The authors investigated the impact of new onset a-fib after esophagectomy in 437 pts. Risk factors included age, diabetes, induction therapy, and cardiac history. A-fib was associated with postoperative pneumonia, symptomatic pleural effusions, and an increase in C-reactive protein. It was not associated with anastomotic leak or mortality. 92% o
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Cancer
October 8, 2014
The histologic response to induction therapy is usually a binary function. In the current study, the authors explored methods of refining the histologic response classification to improve prediction of prognosis for patients with esophageal adenocarcinoma. They identified 3 unique groups: major response in the primary tumor with ypN0; either major
October 8, 2014
It has recently been reported that the number of lymph nodes resected during esophagectomy is related to long-term survival, leading to recommendations for the proper extent of nodal dissection. The current study used data from the CROSS trial to investigate this relationship in groups of esophagectomy patients with and without induction chemoradiot
October 8, 2014
It has recently been reported that a longer interval to esophagectomy following induction therapy results in higher pathologic response rates. The current study used data from the CROSS trial to determine whether a longer interval to esophagectomy following induction therapy results in improved survival. Time to surgery (TTS) was a median of 48 day
October 8, 2014
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
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