Background Solitary fibrous tumors of the pleura (SFTPs) are primary pleural tumors originating from the mesenchymal tissue. Surgical treatment was the first choice for management of SFTPs. There were no defined guidelines for the follow-up of these tumors and the postoperative therapy due to the rarity of these tumors. Methods We conducted a retrospective, multicenter study from two high-volume centers in Italy. Data of patients diagnosed with pleural solitary fibrous tumors between January 2003 and October 2022 were prospectively recorded and retrospectively analyzed. The aim of this study was to identify predictive prognostic factors and the correlation between tumor characteristics and recurrence. Results In all, 107 patients undergoing R0 surgical resection of pleural solitary fibrous tumor were included in the study. Patients were divided in two groups: benign and malignant. All the patients were treated with surgery with the aim to obtain R0 resection. Lung resection was necessary when the tumor adhered strongly to the lung parenchyma or infiltrated it. Twenty of the 107 patients had tumor recurrence. At a multivariate analysis, histological characteristics (high mitotic index) and maximum standardized uptake values (maxSUV) were related to recurrence. The mean disease-free survival (DFS) was 143.3 ± 6.1 months. Conclusion In our experience, histological features of malignancy and maxSUV are significantly related to recurrence, which can occur even years after the first diagnosis. Surgical excision with negative surgical margins results in good long-term outcomes. After surgery, a long-term and strict follow-up should be done, in order to detect recurrence early. R0 of the recurrence is associated with long-term survival.

Introduction: Bronchial carcinoid (BC) tumors represent between 1% and 5% of all lung cancers and about 20–30% of carcinoid tumors; they are classified into two groups: typical and atypical bronchial carcinoids. The aim of the present study was to review the results of endoscopic treatments as an alternative to surgical treatment in selected patients. Materials and methods: The present study was a retrospective and multicentric study, in which all data were reviewed for patients with BC in the central airways, referred to the Thoracic Surgery Units of Luigi Vanvitelli University of Naples and Sant’Andrea Hospital in Rome between October 2012 and December 2022 Overall, 35 patients, 13 of whom were female, were included in the study (median age, 53 years; range, 29–75 years). All patients underwent rigid bronchoscopy combined with flexible bronchoscopy. Tumor clearance was mostly performed by use of Argon Plasma Coagulation or Thulep Laser, mechanical debridement and excision with the use of forceps and aspirator through the working channel of the 8.5 mm-sized rigid bronchoscope. There were no complications during the treatment. Results: Endobronchial treatment provided complete tumor eradication in all patients; two patients had controlled bleeding complications; however, bleeding was well controlled without patient desaturation, and only one patient died of renal failure during the follow-up period. We found two recurrences in the left and right main bronchus, in patients with atypical carcinoma during fiberoptic bronchoscopy follow-up. Only one patient died of renal failure. At the first analysis, there were no significant differences between the patients receiving endobronchial treatment and patients receiving surgical treatment in the present study (p-value > 0.05—it means statistically insignificant). Conclusions: Endobronchial treatment is a valid and effective alternative for patients with BC unsuitable for surgery.

Tissue engineering refers to the attempt to create functional human tissue from cells in a laboratory. This is a field that uses living cells, biocompatible materials, suitable biochemical and physical factors, and their combinations to create tissue-like structures. To date, no tissue engineered skeletal muscle implants have been developed for clinical use, but they may represent a valid alternative for the treatment of volumetric muscle loss in the near future. Herein, we reviewed the literature and showed different techniques to produce synthetic tissues with the same architectural, structural and functional properties as native tissues.

Background: In selected patients with pulmonary metastases, surgical resection is the treatment of choice. Despite thoracoscopy is the preferred approach for management early lung cancer, its role in management pulmonary metastases is still debate due to the risk of leaving undetected malignant nodules during surgery. We aimed to evaluate the outcome of patients undergoing resection of lung metastasis performed using thoracoscopy to establish whether this approach did not compromise oncological results. Methods: We performed a systematic review of literature using Medline, PubMed, Scopus, Google Scholar, and Cochrane databases until the end of March 2020. English papers reporting the survival and/or recurrence after thoracoscopic metastasectomy were included in the analysis. Results: Ten papers were selected. Nine out of ten studies compared survival and/or recurrence rates between thoracoscopy and thoracotomy approach; no significant differences were found in 7 studies, while in two thoracoscopy was associated with a better overall survival. The remaining one study evaluated only thoracoscopy outcome, finding an overall 5-year survival rate of 54%, that was comparable to that expected for metastasectomy by thoracotomy. Multivariable analysis were performed in four studies; in one thoracoscopy was correlated to better survival, while in the other three the surgical approach did not influence outcomes. Two studies evaluated perioperative outcomes, and in both studies thoracoscopy was associated with shorter hospital stay, and lesser postoperative morbidity than thoracotomy. Conclusions: Despite our results seems to support the use of thoracoscopy, however several limitations should be taken in account before drawing definitive conclusions. All evaluated studies are retrospective; the different patient characteristics (i.e. number of lesions, laterality, size, primary metastatic cancer type), and the extend of resection make thoracoscopy and thoracotomy groups not comparable. Thus, only future randomized controlled trials could definitively define the oncological validity of video-assisted thoracoscopic surgery (VATS) for treatment of lung metastases.

A significant part of all neoplasms growing in anterior mediastinum are lymphomas (25%). Achieving a correct diagnosis and a clear definition of a lymphoma’s subtype is crucial for beginning chemotherapy as soon as possible. However, most patients present a large mediastinal mass that compresses vessels and airway, with serious cardiorespiratory repercussions. Therefore, having multiple tools available to biopsy the lesion without worsening morbidity becomes fundamental. Patients enrolled in this study were unfit for a surgical biopsy in general anesthesia and the need to begin chemotherapy as fast as possible prompted us to avoid percutaneous fine needle aspiration to prevent diagnostic failures. Our observational study included 13 consecutive patients with radiological findings of anterior mediastinal mass. Ultrasonography was performed directly in the theatre to mark the lesion and to localize vessels and vascularized neoplastic tissue. Open biopsy was carried out in spontaneous breathing with a laryngeal mask and with short-acting medications for a rapid anesthesia, performing an anterior mediastinotomy. The mean operative time was 33.4 ± 6.2 min and spontaneous respiration was maintained throughout the procedure. No complications were reported. All patients were discharged in the first or second postoperative day after a chest X-ray (1.38 ± 0.5 days). The diagnostic yield of this approach was 100%. With the addition of ultrasonography right before the procedure and with spontaneous breathing, anterior mediastinotomy still represents a useful tool in critical patients that could hardly tolerate a general anesthesia. The diagnostic yield is high, and the low postoperative morbidity allows a rapid onset of chemotherapy.

It has been brought to the publisher’s attention that the surname of the author “Antonio D'Andrilli” was appearing incorrect in the Journal of The Thoracic and Cardiovascular Surgeon, (DOI: 10.1055/s-0043-1777260). The surname has been corrected in the article. Article published online: 21 October 2024 © 2024. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany