P-253UNIPORTAL VIDEO-ASSISTED THORACIC SURGERY LOBECTOMY COMBINED WITH POSTERIOR MIDLINE APPROACH FOR SUPERIOR SULCUS TUMOURS INVADING THE SPINE
Bibliographic record
Abstract
Objectives: Expertise in VATS oncological procedures is on the rise since it has become associated with diminished perioperative pain and morbidity. Locally advanced lung cancers, such as Pancoast tumours with spine invasion, can present a technical challenge. We believe that even for such advanced cancers, combining posterior spine resection with VATS lobectomy can decrease perioperative morbidity but still maintain the same oncological resection quality as compared to that of open surgery. Case description: The following is a report of 2 cases of right sided superior sulcus tumour with vertebral invasion. Both patients received induction chemoradiation and surgical resection according to the SWOG 9416 protocol. Superior lobectomy was then performed by uniportal VATS, including mediastinal node dissection and extra-pleural delimitation around the tumour, in order to obtain macroscopically clear margins for the spine and chest wall resection borders. The bronchial stump was buttressed with mediastinal fat and pleural flaps. The patient was then placed in the ventral position and partial corpectomy with chest wall resection and spine stabilization was performed through a posterior midline incision. The en-bloc surgical specimen was then removed via this posterior approach. Both patients had a complete resection (R0). The first patient developed a bronchopleural fistula and spine fixation material displacement requiring surgical intervention on postoperative day 17. At the 1-year follow-up, the patient remained disease free and continued to have good functional status. The second patient was discharged on postoperative day 8 and was treated for atrial flutter on postoperative day 20. Conclusions: Pancoast tumours invading the spine require aggressive yet morbid surgery in order to obtain a margin free en-bloc resection. VATS lobectomy combined with posterior spine resection and stabilization is safe and can diminish the early surgical morbidity without compromising the quality of the resection. Disclosure: No significant relationships.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".