René Horsleben Petersen

Beyond feasibility: defining surgical quality in second pulmonary resection

Objectives: The Women in General Thoracic Surgery (WGTS) Academy, organized by the European Society of Thoracic Surgeons (ESTS), supports early and mid-career women thoracic surgeons through mentorship, leadership development, and clinical immersions in a gender-equitable environment. Methods: We conducted a prospective cross-sectional survey-based evaluation of all fellows participating in the WGTS Academy between 2023 and 2025. The survey addressed the value of face-to-face meetings, simulation training, and clinical immersions, as well as professional connections, challenges faced, and suggestions for future improvements. Results: Twenty-nine women Academy fellows were invited, and 24 completed the survey (82.8%). Thirteen participants (54.2%) worked in academic or university hospitals. Face-to-face meetings during clinical immersions were highly valued (62.5% rating them 10/10). Simulation training was considered valuable by 23 participants (95.8%). The most appreciated topics were mentorship, leadership, robotic surgery, gender-related discussions, and opportunities to interact with women leaders. Participants identified key benefits such as international networking, mentorship, professional development, emotional support, and friendships. Regarding clinical impact, 8 participants (33.3%) reported changes in their practice, and 11 (45.8%) planned to implement changes. Six participants (25.0%) had already assumed leadership roles, and 7 participants (29.2%) were engaged in research. Overall, 23 participants (95.8%) would recommend the Academy, and 21 (87.5%) expressed willingness to participate in future activities. Conclusions: The WGTS Academy was highly valued by participants, who reported perceived benefits related to mentorship, networking, leadership development, and clinical practice. Participants identified opportunities for further program development, particularly in hands-on training and research support.

Background and purpose: This study aims to evaluate survival, relapse, comorbidities, and prognostic factors in patients with thymic epithelial tumours (TETs) to improve risk stratification for TET-related mortality and relapse and support evidence-based follow-up and treatment strategies.Patient/material and methods: The cohort consists of consecutive Danish patients diagnosed with thymoma, thymic carcinoma (TC), or thymic neuroendocrine tumor (NET) between January 1st, 2015 and December 31st, 2020, with follow-up data available.Data were collected from online medical records including disease characteristics, survival outcomes, comorbidities, and relapse. Statistical analyses were performed in R 4.3.2 and the prognostic value baseline traits were analyzed using Cox Proportional Hazards models.Results: Our cohort comprised 282 patients with a mean diagnostic age of 65 years and the following histological distribution: thymoma (85%), TC (13.6%), and NET (1.4%). During the 72-month mean follow-up, 65 deaths occurred yielding overall survival (OS) of 81% in patients with thymoma and 47% in patients with TC. TET-related deaths predominated in TC, yielding a cancer-specific survival) of 53% compared with 96% in thymoma. Reduced OS was associated with increasing age (p < 0.001) and advanced Tumor, Node, Metastasis-stage (III p < 0.05; IV p < 0.001). Disease progression was verified in 13/201 (6%) of thymoma patients with R0 or R1 resection.Interpretation: We report a high OS of Danish TET patients compared to existing population-based studies. The occurrence of TET-related mortality and disease progression in patients with thymoma and TC, highlights the need for long-term follow-up and therefore risk stratification in TET management.

Loss of elastic recoil in emphysema causes hyperinflation of the lung tissue, stretching the respiratory muscles. Maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) decline in severe emphysema. We hypothesized that treating hyperinflation with lung volume reduction surgery (LVRS) or via bronchoscopic lung volume reduction (BLVR) with valves could lead to improved MIP or MEP. Consecutive emphysema patients referred for treatment with LVRS or BLVR from October 2020 to June 2023 were included. We applied a mixed linear model with the different treatments as independent variables to compare MIP/MEP prior to treatment, with values at 3-month follow-up. A total of 61 patients had preoperative MIP/MEP done prior to LVRS (42) or BLVR (19) treatment. Thirty-nine also had MIP/MEP measurements at 3 months follow-up, 31 after LVRS and 8 after BLVR, respectively. There was no significant increase in MIP from baseline to follow-up in the LVRS ( p = 0.37) and BLVR ( p = 0.32) groups. Nor was there any difference between the BLVR and LVRS group at baseline ( p = 0.12) or at follow-up ( p = 0.19). Similarly, MEP values were unchanged in the BLVR and LVRS groups from preoperative level to 3-month follow-up for BLVR ( p = 0.59) and for LVRS ( p = 0.11).

Objectives: Pulmonary artery sarcoma (PAS) is a rare and aggressive malignancy often mimicking pulmonary embolism, leading to diagnostic delays and poor outcomes. This study aims to describe the clinical characteristics, diagnostic pathways, treatment modalities, and outcomes of PAS patients in a multicentre cohort. Methods: This retrospective cohort study included patients from 7 institutions between 1994 and 2024. Clinical, radiological, histological, and treatment data were collected via a standardized REDCap-based platform. All patients underwent either multimodal treatment or single therapy approach, including systemic therapy, surgery, and/or radiotherapy. Kaplan–Meier survival analysis and log-rank testing were performed to assess overall survival (OS) and progression-free survival (PFS). Results: 84 patients from 7 international centres were analysed. The mean age was 54.4 years, and 43.8% of patients were female. The most common presenting symptoms were dyspnoea (81.2%) and chest pain (50.0%). Pulmonary embolism was the most frequent initial misdiagnosis (49.1%). Histologically, PAS was diagnosed in 46 cases. Tumours were bilateral in 58.1% of patients with surgery only. Most commonly, endarterectomy was performed in 59.5%. After a median follow-up time of 39 months, 19 were excluded as they either had no treatment information or received monotherapy only. Additionally, 11 patients were excluded due to missing date of diagnosis and 17 due to missing overall follow-up date. There was moderate evidence that OS differed between treatment groups (75th quantile: 34 months for multimodal [95% CI, 26 to not reached] vs 11 months for surgery only [95% CI, 7-21]; log-rank P = .022). There was no evidence that PFS differed between treatment groups (median 19 months for multimodal [95% CI, 14-39] vs 16 months surgery only [95% CI, 11-21]; log-rank P = .69). Conclusions: This study represents the largest reported PAS cohort to date and underscores the diagnostic challenges and poor prognosis associated with this disease. Our findings offer evidence that multimodal treatment provides significant prognostic benefits. However, further prospective studies are warranted to establish standardized diagnostic and therapeutic protocols.