Most recently added articles listed first
Comment by Dr Mark Lavercombe:
In this study from Hong Kong, the authors explore factors predicting disease free survival in patients with surgically resected stage 1 adenocarcinoma. Multivariate analysis was used to build a prediction model that, when applied to a validation cohort, achieved an area under the receiver operating characteristic curve of 0.863. The generalisability of this result is unclear due to the relatively high rate of never smoking and epidermal-growth factor receptor mutation positivity in this cohort.
Comment by Dr Mark Lavercombe:
Although reporting of bronchoprovocation testing relies heavily on a change in FEV1 following exposure to the provoking agent, it is plausible that other lung function parameters might provide additional information in the assessment of airway hyperresponsiveness (AHR). In this study, the authors performed lung volume estimation using body plethysmography as part of their protocol for methacholine challenge testing. They demonstrate that specific airway conductance (sGaw) is reduced in a substantial number of patients that did not achieve a reduction of 20% in FEV1, and suggest that incorporation of sGaw leads to a higher sensitivity for AHR.
Comment by Dr Mark Lavercombe:
In this large cohort of over 21,000 cases of confirmed lung cancer in women aged 40-80 in Taiwan, a history of ever smoking, living in an urban area, or diagnosis of COPD, prior tuberculosis, or malignant neoplasm were found to be risk factors. An association between time-weighted average exposure to inhaled PM2.5 particles and lung adenocarcinoma is demonstrated, with increased levels of exposure associated with increased malignancy risk. Given the low rate of smoking in adult women in Taiwan (<5%), this data suggests another possible contributor to the development of adenocarcinoma in non-smoking women.
Comment by Dr Mark Lavercombe:
In this large study of over 100,000 patients in the Korea NHIS, the association between a diagnosis of IPF and malignancy is explored. Overall cancer risk is confirmed to be higher (HR-2), largely driven by a significant excess in lung cancer diagnoses (HR-6).
Comment by Dr Mark Lavercombe:
Non-expansile lung is considered a contraindication to talc slurry pleurodesis in malignant pleural effusion, however inter-observer agreement for diagnosing non-expansile lung on chest radiography is unknown. This study demonstrates poor correlation between experienced observers. Implications for study design and clinical treatment choices are considered.
Comment by Dr Mark Lavercombe:
Although malignant pleural effusion can be treated with repeated thoracenteses, identification of patients more likely to suffer recurrence of their effusion might lead to earlier definitive intervention. The authors identify several risk factors for recurrence in their cohort, however further study is required to develop a predictive model with external validity.
Comment by Dr Mark Lavercombe:
Vocal cord dysfunction is not uncommon in patients after lung cancer resection, and this study demonstrates a significant association with poor post-operative outcomes including pneumonia, need for bronchoscopy and re-intubation. The authors recommend routine laryngeal screening within 24h of surgery, although treatment outcomes were not assessed in this study.
Comment by Dr Mark Lavercombe:
The authors of this paper describe the natural history of single and multiple ground glass nodules (GGN) over a 36 month period. They demonstrate that partly solid and ≥ 10mm size solitary GGN are more likely to progress, while ≥ 10 mm and past history of lung cancer were associated with progression in multiple GGN.
Comment by Dr Mark Lavercombe:
The authors of this paper outline the use of EBUS elastography for both qualitative and quantitative assessment of mediastinal lymphadenopathy for the presence of malignancy. Their promising findings suggest the need for further study to better define the elastographic features in both benign and malignant conditions, in order to guide the need for TBNA sampling.
Comment by Dr Mark Lavercombe:
This original article suggests that malignant pleural effusion in mesothelioma might not be purely a consequence of the malignancy, but could contribute to its pathobiology. This suggests the possibility of future therapeutic targets in this disease.
Interstitial lung disease associated with gemcitabine: A Japanese retrospective cohort study. Hamada et al.
onlinelibrary.wiley.com/doi/10.1111/resp.12665/abstract (Nov 2015)