Predicting death from surgery for lung cancer: a comparison of two scoring systems in two European countries

Objectives: Current British guidelines advocate the use of risk prediction scores such as Thoracoscore to estimate mortality prior to radical surgery for non-small cell lung cancer (NSCLC). A recent publication used the National Lung Cancer Audit (NLCA) to produce a score to predict 90 day mortality (NLCA score). The aim of this study is to validate the NLCA score, and compare its performance with Thoracoscore. Materials and methods: We performed an internal validation using 2858 surgical patients from NLCA and an external validation using 3191 surgical patients from the Danish Lung Cancer Registry (DLCR). We calculated the proportion that died within 90 days of surgery. The discriminatory power of both scores was assessed by a receiver operating characteristic (ROC) and an area under the curve (AUC) calculation. Results: Ninety day mortality was 5% in both groups. AUC values for internal and external validation of NLCA score and validation of Thoracoscore were 0.68 (95% CI 0.63–0.72), 0.60 (95% CI 0.56–0.65) and 0.60 (95% CI 0.54–0.66) respectively. Post-hoc analysis was performed using NLCA records on 15554 surgical patients to derive summary tables for 30 and 90 day mortality, stratified by procedure type, age and performance status. Conclusions: Neither score performs well enough to be advocated for individual risk stratification prior to lung cancer surgery. It may be that additional physiological parameters are required; however this is a further project. In the interim we propose the use of our summary tables that provide the real-life range of mortality for lobectomy and pneumonectomy

Observation of direct-photon collective flow in sqrt(s_NN)=200 GeV Au+Au collisions

The second Fourier component v_2 of the azimuthal anisotropy with respect to the reaction plane was measured for direct photons at midrapidity and transverse momentum (p_T) of 1--13 GeV/c in Au+Au collisions at sqr(s_NN)=200 GeV. Previous measurements of this quantity for hadrons with p_T < 6 GeV/c indicate that the medium behaves like a nearly perfect fluid, while for p_T > 6 GeV/c a reduced anisotropy is interpreted in terms of a path-length dependence for parton energy loss. In this measurement with the PHENIX detector at the Relativistic Heavy Ion Collider we find that for p_T > 4 GeV/c the anisotropy for direct photons is consistent with zero, as expected if the dominant source of direct photons is initial hard scattering. However, in the p_T < 4 GeV/c region dominated by thermal photons, we find a substantial direct photon v_2 comparable to that of hadrons, whereas model calculations for thermal photons in this kinematic region significantly underpredict the observed v_2.Comment: 384 authors, 6 pages, 3 figures, and 1 table. Submitted to Phys. Rev. Lett. v2 has minor changes to match the submission version. Plain text data tables for the points plotted in the figures are publicly available at http://www.phenix.bnl.gov/phenix/WWW/info/data/ppg126_data.htm

Systematic study of charged-pion and kaon femtoscopy in Au++Au collisions at sNN\sqrt{s_{_{NN}}}=200 GeV

We present a systematic study of charged pion and kaon interferometry in Au$+$Au collisions at $\sqrt{s_{_{NN}}}$=200 GeV. The kaon mean source radii are found to be larger than pion radii in the outward and longitudinal directions for the same transverse mass; this difference increases for more central collisions. The azimuthal-angle dependence of the radii was measured with respect to the second-order event plane and similar oscillations of the source radii were found for pions and kaons. Hydrodynamic models qualitatively describe the similar oscillations of the mean source radii for pions and kaons, but they do not fully describe the transverse-mass dependence of the oscillations.Comment: 499 authors, 27 pages, 13 figures, and 11 tables. v2 is the version accepted for publication in Phys. Rev. C. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

Measurement of higher cumulants of net-charge multiplicity distributions in Au++Au collisions at sNN=7.7−200\sqrt{s_{_{NN}}}=7.7-200 GeV

We report the measurement of cumulants ($C_n, n=1\ldots4$) of the net-charge distributions measured within pseudorapidity ($|\eta|<0.35$) in Au$+$Au collisions at $\sqrt{s_{_{NN}}}=7.7-200$ GeV with the PHENIX experiment at the Relativistic Heavy Ion Collider. The ratios of cumulants (e.g. $C_1/C_2$, $C_3/C_1$) of the net-charge distributions, which can be related to volume independent susceptibility ratios, are studied as a function of centrality and energy. These quantities are important to understand the quantum-chromodynamics phase diagram and possible existence of a critical end point. The measured values are very well described by expectation from negative binomial distributions. We do not observe any nonmonotonic behavior in the ratios of the cumulants as a function of collision energy. The measured values of $C_1/C_2 = \mu/\sigma^2$ and $C_3/C_1 = S\sigma^3/\mu$ can be directly compared to lattice quantum-chromodynamics calculations and thus allow extraction of both the chemical freeze-out temperature and the baryon chemical potential at each center-of-mass energy.Comment: 512 authors, 8 pages, 4 figures, 1 table. v2 is version accepted for publication in Phys. Rev. C as a Rapid Communication. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

Medium modification of jet fragmentation in Au+Au collisions at sqrt(s_NN)=200 GeV measured in direct photon-hadron correlations

The jet fragmentation function is measured with direct photon-hadron correlations in p+p and Au+Au collisions at sqrt(s_NN)=200 GeV. The p_T of the photon is an excellent approximation to the initial p_T of the jet and the ratio z_T=p_T^h/p_T^\gamma is used as a proxy for the jet fragmentation function. A statistical subtraction is used to extract the direct photon-hadron yields in Au+Au collisions while a photon isolation cut is applied in p+p. I_ AA, the ratio of jet fragment yield in Au+Au to that in p+p, indicates modification of the jet fragmentation function. Suppression, most likely due to energy loss in the medium, is seen at high z_T. The fragment yield at low z_T is enhanced at large angles. Such a trend is expected from redistribution of the lost energy into increased production of low-momentum particles.Comment: 562 authors, 70 insitutions, 8 pages, and 3 figures. Submitted to Phys. Rev. Lett. v2 has minor changes to improve clarity. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

Spectra and ratios of identified particles in Au+Au and d+Au collisions at sqrt(s_NN)=200 GeV

The transverse momentum (p_T) spectra and ratios of identified charged hadrons (\pi^+/-, K^+/-, p, p^bar) produced in sqrt(s_NN)=200 GeV Au+Au and d+Au collisions are reported in five different centrality classes for each collision species. The measurements of pions and protons are reported up to p_T=6 GeV/c (5 GeV/c), and the measurements of kaons are reported up to p_T=4 GeV/c (3.5 GeV/c) in Au+Au (d+Au) collisions. In the intermediate p_T region, between 2--5 GeV/c, a significant enhancement of baryon to meson ratios compared to those measured in p+p collisions is observed. This enhancement is present in both Au+Au and d+Au collisions, and increases as the collisions become more central. We compare a class of peripheral Au+Au collisions with a class of central d+Au collisions which have a comparable number of participating nucleons and binary nucleon-nucleon collisions. The p_T dependent particle ratios for these classes display a remarkable similarity, which is then discussed.Comment: 416 authors, 18 pages, 15 figures, 4 tables. Submitted to Phys. Rev. C. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm