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Cancer

March 15, 2014
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
March 8, 2014
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%. 
March 8, 2014
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 spec
March 3, 2014
This video demonstrates the technical details of performing a totally endoscopic anterior approach, right video-assisted thoracoscopic sleeve lobectomy in a 42-year-old male smoker with a stage I adenocarcinoma of the right upper lobe of lung.
March 2, 2014
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.
February 24, 2014
Using SEER data the authors compared open to VATS segmental resection in a population of pts >65 years old. Propensity score matching was used to adjust for baseline differences between the groups. VATS pts had lower complication rates, fewer ICU admissions, and shorter length of hospital stay. Outcomes did not appear to be surgeon-specific.
February 24, 2014
This study evaluated safety and efficacy of EBUS-TBNA in a population of pts 70 or older and compared their results to those of younger patients. Tolerance was better in the older group, and complication rates were similar. Overall accuracy was higher in the older group, possibly related to differences in the underlying diagnoses.
February 24, 2014
The authors hypothesized that major lung surgery may predispose patients to post-traumatic stress disorder (PTSD). 47 pts were evaluated prospectively. 50% were identified as having an elevated PTSD risk score 3 months posteroperatively. Predictors included excess preoperative anxiety and increased acute postoperative pain.
February 15, 2014
Over 700 lung cancer patients were surveyed at diagnosis and a mean of 54 months later regarding smoking status. 56% of those smoking at the time of diagnosis and stopped smoking 1 year later. Smoking cessation was adversely affected by second hand smoke exposure from housemates, spouses, and peers; these effects were cumulative.
February 15, 2014
Pts surviving esophagectomy longer than 10 years were queried as to QOL. Alimentary comfort rating was 9 out of 10. 33% experienced diarrhea, dumping, or regurgitation. 15% had aspiration requiring hospital care. Mean weight loss was 26 lbs. Median GI QOL score was 2.9 out of 4.

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