No Excess Mortality in Patients Aged 50 Years and Older Who Received Treatment for Ductal Carcinoma In Situ of the Breast

Background. The incidence of ductal carcinoma in situ (DCIS) has increased at a fast rate.The aim of this study was to assess the incidence and treatment in the Netherlands and estimate the excess mortality risk of DCIS. Methods. From the Netherlands Cancer Registry, adult female patients (diagnosed 1997–2005) with DCIS were selected. Treatment was described according to age. Relative mortality at 10 years of follow-up was calculated by dividing observed mortality over expected mortality. Expected mortality was calculated using the matched Dutch general population. Results. Overall, 8421 patients were included in this study. For patients aged 50–64, and 65–74 an increase in breast-conserving surgery was observed over time (P < 0.001). For patients over 75 years of age, 8.0% did not undergo surgery; this percentage remained stable over time (P = 0.07). Overall, treated patients aged >50 years experienced no excess mortality regardless of treatment (relative mortality 1.0). Conclusion. The present population-based study of almost 8500 patients showed no excess mortality in surgically treated women over 50 years with DCIS

Stage III Non-Small Cell Lung Cancer in the elderly: Patient characteristics predictive for tolerance and survival of chemoradiation in daily clinical practice

Background: In unselected elderly with stage III Non-Small Cell Lung Cancer (NSCLC), evidence is scarce regarding motives and effects of treatment modalities. Methods: Hospital-based multicenter retrospective study including unresectable stage III NSCLC patients aged >= 70 and diagnosed between 2009 and 2013 (N = 216). Treatment motives and tolerance (no unplanned hospitalizations and completion of treatment), and survival were derived from medical records and the Netherlands Cancer Registry. Results: Patients received concurrent chemoradiation (cCHRT, 33%), sequential chemoradiation (sCHRT, 24%), radical radiotherapy (RT, 16%) or no curative treatment (27%). Comorbidity, performance status (58%) and patient refusal (15%) were the most common motives for omitting cCHRT. Treatment tolerance for cCHRT and sCHRT was worse in case of severe comorbidity (OR 6.2 (95%Cl 1.6-24) and OR 6.4 (95%CI 1.8-22), respectively). One-year survival was 57%, 50%, 49% and 26% for cCHRT, sCHRT, RT and no curative treatment, respectively. Compared to cCHRT, survival was worse for no curative treatment (P = 0.000), but not significantly worse for sCHRT and RT (P = 0.38). Conclusion: Although relatively fit elderly were assigned to cCHRT, treatment tolerance was worse, especially for those with severe comorbidity. Survival seemed not significantly better as compared to sCHRT or RT. Prospective studies in this vital and understudied area are needed

Governance and assessment insights in Information Technology: the Val IT Model

The purpose of this paper is the investigation of the relationship between Information Technology and value creation. In doing so, the paper presents a conceptual framework based on the Val IT model. This framework can assist companies in the selection, implementation and optimization of IT investments to create long-term value. The paper is based on a qualitative approach with the inclusion of a single-method approach. Research is developed according to the study of national and international literature. Following an initial analysis of existing literature on the evaluation of company investments, research has been conducted through the Val IT method to assess these intangible assets. The sources of research are secondary in nature (documents, reports, newspaper articles, papers and scientific books). This methodology emphasises the connection between the modern services created in the knowledge economy and the application of new technologies, especially in the field of Information Technology. Val IT is a governance framework for creating business value from IT investments. It allows companies to increase the possibility of selecting investments with a high potential of value creation, as well as with a greater possibility of success in executing, creating, strengthening and using these services

Mixed-Hybrid Finite Element Approximation Of The Potential Fluid Flow Problem

: In the paper a mixed-hybrid approximation of the potential fluid flow problem based on prismatic discretization of the domain is presented. Trilateral prismatic elements with vertical faces and nonparallel bases suitable for the modelling of real geological circumstances are considered. The set of linearly independent vector basis functions is defined and existence and uniqueness of the approximate solution from the resulting symmetric indefinite system are examined. Possible approaches to the solution of the discretized system are discussed. Keywords: potential flow problem in porous media, mixed-hybrid formulation, general prismatic elements, symmetric indefinite linear systems. AMS classification: 65N30, 65K10, 73C99 1 Introduction Solution of the underground water flow problem in real conditions must reflect complex geological structure of sedimented minerals. Layers of stratified rocks with substantially different physical properties must be modelled using an appropriate disc..