Objectives: High maximum standardized uptake value (SUVmax) is associated with poorly differentiated tumors and lymph node metastasis. It is still controversial which tumors can be treated with sublobar resection and there are publications stating that SUVmax of the tumor may be important in choosing sublobar resection. Our aim in this study is to examine the prognostic value of tumor SUVmax in stage 1 non-small cell lung cancer and to determine its place in sublobar resection preference. Methods: The study included 314 patients who underwent wedge resection, segmentectomy or lobectomy for pathological stage I NSCLC with tumor size ≤ 3 cm between January 2008 and December 2020. SUVmax of the tumors are dichotomized according to ROC threshold value 5.2 and prognostic factors for recurrence-free and overall survival were analysed. Results: In the multivariate survival analysis, SUVmax (p = 0.012), lymphovascular and/or perineural invasion (p < 0.001) and visceral pleural invasion (p = 0.031) were found to be independent prognostic factors for recurrence-free survival; age (p = 0.027), sex (p = 0.010) and SUVmax (p = 0.036) for overall survival. While there was no difference between lobar or sublobar resection in terms of recurrence-free survival (p = 0.647) in patients with SUVmax ≤ 5.2, lobectomy was found to be advantageous over sublobar resection for recurrence-free survival in patients with SUVmax > 5.2 (76.6% ± 3.9% / 53.4% ± 12.1%, p = 0.006, respectively). Conclusions: High SUVmax (> 5.2) is associated with poor recurrence-free survival and overall survival rates in pathological stage 1 NSCLC patients. In stage 1 patients, sublobar resection should be avoided if the primary tumor has a high SUVmax.

Partial anomalous pulmonary venous connection (PAPVC) is a rare congenital anomaly. Generally, it is seen on the right side and is associated with an atrial septal defect. Herein, we present a case of a 50-year-old male patient with a supracardiac type PAPVC detected during pneumonectomy for a right hilar mass. This is the second case report in the literature presenting surgical treatment of both lung cancer and PAPVC using pneumonectomy. Thoracic surgeons should be aware of this anomaly when they are planning to perform a major lung resection. If PAPVC and lung cancer are in the same lobe, anatomical lung resections including pneumonectomy can be safely performed.

The recommended treatment for early stage thymoma without myasthenia gravis is complete thymectomy (CT). Limited thymectomy (LT) (simply resecting the thymoma with safe surgical margins) is gaining popularity. In this study, we compared the surgical and oncological results of complete and limited thymectomy in non-myasthenic patients with early stage thymoma. Non-myasthenic, Masaoka stage I–II, 86 patients who underwent surgical resection for thymoma were included in the study. Complete thymectomy (n:44) included patients who had resection of the thymoma together with the entire thymus and limited thymectomy (n:42) included patients who had resection of the thymoma without remaining thymus. The surgical approach, tumor size, histological type, pathological stage, adjuvant therapy, complications, postop myasthenia gravis, recurrence and death were recorded and compared between groups. Complete thymectomy group had more WHO type B1-3 tumors, more complications and more deaths than patients in the limited thymectomy group (p = 0.03, 0.018 and 0.023 respectively). Although statistically not significant CT group had more recurrences than LT group (11.4%/4.8%, p = 0.43). The 10-year freedom from recurrence (FFR) rate in the CT group was 84.8% and in the LT group ıt was 97.6%, the difference was not statistically significant (p = 0.15). None of the factors including surgical extent analysed with univariate and multivariate analysis had a significant effect on FFR. Limited thymectomy may be a good treatment option for non-myasthenic early stage thymoma patients but randomized controlled trials with long follow-up periods, ideally comparing patients operated with minimally invasive surgery are necessary.