Rodríguez-Pérez, M.C. (María C.)
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- Prognostic impact of lung adenocarcinoma second predominant pattern from a large European database(Willey, 2020) Aprile, V. (Vittorio); Lococo, F. (Filippo); Bertoglio, P. (Pietro); Franzi, F. (Francesca); Guerrera, F. (Francesco); Cattoni, M. A. (Maria Angela); Femia, F. (Federico); Ampollini, L. (Luca); Nachira, D. (Dania); Viti, A. (Andrea); Bacchin, D. (Diana); Imperatori, A. S. (Andrea Selenito); Margaritora, S. (Stefano); Terzi, A. C. (Alberto Claudio); Ruffini, E. (Enrico); Rodríguez-Pérez, M.C. (María C.); Bellafiore, S. (Salvatore); Minervini, F. (Fabrizio); Bogina, G. S. (Giuseppe Salvatore); Lucchi, M. (Marco); Paci, M. (Massimiliano); Gnetti, L. (Letizia); Querzoli, G. (Giulia); Ventura, L. (Luigi); Rindi, G. (Guido); Kestenholz, P. (Peter)Background and Objectives: Adenocarcinoma patterns could be grouped based on clinical behaviors: low‐ (lepidic), intermediate‐ (papillary or acinar), and high‐grade (micropapillary and solid). We analyzed the impact of the second predominant pattern (SPP) on disease‐free survival (DFS). Methods: We retrospectively collected data of surgically resected stage I and II adenocarcinoma. Selection criteria: anatomical resection with lymphadenectomy and pathological N0. Pure adenocarcinomas and mucinous subtypes were excluded. Recurrence rate and factors affecting DFS were analyzed according to the SPP focusing on intermediate‐grade predominant pattern adenocarcinomas. Results: Among 270 patients, 55% were male. The mean age was 68.3 years. SPP pattern appeared as follows: lepidic 43.0%, papillary 23.0%, solid 14.4%, acinar 11.9%, and micropapillary 7.8%. The recurrence rate was 21.5% and 5‐year DFS was 71.1%. No difference in DFS was found according to SPP (p = .522). In patients with high‐grade SPP, the percentage of SPP, age, and tumor size significantly influenced DFS (p = .016). In patients with lepidic SPP, size, male gender, and lymph‐node sampling (p = .005; p = .014; p = .038, respectively) significantly influenced DFS. Conclusions: The impact of SPP on DFS is not homogeneous in a subset of patients with the intermediate‐grade predominant patterns. The influence of high‐grade SPP on DFS is related to its proportion in the tumor.
- Pre-COVID-19 National Mortality Trends in Open and Video-Assisted Lobectomy for Non-Small Cell Lung Cancer(Elsevier, 2022) Dezube, A.R. (Aaron R.); Axtell, A. (Andrea); Mody, G.N. (Gita N.); Shah, R. (Rohan); Jaklitsch, M.T. (Michael T.); Rodríguez-Pérez, M.C. (María C.); Hirji, S. (Sameer); Swanson, S.J. (Scott J.)Introduction In the current era of episode-based hospital reimbursements, it is important to determine the impact of hospital size on contemporary national trends in surgical technique and outcomes of lobectomy. Methods Patients aged >18 y undergoing open and video-assisted thoracoscopic surgery (VATS) lobectomy from 2008 to 2014 were identified using insurance claims data from the National Inpatient Sample. The impact of hospital size on surgical approach and outcomes for both open and VATS lobectomy were analyzed. Results Over the 7-y period, 202,668 lobectomies were performed nationally, including 71,638 VATS and 131,030 open. Although the overall number of lobectomies decreased (30,058 in 2008 versus 27,340 in 2014, P < 0.01), the proportion of VATS lobectomies increased (24.0% versus 46.9%), and open lobectomies decreased (76.0% versus 53.0%, all P < 0.01). When stratified by hospital size, small hospitals had a significant increase in the proportion of open lobectomies (6.4%-12.2%; P = 0.01) and trend toward increased number of VATS lobectomies (2.7%-12.2%). Annual mortality rates for VATS (range: 1.0%-1.9%) and open (range: 1.9%-2.4%) lobectomy did not significantly differ over time (all P > 0.05) but did decrease among small hospitals (4.1%-1.3% and 5.1%-1.1% for VATS and open, respectively; both P < 0.05). After adjusting for confounders, hospital bed size was not a predictor of in-hospital mortality. Conclusions Utilization of VATS lobectomies has increased over time, more so among small hospitals. Mortality rates for open lobectomy remain consistently higher than VATS lobectomy (range 0.4%-1.4%) but did not significantly differ over time. This data can help benchmark hospital performance in the future.
