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Journal and News Scan
The authors evaluated the impact of small (<10mm) pleural effusion on outcomes in patients with NSCLC. Of over 2000 pts, minimal PE was present in 13%. It was more common in patients with more advanced stages. Minimal PE was associated with decreased median survival (7.7 vs 17.7 mos) after adjustment for other prognostic variables. The impact on outcomes was greater for earlier stages of disease.
During the period 1997-2009, nearly 3,000 military veterans with NSCLC were evaluated regarding the utility of PET in staging their cancers. PET use increased in frequency during the study period from 9% to 91%. PET reduced the chance of unnecessary surgery by nearly 50%.
In an effort to provide diagnostic information complementary to radiographic screening for lung cancer, the authors evaluated the diagnostic performance of plasma mRNA. The mRNA signature classifier demonstrated 87% sensitivity and 81% specificity, with a negative predictive value of 99%. In contrast, low dose CT had a sensitivity of 79% and a specificity of 81%. Combining the mRNA signature classifier and low dose CT resulted in a 5-fold decrease in false positive findings based on CT alone.
LVI is thought to be an adverse prognostic indicator of survival in patients with NSCLC. This review quantified the relationship of LVI and survival. The unadjusted effect of LVI for recurrence-free survival was HR=3.63 and for overall survival was HR=2.38. After adjustment for covarates, these HRs were 2.52 and 1.81, both highly significant.