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Objective: The introduction of modern staging systems such as computed tomography (CT) and positron emission tomography/CT (PET/CT) with fluorodeoxyglucose ([ 18 F]FDG) has increased the detection of small peripheral lung cancers at an early stage. We analyzed the behavior of pathological T1 non-small-cell lung cancer (NSCLC) to identify criteria predictive of nodal involvement, and the role of cancer size in lymph node metastases. Methods: We retrospectively analyzed 219 patients with pathological T1 NSCLC. All patients were staged by high-resolution CTand PETas stage I, and underwentanatomical resectionand radical lymphadenectomy. Our data were collected based on pathological nodulesize (0— 10 mm; 11—20 mm; and 21—30 mm); morphological features of lung nodule and FDG uptake of the tumor measured by standardized uptake value (SUV). Results:A total of 190 patients (87%) were pN0, 14 (6%) pN1, and 15 (7%) pN2. No nodal involvement was observed in any of the 62 patients with nodule size less than 10 mm, in 20 out of 120 patients (17%) with nodule size 11—20 mm, and in nine out of 37 tumors (28%) 21—30 mm in size (p = 0.0007). All 55 patients with nodule SUV < 2.0 and all 26 non-solid lesions were pN0 (respectively, p = 0.0001 and p = 0.03). All nodal metastases occurred amongthe group of 132patients with size larger than 10 mm and SUV higher than 2.0 with a 22% rate of nodalinvolvement of (29 patients) (p < 0.0001). Conclusions: The low probability of lymph node involvement in NSCLC

Objective: The clinical outcome of 180 non-thymomatous myasthenia gravis (MG) consecutive cases surgically treated is reported herein. The original surgical access, consisting of a video-assisted infra-mammary cosmetic incision and median sternotomy, has originally been designed and described by our group. Methods: The in-hospital patients’ charts and the outpatients’ clinic follow-up information of the 180 cases have been extensivelyreviewed.In additionto the strictly surgicalbenchmarkreferral,data on therate of cure of the MG (completestableremission— CSR; pharmacological remission — PR) as indicated by the Myasthenia Gravis Foundation of America (MGFA) have been analysed as recorded at the 12 months after surgery checkpoint. Cosmetic outcome was evaluated as well. Results: Female to male ratio was 156 (86.7%):24 (13.3%). Mean age: 29.1 10.9 years. Preoperative MGFA score: stage I: 4 patients (2.2%); IIa: 57 (31.7%); IIb: 32 (17.8%); IIIa: 41 (23.3%); IIIb: 42 (23.3%); IVa: 2 (1.1%); V: 2 (1.1%). Median operative time was 110 min (70—130 min) and median postoperative hospital stay was 4 days (3—10 days). Postoperative mortality was nil and morbidity occurred in seven patients (3.8%). Final pathology was consistent with: 146 hyperplastic thymus (81.1%); 28 involuted thymus (15.6%) and 6 normal thymus (3.3%). Ectopic thymic tissue was found in 68% of the patients. Mean follow-up was 62.9 34.6 months. A CSR was obtained in 55%; PR in 18.3%; improvement in 39.9%, unchanged in 3.5%, worse in 1.1% and died in 0.5%. Kaplan— Meier estimates of CSR were 34.1% and 75.8% at 5 and 10 years, respectively. The preoperative therapy was the only parameter significantly associated with Kaplan—Meier CSR rates (univariate analysis — p < 0.001). Remarkably, 171 (95%) patients judged their cosmetic results to be excellent or very good.Conclusions:Thymectomy in MG patients via video-assisted infra-mammary cosmetic incision and median sternotomyhas shown to be a useful surgical approach as demonstrated by the good functional and very good aesthetic results, associated with a very low morbidity and no mortality. Patients with preoperative mono-therapy have higher CSR rates. CSRs are durable, as the CSR rate improves with extended follow-up. # 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.