Recent improvement in lung cancer screening: a comparison of the results carried out in two different time periods

Does cardiac development provide heart research with novel therapeutic approaches?

Embryonic heart progenitors arise at specific spatiotemporal periods that contribute to the formation of distinct cardiac structures. In mammals, the embryonic and fetal heart is hypoxic by comparison to the adult heart. In parallel, the cellular metabolism of the cardiac tissue, including progenitors, undergoes a glycolytic to oxidative switch that contributes to cardiac maturation. While oxidative metabolism is energy efficient, the glycolytic-hypoxic state may serve to maintain cardiac progenitor potential. Consistent with this proposal, the adult epicardium has been shown to contain a reservoir of quiescent cardiac progenitors that are activated in response to heart injury and are hypoxic by comparison to adjacent cardiac tissues. In this review, we discuss the development and potential of the adult epicardium and how this knowledge may provide future therapeutic approaches for cardiac repair.

Temporal trends in demographics and overall survival of non-small-cell lung cancer patients at Moffitt Cancer Center from 1986 to 2008

BACKGROUND

An assessment of historical trends in patient survival is important to determine the progress toward patient outcomes and to reveal where advancements must be made. The goal of this study was to assess changes in demographics and overall survival of non-small-cell lung cancer (NSCLC) patients who were seen at Moffitt Cancer Center spanning 22 years.

METHODS

This analysis included 4,997 NSCLC patients who were treated at our institute over 5 time periods: 1986 to 1988, 1991 to 1993, 1996 to 1998, 2001 to 2003, and 2006 to 2008. Kaplan-Meier survival curves and the log-rank statistic were used to assess changes in 5-year survival rates over the 5 time periods, and multivariable hazard ratios were estimated from Cox proportional hazards models.

RESULTS

From 1986 to 2008 we observed statistically significant increases in the percentage of patients over the age of 70 years, women, never-smokers and former smokers, and patients with stage I tumors. Over the same time period the median survival time statistically significantly increased from 1.09 years (95% confidence interval [CI], 0.95-1.34, P < .001) to 2.27 years (95% CI, 2.07-2.46, P < .001), and the overall 5-year survival rate for all patients significantly increased from 14.7% to 31.1% (P < .001). Among stage I patients, the 5-year survival rate increased from 31.7% to 54.0% (P < .001), 13.3% to 36.0% for stage II (P < .001), 10.5% to 21.7% for stage III (P < .001), and 3.4% to 9.6% for stage IV (P < .001).

CONCLUSIONS

This analysis demonstrated important temporal changes in the demographics and improvements in overall survival of NSCLC patients treated at our institute from 1986 to 2008. The 5-year survival rates and median survival time of patients diagnosed with NSCLC has significantly improved across all stages, including patients with late-stage disease.

Trends in prevalence of prognostic factors and survival in lung cancer patients from 1985 to 2004 at a tertiary care center

BACKGROUND

After a prolonged period of increasing rates of lung cancer incidence and mortality for both men and women, incidence and mortality rates are decreasing in men and stabilizing in women. The goal of this study was to assess changes over 20 years in the prevalence of known risk factors for lung cancer and to elucidate possible predictors associated with lung cancer survival.

METHODS

The study included a total of 908 patients with primary lung cancer referred to The University of Texas M.D. Anderson Cancer Center over three study periods 1985-1989 (N=392), 1993-1997 (N=216), and 2000-2004 (N=300). Detailed questionnaires were used to collect information from the patients. Hazard ratios were estimated by fitting a Cox proportional hazards model. Using the Kaplan-Meier method, survival in months was calculated up to 2 years from the date of diagnosis to achieve comparability in the three groups.

RESULTS

We observed a decrease in the proportion of patients who are current cigarette smokers and an increase in the proportion of patients who present with adenocarcinoma of the lung, are obese and patients who present with localized disease. We also found an increase in the number of patients who report a family history of lung cancer. The overall median survival duration has increased over the years from 12.0 months in 1985-1989 to 17.5 months in 2000-2004. Also, the probability of survival of patients who were alive at 2 years after diagnosis has also increased (26.5% in 1985-1989 to 40.8% in 2000-2004). Overall, women had a better median survival than men.

CONCLUSIONS

The results show that the demographic, histologic, clinical, and outcome variables of patients with lung cancer have changed over the past 20 years. Most important, the survival of patients with lung cancer has improved.