Non-small cell lung cancer (NSCLC) has a high mortality rate, emphasizing the need for reliable preoperative prognostic tools. Recent studies have focused on markers that reflect both inflammatory and nutritional status. This study aimed to evaluate the prognostic value of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score in predicting postoperative outcomes in NSCLC patients. This retrospective observational study included patients diagnosed with NSCLC who underwent curative surgery between January 1, 2019, and January 1, 2024. Preoperative HALP scores were calculated from routine blood tests to assess their potential as independent predictors of survival and long-term outcomes. The study cohort comprised 238 patients, divided into 2 groups: survivors (n = 153, 64.3%) and deceased patients (n = 85, 35.7%). The median HALP score was significantly lower in the deceased group (31.2) compared to survivors (52.3; P < .001). Follow-up duration was also significantly shorter in the deceased group (median 22 months) compared to survivors (median 34 months; P < .001). In the Cox univariate analysis, age ≥ 65 years (hazard ratio [HR] 2.02, 95% confidence intervals [CI] 1.32–3.1, P = .002), positive surgical margins (HR 3.04, 95% CI 1.61–5.76, P = .003), and low HALP scores (HR 5.17, 95% CI 3.33–8.03, P < .001) were significantly associated with decreased survival. However, in the multivariate analysis, positive surgical margins (HR 2.74, 95% CI 1.35–5.56, P = .005) and low HALP scores (HR 5.80, 95% CI 3.6–9.3, P < .001) remained independent predictors of decreased survival, while age ≥ 65 years did not retain significance. These findings suggest that positive surgical margins and low HALP scores are key prognostic factors for survival in NSCLC patients. The HALP score was identified as an independent predictor of postoperative mortality in NSCLC patients. Lower scores were significantly associated with higher mortality, indicating its potential use in both risk assessment and guiding postoperative management.

Background: Pulmonary sarcomatoid carcinomas are very rare lung neoplasms, and no consensus exists regarding their optimal treatment. The prognosis of sarcomatoid carcinomas has been reported to be unfavorable compared with non-small-cell lung cancers; however, prognostic factors in patients undergoing surgery for sarcomatoid carcinomas remain unclear. Aims: To analyze clinicopathologic prognostic factors and survival outcomes in patients who underwent surgery for pulmonary sarcomatoid carcinoma. Study Design: Retrospective cross-sectional study. Methods: We designed a retrospective cross-sectional study in patients who underwent surgery for pulmonary sarcomatoid carcinomas and statistically analyzed the prognostic factors regarding clinicopathologic features with respect to survival outcomes. Results: We had a total of 44 patients with sarcomatoid carcinoma who had pulmonary resection. Sex distribution was 34 (77%) males and 10 (22.7%) females, which was determined by declaration. The mean age of patients was 57.3 +/- 16 years with a median of 60 years. The 5-year progression-free survival and overall survival rates were 59% and 58%, respectively. The 5-year survival rates were significantly different for tumors > 5 cm (P = 0.044), tumorstatus (T) (P=0.016), lymph node status (N) (P=0.005), and pathologic tumor-node-metastasis (TNM) stage (P = 0.0001). However, histologic subtype (P = 0.628) and adjuvant treatment (P = 0.804) did not have any significant effect on survival. Similarly, the significant prognostic factors in univariate analysis were tumor size (P = 0.085), T status (P = 0.005), N status (P = 0.028), and pathologic TNM stage (P = 0.0001). Multivariate analysis showed only T status (P = 0.058), N status (P = 0.018), and pathologic TNM stage (P = 0.019) as independent prognostic factors, with statistical power of 87%, 43.1% and 21.2%. Conclusion: Surgery appears to be an optimal treatment with favorable outcomes for patients with pulmonary sarcomatoid carcinoma. Patients with small tumors at earlier stages are very likely to benefit from surgery, regardless of histologic subtype.

Background: In this study, we aimed to evaluate the predictive value of the Haller index for recurrence risk in primary spontaneous pneumothorax patients. Methods: Between January 2018 and December 2023, a total of 285 patients (260 males, 25 females; median age: 23 years; range, 17 to 35 years) with primary spontaneous pneumothorax who underwent thoracic computed tomography and followed for at least one year were retrospectively analyzed. The patients were divided into two groups as the non-recurrence group (n=170) and recurrence (n=115) group. The Haller index was calculated from computed tomography scans at presentation and its predictive value for recurrent pneumothorax was estimated. Results: The median age was significantly higher in the non-recurrence group than in the recurrence group (p< 0.001). The median time to recurrence was two (IQR 1-3) months. The diagnostic validity of Haller index for predicting recurrence showed an area under the receiver operating characteristic of 0.824 (95% confidence interval [CI]: 0.775-0.866) (p< 0.001). The optimal cut-off value of Haller index (>2.4) showed a sensitivity of 70.43% (95% CI: 61.2-78.6) and specificity of 76.47% (95% CI: 69.4-82.6). Conclusion: A high Haller index is associated with increased recurrent pneumothorax risk in primary spontaneous pneumothorax patients. Traditionally used for pectus excavatum severity, incorporating Haller index in the management of these patients may help to identify high-risk patients and guide personalized management strategies.

Background Mediastinal lymphadenopathies with high 18-fluorodeoxyglucose uptake in patients previously operated on for lung cancer are alarming for recurrence and necessitate invasive diagnostic procedures. Peroperative placement of oxidized cellulose to control minor bleeding may lead to a metastasis-like image through a foreign body reaction within the dissected mediastinal lymph node field at postoperative examinations. In this study, we investigated clinicopathological features and the frequency of foreign body reaction mimicking mediastinal lymph node metastasis. Methods Patients who underwent surgery for lung cancer between January 2016 and August 2021 and who were subsequently evaluated for mediastinal recurrence with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) were included. Patients were grouped according to the results of EBUS-TBNA as metastasis, foreign body, and reactive. Clinicopathological features of these patients were compared and characteristics of patients in the foreign body group were scrutinized. Results EBUS-TBNA was performed on a total of 34 patients during their postoperative follow-up due to suspicion of mediastinal recurrence. EBUS-TBNA pathological workup revealed metastasis in 18 (52.9%), foreign body reaction in 10 (29.4%) and reactive lymph nodes in 6 (17.6%) patients. Mean maximum standardized uptake value (SUVMax) for metastasis group and foreign body group were 9.39 ± 4.69 and 5.48 ± 2.54, respectively (p = 0.022). Time interval between the operation and EBUS-TBNA for the metastasis group was 23.72 ± 10.48 months, while it was 14.90 ± 12.51 months in the foreign body group (p = 0.015). Conclusion Foreign body reaction mimicking mediastinal lymph node metastasis is not uncommon. Iatrogenic cause of mediastinal lymphadenopathy is related to earlier presentation and lower SUVMax compared with metastatic lymphadenopathy.