The combination of vinorelbine plus gemcitabine is not more effective than single-agent vinorelbine or gemcitabine in the treatment of elderly patients with advanced NSCLC.

No abstract

Lung neuroendocrine tumors are catalogued in four categories by the World Health Organization (WHO 2004) classification. Its reproducibility and prognostic efficacy was disputed. The WHO 2010 classification of digestive neuroendocrine neoplasms is based on Ki67 proliferation assessment and proved prognostically effective. This study aims at comparing these two classifications and at defining a prognostic grading system for lung neuroendocrine tumors. The study included 399 patients who underwent surgery and with at least 1 year follow-up between 1989 and 2011. Data on 21 variables were collected, and performance of grading systems and their components was compared by Cox regression and multivariable analyses. All statistical tests were two-sided. At Cox analysis, WHO 2004 stratified patients into three major groups with statistically significant survival difference (typical carcinoid vs atypical carcinoid (AC), PZ0.021; AC vs large-cell/ small-cell lung neuroendocrine carcinomas, P!0.001). Optimal discrimination in three groups was observed by Ki67% (Ki67% cutoffs: G1 !4, G2 4-!25, G3 R25; G1 vs G2, PZ0.021; and G2 vs G3, P%0.001), mitotic count (G1 %2, G2 O2-47, G3 O47; G1 vs G2, P%0.001; and G2 vs G3, P%0.001), and presence of necrosis (G1 absent, G2 !10% of sample, G3 O10% of sample; G1 vs G2, P%0.001; and G2 vs G3, P%0

A recommendation to collapse both clinical and pathological T1a and T1b into a T1 classification will be made for the eighth edition staging system. Simple measurement of pleural thickness has prognostic significance and should be examined further with a view to incorporation into future staging.

This first evidence-based revision of the TNM classification for MPM leads to substantial changes in the T and N components and the stage groupings.