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Journal and News Scan
June 26, 2014
Submitted by: Mark Ferguson
Although lung cancer is common in the elderly population, little information specific to this population is available to inform healthcare practitioners. The EORTC, in collaboration with the International Society of Geriatric Oncology, released a concensus statement in 2010 on this topic. Since then a number of related studies have been published. The current publication is an update on the 2010 statement that includes new recommendations for treatment, data on patient preferences, and concepts regarding geriatric assessment.
June 25, 2014
Submitted by: Marcelo Jimenez
In this study presented by Dr. Joshua A. Roth recently at the ASCO meeting, they used a model to forecast the 5-year results of implementation of a screening program (as suggest the NLST, age older than 55 with at least 30 pack-years of smoking history) in comparison to no screening program. They modeled various scenarios involving faster and slower diffusion of the program. The number of lung cancer detected at the localize stage will raise from 15% to 32% with 54900 of new lung cancer diagnoses, but the cost of this advantage will exceed 9.3 $ billion.
June 25, 2014
Submitted by: Mark Ferguson
Predictors of resectability on preoperative CT were evaluated in 133 pts undergoing resection for thymoma over a 13 year period in a single institution. 60% of pts were Masaoka stage I or II. 17% of pts had an incomplete resection. On multivariate analysis, pleural nodularity and the degree of abutment of adjacent vessels predicted incomplete resection.
June 25, 2014
Submitted by: Mark Ferguson
This single institution study evaluated prognostic factors in 262 pts undergoing thymectomy for thymic tumors over a 25-year period. The majority of tumors were Masaoka stage II and the most common histology was WHO type B. 15 year survival was 91%. Recurrence was related to Masaoka stage and tumor size.
June 22, 2014
Submitted by: Mark Ferguson
This prospective study evaluated the relationship of inflammatory gene polymorphisms and postoperative pneumonia after esophagectomy in 120 pts. One genotype for IL-10 was significantly associated with reduced postoperative serum IL-10 levels and an increased rate of postoperative pneumonia. IL-10 polymorphism was an independent predictor of pneumonia.
June 22, 2014
Submitted by: Joel Dunning
This lecture documents the lack of conclusive evidence for LA appendage occlusion.
This is one of a series of lectures given on management of the Left Atrial appendage at the SCTS University 2014 so click below to see several others including talks by many eminent speakers including Jim Cox
http://173.45.225.219/categories/scts-edinburgh-2104
June 22, 2014
Submitted by: Mark Ferguson
In two double blind trials involving nearly 1400 pts being treated with opiods for non-cancer pain and experiencing constipation, oral naloxegol was compared to placebo with the primary outcome being spontaneous bowel activity. Naloxegol was superior to placebo overall and in the subgroup of patients who had failed to respond to laxatives. Pain scores did not differ, indicating that the oral opiod receptor antagonist did not interfere with pain management.
June 22, 2014
Submitted by: Mark Ferguson
This multicenter prospective study evaluated indications for and outcomes of ICU admission for 449 patients with lung cancer. Most patients had a newly diagnosed lung cancer, and the most common indication for ICU admission was airway compromise. Hospital and 6-month mortality rates were 39% and 55%. Determinants of mortality were severity of organ system dysfunction, recurrent or progressive cancer, poor performance status, and cancer-related complications. Mortality was lower in high volume centers.
June 20, 2014
Submitted by: Stuart Grant
This single-centre propensity matched study aimed to compare the outcomes between patients undergoing transapical TAVI or surgical aortic valve replacement in patients who have previously undergone cardiac surgery. Patients who underwent procedures between 2005 and 2012 were included with 40 patients in each group following propensity matching. The majority of patients in both the redo TAVI and redo surgical AVR group had previously undergone CABG. Post-operative permanent neurological defect was more common in the redo surgical AVR group with a trend towards lower 30-day mortality in the redo TAVI group. At four years follow up there was no difference in overall survival between the groups but there was a statistically significant difference in major adverse events which was driven by the rate of permanent neurological deficit in the redo surgical AVR group. The incidence of mild/moderate paravalvular leak in the redo TAVI group was 33%.
June 20, 2014
Submitted by: Stuart Grant
This registry study which links Society of Thoracic Surgeons (STS) data with Medicare data examined the rates and predictors of readmission within 30-days of coronary artery surgery. The median readmission rate across 846 hospitals was 16.8%. Predictors of readmission within 30-days of surgery were dialysis, chronic lung disease, creatinine, insulin-dependent diabetes, obesity in women, female gender, immunosupression, pre-operative atrial fibrillation, age, recent MI and low body surface area in men. The c-index for the developed model was 0.648 with 6.1% of hospitals having statistcially worse or better readmission rates than expected.