Journal and News Scan

The authors queried the National Cancer Data Base to assess outcomes of patients with R1 resection margins related to the presence and type of postoperative adjuvant therapy.  3.1% of over 54,000 resections had R1 margins, which negatively affected long-term survival.  Combined chemotherapy and radiation therapy improved outcomes; administration of chemotherapy or radiation therapy alone had a lesser impact on survival. 

This manuscript describes the findings of a retrospective analysis of 874 consecutive high risk or inoperable patients undergoing TAVR in three different centres, evaluating outcomes after up to three years of follow up. In-hospital mortality was 5%. Early mortality was strongly associated with the occurrence of procedural complications. The relative incidence of non-cardiovascular death increased with time to become the principal cause of mortality beyond 6 months and outnumbering cardiovascular mortality beyond 24 months. Cumulative mortality at three years was 31.5%. Baseline comorbidities, particularly COPD and renal impairment, had a major detrimental impact on long-term mortality.

There is growing recognition of the utility of EBUS in staging NSCLC.  In this study EBUS and mediastinoscopy were performed in 127 patients requiring mediastinal staging for clinical N1-3 NSCLC.  The authors found that EBUS had superior accuracy (93% vs 89%) and negative predictive value (85% vs 79%). 

There is growing recognition that hospital mortality is not an accurate metric for surgery-related mortality after cancer operations.  This article evaluated SEER data for 1-month mortality after cancer surgery in nearly 54,000 patients.  4.8% died within 1 month of surgery.  Favorable factors included being married, being insured, having an above-median income, and having an above-median educational status.  Eliminating such adverse outcomes in those with socioeconomic disparities provides the opportunity to substantially improve cancer survival.