectomy or pleurectomy. After pneumonectomy, the dose to the contralateral lung must be minimized, preferably with a volume of lung receiving 20 Gy (V20) to less than 5% and a mean lung dose of approximately 10%. In the setting of 2 intact lungs, the mean lung dose can be as high as 20 Gy. Expected rates of grade 3 or worse radiation pneumonitis are 12%-20%. The rates of fatal pneumonitis are approximately 3%-8% in these studies, which demonstrate the considerable toxicity of treatment, even with improved technique.

  © 2013 Published by Elsevier Inc.

• The state of the art in the technical performance of lung-sparing operations for malignant pleural mesothelioma. J.S. Friedberg. 2013;25(2):125-43. Review PubMed · Publisher

  Abstract

  Malignant pleural mesothelioma remains an incurable disease for which the role of surgery remains controversial. Though not yet clearly defined there does appear to be a subset of patients who benefit from a surgery-based multimodal treatment plan, beyond what would be expected with current nonoperative therapies. As with other pleural cancers it is probably not possible to achieve a microscopic complete resection with any operation. The goal of surgery in this setting, therefore, is to remove all visible and palpable disease - a macroscopic complete resection. There are basically two surgical approaches to achieve a macroscopic complete resection, lung-sacrificing and lung-sparing. Lung-sacrificing surgery, which likely leaves behind the least amount of microscopic disease, is accomplished as an extrapleural pneumonectomy. This is a well established and standardized operation. Lung-sparing surgery for malignant pleural mesothelioma, on the other hand, does not currently enjoy any degree of consistency. Not only are the reported variations on the operation widely disparate, but even the nomenclature to describe the operation is highly variable. Often the selection of a lung-sparing approach is reported as an intraoperative decision that hinges on the bulk of the cancer and/or the degree of extension into the pulmonary fissures. This article describes the current evolution of a lung-sparing procedure, radical pleurectomy, which has been used to achieve a macroscopic complete resection in over a hundred patients. Many of these cases involved bulky cancers, some exceeding two liters in volume, and often with extensive invasion of the pulmonary fissures. With the described technique there has not yet been an instance where conversion to extrapleural pneumonectomy would have contributed to the ability to achieve a macroscopic complete resection. Whether or not radical pleurectomy is the optimal approach for any or all patients undergoing surgery-based multimodal treatment for malignant pleural mesothelioma is not known, but the described technique does offer an operation that can serve as a consistent foundation for any surgery-based treatment strategy where achieving a macroscopic complete resection, while sparing the lung, is desired.

  Copyright © 2013. Published by Elsevier Inc.

2000s

• Current status of screening for malignant pleural mesothelioma. H.I. Pass, M. Carbone. 2009;21(2):97-104. Review PubMed · Publisher

  Abstract

  Malignant mesothelioma is characterized by its association with asbestos, its long latency period, and the propensity for the diagnosis to be obtained in the later stages of the disease. Because the high-risk cohorts for mesothelioma are fairly well defined by the association with asbestos, and the exposure is usually in the workplace, it is hypothesized that early detection of the disease could (1) find patients at an earlier, more treatable stage and (2) result in prolonged survival over the present median 12 months from the start of therapy. Many studies have used standard chest X-ray to characterize changes associated with asbestos-exposed individuals, but the insensitivity of X-ray in screening patients with mesothelioma has never supported the wide-scale adaptation of such an effort. With the advent of computerized tomography, prospective trials, many of which are chiefly prevalence detection studies, have been performed and stress the importance for proper detailing by carefully qualifying suspicious changes, as well as defining the correct cohort to screen. Most recently, serum biomarkers with the potential to discriminate asbestos-exposed, non-cancer-bearing individuals from those with mesothelioma have been investigated both at single institutions and with multi-institutional-blinded trials. These markers, including soluble mesothelin-related protein, osteopontin, and megakaryocyte potentiating factor, may, in the future, be incorporated into a screening algorithm for high-risk asbestos-exposed individuals to help monitor these cohorts in a noninvasive fashion and guide the use of computerized tomography.

• Making the case for molecular staging of malignant pleural mesothelioma. R. Bueno. 2009;21(2):188-93. Review PubMed · Publisher · Free full text

  Abstract

  Malignant pleural mesothelioma is an aggressive malignancy for which surgical treatment is an option for a subset of patients. A gene ratio test based on the relative expression levels of four genes has been validated in clinical trials to predict which patients will benefit from surgical therapy. A description of the test properties and the independent predictors for outcome are provided.

• Malignancies involving the pericardium. W.H. Warren. 2000;12(2):119-29. Review PubMed · Publisher

  Abstract

  Malignancies rarely arise from the pericardium. Mesothelioma, the most common of these, is usually unresectable and almost always incurable. Malignancies may secondarily involve the pericardium by direct extension. Carcinoma of the lung and malignant thymoma with limited direct invasion of the pericardium both can undergo complete and potentially curative resections, but adjuvant therapy is usually indicated. More frequently, malignancies involve the pericardium by a process of retrograde lymphangitic spread or hematogenous dissemination. These patients present with a symptomatic pericardial effusion and occasionally pericardial tamponade. Subxiphoid pericardiostomy and drainage is a safe procedure that provides effective and durable symptomatic relief in these terminally ill patients. More aggressive open procedures should be reserved for loculated or recurrent pericardial effusions.

• Unusual primary tumors of the heart. T.J. Vander Salm. 2000;12(2):89-100. Review PubMed · Publisher

  Abstract

  Primary tumors of the heart, with the exception of atrial myxomas, occur rarely; tumors metastatic to or directly invasive of the heart are far more common. About 75% of primary tumors are benign, and 75% of these are atrial myxomas. The benign tumors include rhabdomyomas, fibromas, papillary fibroelastomas, hemangiomas, pericardial cysts, lipomas, hamartomas, teratomas, mesotheliomas, and paragangliomas or pheochromocytomas. The last 3 may also be malignant. The malignant tumors consist of various sarcomas: myxosarcoma, liposarcoma, angiosarcoma, fibrosarcoma, leiomyosarcoma, osteosarcoma, synovial sarcoma, rhabdomyosarcoma, undifferentiated sarcoma, reticulum cell sarcoma, neurofibrosarcoma, and malignant fibrous histiocytoma. Cardiac tumors produce a large variety of symptoms through any of 4 mechanisms. Their mass can obstruct intracardiac blood flow or interfere with valve function. Local invasion can lead to arrhythmias or pericardial effusions with tamponade. Bits of tumor can embolize, causing systemic deficits when the tumors are on the left side of the heart. Finally, the tumors may cause systemic or constitutional symptoms. Some tumors, of course, produce no symptoms and become evident as incidental findings. The most useful diagnostic tool is the echocardiogram, which in almost all cases precisely locates the tumor and defines its extent. The echocardiographic appearance may also allow quite accurate prediction of the tumor type and whether it is malignant or benign. Magnetic resonance imaging serves as the next most important test where the density of T1 and T2 images may allow tumor cell type identification. With few exceptions, these tumors require operative excision. Most benign tumors can be resected completely; a few, because of their large size, cannot be, and only tumor debulking may be possible. Heart transplantation should be considered for these patients. Many of the malignant tumors cannot be resected completely, either because of the extent of local spread and invasion or because of the frequent distant metastases. Transplantation may also be an option for those with extensive local disease. The long-term results for resected benign tumors are excellent; the long-term results for sarcomas are very poor, and there are few survivors. For patients with unresectable sarcomas, radiation and chemotherapy may be used, but without great expectation of successful results.

Browse every journal in the library or the library by type of article, or return to medical research.