Should salvage surgery be considered for local recurrence after definitive chemoradiation in locally advanced non-small cell lung cancer?

Background Incidence of local relapse after definitive chemoradiation (>59 Gy) for locally advanced non-small-cell lung cancer (NSCLC) is high, irrespective of high dose radiation applied. Experience with salvage lung resections in patients with locally relapsed NSCLC after definitive chemoradiation is limited. We present our series of salvage lung resections for local NSCLC relapse after curative–intent chemoradiation for locally advanced tumor. Methods Nine consecutive patients with local tumor recurrence or persistence following definitive chemoradiation were reviewed. Kaplan-Meier analysis was used to assess patient survival. Results All patients received definitive radiation (median dose 66.2 Gy) with concurrent chemotherapy. Tumor stage prior to chemoradiation was IIIA in 8 patients and IV in 1. In 4 patients tumor invaded the chest wall, in 2 the spine and in 1 the aorta. Median interval between chemoradiation and salvage resection was 30.2 weeks. Nine patients underwent 9 resections (6 lobectomies, 1 bilobectomy, 1 pneumonectomy and 1 bi-segmentectomy). One death occurred on the 12th postoperative day. Median overall survival was 23 months; postoperative 3-year survival was 47 %. Median progression-free survival was 21 months. Conclusion Salvage lung resection for locally recurrent or persisted NSCLC in selected patients with locally advanced NSCLC following definitive chemoradiation is a worthwhile treatment option

Cellular phones in clinical teledermatology

We read with interest the article by Braun et al,1 who merely demonstrated the feasibility of telemedical wound care consultation via a new generation of cellular phones. In this context, we would like to share our experience with cellular phones and patients with typical skin conditions in a routine clinical setting. A total of 95 patients (male-female ratio, 39:56; mean age, 49 years; median age, 46 years; and age range, 6-90 years) were selected consecutively in the outpatient service of the Department of Dermatology, Medical University of Graz, Graz, Austria, in July 2003. Patients who presented for the first time and who were referred for all skin conditions except melanocytic lesions were included. Only patients who agreed and signed the patient consent form were enrolled. A face-to-face diagnosis was always formulated by the same board-certified dermatologist (I.Z.). A medical student (E.W.) acquired the images (under routine conditions, with no additional . . . [from full text of this article