- Usos y aplicaciones de programas informáticos en nutrición y dietética(Sociedad Española de Dietética y Ciencias de la Alimentación (SEDCA), 1994) Martinez, J.A. (José Alfredo); Rodríguez-Pérez, M.C. (María C.); Larralde-Berrio, J. (J.)La evolución tecnológica constante en el campo de la informática ha permitido el diseño de aplicaciones muy variadas en nutrición y dietética que posibilitan recoger y manejar un gran volumen de información nutricional de forma rápida, lógica y ordenada. Entre estas aplicaciones destacan las destinadas a la automatización de los servicios de dietas, a la evaluación del estado nutritivo de un individuo o colectividad, las empleadas en la enseñanza asistida en el ordenador y las utilizadas en investigación nutricional y campos afines. Los programas que registran la ingesta dietética y analizan los nutrientes de la dieta deben contar con una base de datos con la composición de los alimentos c ompleta, actualizada, modificable y de fácil acceso. Un programa informático de nutrición debe ser exacto, flexible, de fácil manejo, práctico, y en definitiva, debe responder a las necesidades específicas del usuario.
- Development and validation of the artificial intelligence (AI)-based diagnostic model for bronchial lumen identification(2022) Bignami, E. (Elena); Xie, F. (Fangfang); Sun, J. (Jiayuan); Zheng, X. (Xiaoxuan); Gu, Y. (Yun); Ye, L. (Lin); Li, Y. (Ying); Rodríguez-Pérez, M.C. (María C.); Tandon, Y. K. (Yasmeen K.)Background: Bronchoscopy is a key step in the diagnosis and treatment of respiratory diseases. However, the level of expertise varies among different bronchoscopists. Artificial intelligence (AI) may help them identify bronchial lumens. Thus, a bronchoscopy quality-control system based on AI was built to improve the performance of bronchoscopists. Methods: This single-center observational study consecutively collected bronchoscopy videos from Shanghai Chest Hospital and segmented each video into 31 different anatomical locations to develop an AI-assisted system based on a convolutional neural network (CNN) model. We then designed a single-center trial to compare the accuracy of lumen recognition by bronchoscopists with and without the assistance of the AI system. Results: A total of 28,441 qualified images of bronchial lumen were used to train the CNNs. In the cross-validation set, the optimal accuracy of the six models was between 91.83% and 96.62%. In the test set, the visual geometry group 16 (VGG-16) achieved optimal performance with an accuracy of 91.88%, and an area under the curve of 0.995. In the clinical evaluation, the accuracy rate of the AI system alone was 54.30% (202/372). For the identification of bronchi except for segmental bronchi, the accuracy was 82.69% (129/156). In group 1, the recognition accuracy rates of doctors A, B, a and b alone were 42.47%, 34.68%, 28.76%, and 29.57%, respectively, but increased to 57.53%, 54.57%, 54.57%, and 46.24% respectively when combined with the AI system. Similarly, in group 2, the recognition accuracy rates of doctors C, D, c, and d were 37.90%, 41.40%, 30.91%, and 33.60% respectively, but increased to 51.61%, 47.85%, 53.49%, and 54.30% respectively, when combined with the AI system. Except for doctor D, the accuracy of doctors in recognizing lumen was significantly higher with AI assistance than without AI assistance, regardless of their experience (P<0.001). Conclusions: Our AI system could better recognize bronchial lumen and reduce differences in the operation levels of different bronchoscopists. It could be used to improve the quality of everyday bronchoscopies.
