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Journal and News Scan
Using data from 2 centers in London, outcomes after induction therapy and resection for esophageal cancer were analyzed according to the pathological response to induction therapy. Downstaging was the strongest predictor of survival (HR 0.43). Downstaging was also associated with a lower rate of local recurrence (6% vs 13%) and systemic recurrence (19% vs 29%). Pathologic stage after induction therapy was a stronger predictor of survival that was pretreatment clinical stage.
Just a quick one and perhaps one to show patients, but a stark contrast between the best lungs and the worst.
Slightly sensationalist but might be effective for a patient that doesn't think that smoking makes a big difference !!
The authors deal with a dramatic complication of acute Type A aortic
dissection - mesenteric malperfusion. They reviewed 309 papers on acute
aortic dissection and concluded that initial interventional management of
mesenteric malperfusion followed by delayed proximal aortic repair is a
reasonable strategy, since the prognosis of those immediately operated on
the ascending aorta was extremely poor.
The authors queried whether PET has utility in clinically staging Tis or T1 esophageal cancers; this was a single institution retrospective study involving 79 pts. The incidence of FDG uptake increased with increasing T status, as did the SUV. Nodal staging was false positive in 3 pts and false negative all 13 pts with nodal involvement. Metastatic staging was false positive in 5 pts. PET is not recommended for pts with Tis or T1 disease on EUS.
The efficacy of induction therapy for clinical T2 esophageal cancer was evaluated using the National Cancer Database. Pretreatment staging was accurate in only 27% of pts. 42% of pts were upstaged and 32% were downstaged. Induction therapy had no survival benefit.
Participants in the Lung Cancer Screening Trial were evaluated for success in smoking cessation linked to findings in their screening CTs. The odds ratios for continued smoking decreased with increasingly worrisome abnormalities on CTs: 0.81 for a major abnormality not suspicious for cancer, 0.79 for an abnormality suspicious for cancer but stable, and 0.66 for a finding suspicious for cancer that was new or changed from prior. CT screening is an opportunity to aid patients with smoking cessation.
This study tracked changes in management for and outcomes of T1a and T1b esophageal cancer using data from the National Cancer Data Base. Endoscopic resection increased nearly 3-fold to 53% for T1a lesions during the interval, and increased nearly 3-fold to 21% for T1b cancers. Nodal involvement was predicted by T status, tumor size >2cm, and tumor grade. The rate of nodal involvement in resected pts was 5% for T1a and 17% for T1b. Endoscopic therapy had a lower risk of procedure-related mortality (HR 0.33). 5-year survival was better after surgical resection (88% vs 77%).
Outcomes of lung adenocarcinoma classified according to the new IASLC/ATS/ERS system were evaluated in this retrospective single-institution study involving 573 pts who underwent surgical treatment. Histologic patterns were associated with sex and tumor TNM factors. Recurrence was higher in micropapillary and solid-predominant cancers. These subtypes were also associated with poorer overall and disease-specific survival compared to other types.
This article presents guidelines on the diagnosis and management of advanced stage lung cancer developed by the ESMO in 2013.
This article summarizes consensus guidelines for the diagnosis and management of early stage lung cancer developed by ESMO in 2013.