Postoperative survival of lung cancer patients: are there predictors beyond TNM?

BACKGROUND/AIM

We report on survival data of 595 patients with stage I-III lung cancer with respect to TNM classification.

MATERIALS AND METHODS

We constructed a basic model consisting of stage and grade, and assessed the improvement of survival prediction after adding comorbidity data, spirometric data, clinical and laboratory parameters.

RESULTS

Body mass index (BMI) and presence of a cardiac disease reached statistical significance for prediction of overall survival in a Cox regression model. In addition to BMI (<25 kg/m(2)) and the presence of cardiovascular disease, the spirometric variable (FEV1) predicted early death (less than five months postoperatively). When the survival random forest method was employed to predict disease outcome, creatinine levels and VO2 max became additional variables of interest for predicting survival.

CONCLUSION

We propose that our lung cancer database may help to identify variables (aside from histomorphological variables) that are suitable for identifying patients at risk of death after surgical treatment of lung cancer.

[Basic documentation: inpatient management in a region by a psychiatric hospital and a psychiatric department. Results of a joint evaluation]

A mental hospital and a psychiatric department of a general hospital in the region of Kassel have jointly analysed their basic documentation to produce an overview of hospital treatment of psychiatric patients in the region. Patients from the urban population occupy twice as many beds as those from the rural population which is a hint that standard bed-ratios per population are inadequate. Instead of the unsuitable official definition of duration of stay in hospital we used "days in hospital per person per year". Making allowance for groups of diagnoses this made possible interesting comparisons about the contributions of the two hospitals to the treatment of the psychiatric patients in the region. The two hospitals are not similar and the results show how the patients make use of the possibility of choosing the various specialities of the two hospitals.

[The type, scope and clinical relevance of early radiologic diagnosis of aneurysms of the popliteal artery]

The popliteal aneurysm as the cause of an acute arterial obliteration pattern is sometimes misinterpreted or overlooked. However, if a femoropopliteal aneurysm is confirmed, the therapeutic approach is substantially different. The article reports on the results of the radiological diagnosis of 17 popliteal aneurysms and the diagnostic relevance of the applied imaging processes is discussed. Real-time sonography and angiography complement each other in their findings and prove to be an indispensable part of preoperative diagnosis.

[Surgical aspects of the implantation of catheters for acute peritoneal dialysis in premature, newborn and young infants]

Ten years experience with acute peritoneal dialysis in 39 preterm-, newborn and small infants shows advantage and low risk of surgically implanted single dacron cuffed silicone catheters compared to trocar catheters.

[Imaging of iatrogenic aneurysms and AV fistulas of the lower extremity with IV-DSA and sonography]

Using IV-DSA and ultrasound (real-time), we demonstrated 13 false aneurysms, 2 isolated AV fistulas, 7 aneurysms of profunda patches and 8 aneurysms of bypass grafts. Aneurysms and AV fistulas developed in all 30 patients after different diagnostic and therapeutic procedures. Ultrasound showed partial thromboses of the aneurysms, perivascular changes and compression of the femoral vein, that could not be demonstrated by IV-DSA. On the other hand IV-DSA allowed the recognition of important findings not shown sonographically, such as AV fistulas and stenoses of the proximal and distal arteries. These findings were relevant for further surgical approach. It is therefore concluded that in patients with suspected aneurysm of the femoral or popliteal artery, IV-DSA and ultrasound should be used in conjunction rather than as alternative methods.