- Pathological and clinical features of multiple cancers and lung adenocarcinoma: a multicentre study(2022) Aprile, V. (Vittorio); Lococo, F. (Filippo); Bertoglio, P. (Pietro); Franzi, F. (Francesca); Guerrera, F. (Francesco); Cattoni, M. A. (Maria Angela); Femia, F. (Federico); Ampollini, L. (Luca); Nachira, D. (Dania); Bacchin, D. (Diana); Imperatori, A. S. (Andrea Selenito); Margaritora, S. (Stefano); Terzi, A. C. (Alberto Claudio); Ruffini, E. (Enrico); Rodríguez-Pérez, M.C. (María C.); Bellafiore, S. (Salvatore); Minervini, F. (Fabrizio); Bogina, G. S. (Giuseppe Salvatore); Lucchi, M. (Marco); Paci, M. (Massimiliano); Lenzini, A. (Alessandra); Gnetti, L. (Letizia); Querzoli, G. (Giulia); Ventura, L. (Luigi); Rindi, G. (Guido); Kestenholz, P. (Peter)OBJECTIVES Lung cancer is increasingly diagnosed as a second cancer. Our goal was to analyse the characteristics and outcomes of early-stage resected lung adenocarcinomas in patients with previous cancers (PC) and correlations with adenocarcinoma subtypes. METHODS We retrospectively reviewed data of patients radically operated on for stage I–II lung adenocarcinoma in 9 thoracic surgery departments between 2014 and 2017. Overall survival (OS) and time to disease relapse were evaluated between subgroups. RESULTS We included 700 consecutive patients. PC were present in 260 (37.1%). Breast adenocarcinoma, lung cancer and prostate cancer were the most frequent (21.5%, 11.5% and 11.2%, respectively). No significant differences in OS were observed between the PC and non-PC groups (P = 0.378), with 31 and 75 deaths, respectively. Patients with PC had smaller tumours and were more likely to receive sublobar resection and to be operated on with a minimally invasive approach. Previous gastric cancer (P = 0.042) and synchronous PC (when diagnosed up to 6 months before lung adenocarcinoma; P = 0.044) were related, with a worse OS. Colon and breast adenocarcinomas and melanomas were significantly related to a lower incidence of high grade (solid or micropapillary, P = 0.0039, P = 0.005 and P = 0.028 respectively), whereas patients affected by a previous lymphoma had a higher incidence of a micropapillary pattern (P = 0.008). CONCLUSIONS In patients with PC, we found smaller tumours more frequently treated with minimally invasive techniques and sublobar resection, probably due to a more careful follow-up. The impact on survival is not uniform and predictable; however, breast and colon cancers and melanoma showed a lower incidence of solid or micropapillary patterns whereas patients with lymphomas had a higher incidence of a micropapillary pattern.
- Diagnosis and Treatment of Pleural Effusion. Recommendations of the Spanish Society of Pulmonology and Thoracic Surgery. Update 2022(2023) Cases, E. (Enrique); Valdés-Cuadrado, L. (Luis); Botana-Rial, M. (Maribel); Pérez-Pallarés, J. (javier); Porcel, J. M. (José Manuel); Cordovilla, R. (Rosa); Rodríguez-Pérez, M.C. (María C.); López-González, F. J. (Francisco Julián); Romero-Romero, B. (Beatriz); Villena-Garrido, V. (Victoria)Pleural effusion (PE) is a common yet complex disease that requires specialized, multidisciplinary management. Recent advances, novel diagnostic techniques, and innovative patient-centered therapeutic proposals have prompted an update of the current guidelines. This document provides recommendations and protocols based on a critical review of the literature on the epidemiology, etiology, diagnosis, prognosis, and new therapeutic options in PE, and addresses some cost-effectiveness issues related to the main types of PE.
- Impact of High-Grade Patterns in Early-Stage Lung Adenocarcinoma: A Multicentric Analysis(2022) Aprile, V. (Vittorio); Lococo, F. (Filippo); Bertoglio, P. (Pietro); Franzi, F. (Francesca); Guerrera, F. (Francesco); Cattoni, M. A. (Maria Angela); Femia, F. (Federico); Nachira, D. (Dania); Solli, P. (Piergiorgio); Bacchin, D. (Diana); Imperatori, A. S. (Andrea Selenito); Margaritora, S. (Stefano); Terzi, A. C. (Alberto Claudio); Ruffini, E. (Enrico); Rodríguez-Pérez, M.C. (María C.); Bellafiore, S. (Salvatore); Minervini, F. (Fabrizio); Bogina, G. S. (Giuseppe Salvatore); Bocchialini, G. (Giovanni); Lucchi, M. (Marco); Paci, M. (Massimiliano); Gnetti, L. (Letizia); Querzoli, G. (Giulia); Ventura, L. (Luigi); Rindi, G. (Guido); Kestenholz, P. (Peter)Objective The presence of micropapillary and solid adenocarcinoma patterns leads to a worse survival and a significantly higher tendency to recur. This study aims to assess the impact of pT descriptor combined with the presence of high-grade components on long-term outcomes in early-stage lung adenocarcinomas. Methods We retrospectively collected data of consecutive resected pT1-T3N0 lung adenocarcinoma from nine European Thoracic Centers. All patients who underwent a radical resection with lymph-node dissection between 2014 and 2017 were included. Differences in Overall Survival (OS) and Disease-Free Survival (DFS) and possible prognostic factors associated with outcomes were evaluated also after performing a propensity score matching to compare tumors containing non-high-grade and high-grade patterns. Results Among 607 patients, the majority were male and received a lobectomy. At least one high-grade histological pattern was seen in 230 cases (37.9%), of which 169 solid and 75 micropapillary. T1a-b-c without high-grade pattern had a significant better prognosis compared to T1a-b-c with high-grade pattern (p = 0.020), but the latter had similar OS compared to T2a (p = 0.277). Concurrently, T1a-b-c without micropapillary or solid patterns had a significantly better DFS compared to those with high-grade patterns (p = 0.034), and it was similar to T2a (p = 0.839). Multivariable analysis confirms the role of T descriptor according to high-grade pattern both for OS (p = 0.024; HR 1.285 95% CI 1.033–1.599) and DFS (p = 0.003; HR 1.196, 95% CI 1.054–1.344, respectively). These results were confirmed after the propensity score matching analysis. Conclusions pT1 lung adenocarcinomas with a high-grade component have similar prognosis of pT2a tumors.
