Cancer
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Local recurrence after surgery for early stage lung cancer: an 11-year experience with 975 patients.
The objective of the current study was to evaluate the actuarial risk of local failure (LF) after surgery for stage I to II nonsmall cell lung cancer (NSCLC) and assess surgical and pathologic factors affecting this risk. ⋯ Greater than half of disease recurrences after surgery for early stage NSCLC involved local sites. Pathologic factors may help to distinguish those patients at highest risk.
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Randomized Controlled Trial Comparative Study
Randomized controlled trials of the efficacy of lung cancer screening by sputum cytology revisited: a combined mortality analysis from the Johns Hopkins Lung Project and the Memorial Sloan-Kettering Lung Study.
: Two randomized controlled trials of lung cancer screening initiated in the 1970s, the Johns Hopkins Lung Project and the Memorial Sloan-Kettering Lung Study, compared 1 arm that received annual chest X-ray and 4-monthly sputum cytology (dual-screen) to a second arm that received annual chest X-ray only. Previous publications from these trials reported similar lung cancer mortality between the 2 groups. However, these findings were based on incomplete follow-up, and each trial on its own was underpowered to detect a modest mortality benefit. ⋯ : These data are suggestive of a modest benefit of sputum cytology screening, although we cannot rule out chance as an explanation for these findings. Cancer 2009. (c) 2009 American Cancer Society.
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Comparative Study
Esophagectomy compared with chemoradiation for early stage esophageal cancer in the elderly.
: Esophagectomy has been the traditional treatment of choice for early stage esophageal cancer. However, esophagectomy is associated with high mortality and morbidity in the elderly, and these patients often receive chemoradiation instead. The authors of this report compared outcomes of esophagectomy versus chemoradiation in a population-based sample of elderly patients with early stage esophageal cancer. ⋯ : Compared with chemoradiation, esophagectomy may be associated with improved survival for early stage esophageal cancer in the elderly. The current results suggest that there also may be a subset of patients with squamous cell carcinoma for whom chemoradiation is adequate therapy. A randomized trial would be useful to determine the optimal treatment for elderly patients with early stage esophageal cancer. Cancer 2009. (c) 2009 American Cancer Society.