The Comprehensive Complication Index (CCI) was compared to more standard methods of categorizing complications for their utility in assessing outcomes after randomized surgical trials. The CCI outperformed standard methods in 2 of 3 published randomized trials (pancreatic and esophageal surgery), demonstrating significant differences in outcomes whe
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Cancer
October 1, 2014
Using a single institution database, the authors propensity score matched patients receiving wedge resection, wedge resection plus brachytherapy, or SBRT for early stage NSCLC. Survival was assessed at a median of 35 mos. Overall recurrence was higher for SBRT vs wedge (30% vs 9%), and recurrence-free and disease-free survival were better after wed
September 25, 2014
Costs of lung cancer screening were determined for individuals with a 2% or greater risk of lung cancer over 3 years for 2059 subjects participating in the Pan-Canadian Early Detection of Lung Cancer Study. During the first 18 mos of screening the per-person cost was $453. Surgical therapy cost $33,344 over 2 years compared to costs of treating adv
September 25, 2014
This phase II trial evaluated outcomes of isolated lung perfusion with Melphalan and complete surgical resection for pulmonary metastases from colorectal cancer or sarcoma in 50 pts. Surgical mortality was 0%, but morbidity (primarily grade 3 or 4 pulmonary morbidity) was 44%. 30 patients suffered local recurrence. 3-year survival was 57% and recu
September 25, 2014
A model for predicting lung cancer in patients with suspicious lung nodules (TREAT) was developed using single institutional data (Vanderbilt), validated using data from another institution, and compared to the Mayo Clinic predictive model. The model accuracy was 87% in the development cohort and 89% in the validation cohort, compared to 80% in the
September 25, 2014
This randomized controlled trial compared VATS partial pleurectomy (VAT-PP) to talc pleurodesis in patients with malignant mesothelioma and a pleural effusion, evaluating overall survival. VAT-PP was associated with significantly greater surgical complications, a higher rate of respiratory complications and prolonged air leak, and a significantly lo
September 25, 2014
This retrospective review evaluated the relationship of pretreatment vs post-induction therapy stage to survival in patients undergoing surgery for esophageal adenocarcinoma in 2 centers in London. Among 584 pts, 400 underwent induction therapy. Downstaging predicted improved survival (HR 0.43). Downstaging was associated with decreased rates of l
September 25, 2014
This meta-analysis of 70 studies evaluated the utility of PET in assessing over 8,511 lung nodules, comparing regions in which infectious lung disease is endemic to other regions. Specificity was lower in regions with endemic infectious diseases, 61% vs 77%. Overall, the accuracy of PET was extremely heterogeneous.
September 16, 2014
This retrospective review of pts undergoing complete resection by extrapleural pneumonectomy 1998-2011 for malignant mesothelioma focused on stage predictors of survival. Surgical mortality was 5%. Overall survival at 5 years was 14%, and median survival was 18 mos. Median survival for N1 or N2 disease was 17 and 13 mos, respectively. Nodal stag
September 16, 2014
This retrospective study evaluated recurrence patterns and management of recurrence after bimodality (chemoradiotherapy) for esophageal cancer in 276 pts. Local relapse alone developed in 23%, and 36% of those patients had salvage esophagectomy. Median survival for those undergoing salvage esophagectomy was 59 mos, whereas pts who were not offered