- TNFA-863 polymorphism is associated with a reduced risk of chronic obstructive pulmonary disease: a replication study(Public Library of Science, 2011) Casanova, C. (Ciro); Medina-Coello, Ch. (Chaxiraxi); Baz-Dávila, R. (Rebeca); Cordoba-Lanus, E. (Elizabeth); Torres, J.P. (Juan P.) de; Aguirre-Jaime, A. (Armando); Rodríguez-Pérez, M.C. (María C.); Maca-Meyer, N. (Nicole); Varo-Cenarruzabeitia, M.N. (Miren Nerea)We replicated the previously reported association between the TNFA -863 SNP and COPD. TNFA -863A allele may confer a protective effect to the susceptibility to the disease in the Spanish population
- Enhanced recovery after surgery pathways in thoracic surgery, do they end at discharge?(AME Publishing Company, 2019) Rodríguez-Pérez, M.C. (María C.); Aymerich-De-Franceschi, M. (María)Fast track pulmonary resection protocols have shown to be feasible and to improve hospital related costs, shortening length of stay and maintaining quality of care (1-4). Despite the increasing number of scientific literature addressing the benefits of specific lobectomy pathways (4,5) and the recent publication of Enhanced Recovery after Surgery (ERAS®) guidelines in thoracic surgery (4-6) the truth is that the description of most of these interventions ends at patients’ discharge, with no clear indications for follow up or measures to prevent unintended hospital readmissions (2,3)
- Prognostic value and immune regulatory role of dynamin 1-like in lung adenocarcinoma(2023) Wu, Y. (Yingxi); Wu, X. (Xuan); Wang, S. (Shuai); Rodríguez-Pérez, M.C. (María C.); Song, W. (Wenping); Li, D. (Ding); Oh, I. (In-Jae); Barr, M. P. (Martin P.)Background Lung adenocarcinoma (LUAD) is the most common histological subtype of non-small cell lung cancer (NSCLC), with poor treatment outcomes worldwide. Dynamin-related protein 1 (DRP1), which is encoded by the dynamin 1-like (DNM1L) gene, acts as a regulator of mitochondrial fission and plays crucial roles in tumor initiation and progression. However, the clinical value and immune regulation of DNM1L in LUAD have not been explored. Methods We comprehensively analyzed the expression of DNM1L in the LUAD cohort of the Human Protein Atlas (HPA) and the University of The ALabama at Birmingham CANcer data analysis Portal (UALCAN) databases. Kaplan-Meier plotter, in addition to the PrognoScan database, was used to estimate the correlation between DNM1L expression and survival outcome of LUAD patients. The association between the immune tumor microenvironment (TME) and DNM1L expression in LUAD was evaluated based on the Tumor IMmune Estimation Resource (TIMER)2.0 database. Finally, the functions of DNM1L were validated in vitro experiments, including reverse transcription-quantitative polymerase chain reaction (RT-qPCR), western blot, wound healing assays, and transwell assays. Results DNM1L was overexpressed in LUAD compared to healthy control tissues and was regarded as an independent prognostic factor. Overexpression of DNM1L was significantly related to clinical variables and poor survival outcomes of LUAD patients. Moreover, DNM1L expression was positively associated with the expression of key genes involved in the regulation of immune cell subsets, including T helper (Th)2 cells, Th cells, B cells, CD8 T cells, dendritic cells, and mast cells. In contrast, DNM1L was negatively correlated with the infiltrating levels of myeloid dendritic cells and B cells. Furthermore, DNM1L may play a role in regulating immune cell infiltration and have prognostic value in LUAD patients. Finally, the in vitro experiments showed that increased DNM1L significantly promoted the proliferation and migration of LUAD cells. Conclusions This study suggested that DNM1L may play an important role in regulating the proliferation and migration of LUAD cells as well as the infiltration of tumor-related immune cells, which suggests DNM1L was a potential therapeutic target in LUAD. Further studies are however warranted to define its exact mechanism of action and potential therapeutic significance in LUAD patients.