Objectives To characterize the chest computed tomography (CT) findings of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) according to clinical severity. We compared the CT features of common cases and severe cases, symptomatic patients and asymptomatic patients, and febrile and afebrile patients. Methods This was a retrospective analysis of the clinical and thoracic CT features of 120 consecutive patients with confirmed SARS-CoV-2 pneumonia admitted to a tertiary university hospital between January 10 and February 10, 2020, in Wuhan city, China. Results On admission, the patients generally complained of fever, cough, shortness of breath, and myalgia or fatigue, with diarrhea often present in severe cases. Severe patients were 20 years older on average and had comorbidities and an elevated lactate dehydrogenase (LDH) level. There were no differences in the CT findings between asymptomatic and symptomatic common type patients or between afebrile and febrile patients, defined according to Chinese National Health Commission guidelines. Conclusions The clinical and CT features at admission may enable clinicians to promptly evaluate the prognosis of patients with SARS-CoV-2 pneumonia. Clinicians should be aware that clinically silent cases may present with CT features similar to those of symptomatic common patients. Key Points • The clinical features and predominant patterns of abnormalities on CT for asymptomatic, typic common, and severe cases were summarized. These findings may help clinicians to identify severe patients quickly at admission. • Clinicians should be cautious that CT findings of afebrile/asymptomatic patients are not better than the findings of other types of patients. These patients should also be quarantined. • The use of chest CT as the main screening method in epidemic areas is recommended.

Neutrophil-to-lymphocyte ratio on admission is an independent risk factor for the severity and mortality in patients with coronavirus disease 2019 The study by Liu et al. had been published in your journal, and reported that the neutrophil-to-lymphocyte ratio (NLR) was an independent risk factor for the mortality of the COVID-19 patients. 1 Based on it, we reported the association between levels of NLR at admission and the disease severity in COVID-19 and further explored the predictive role of NLR for mortality of the COVID-19 patients in more subgroups. Key epidemiological, clinical, laboratory, radiological and outcomes data were obtained through a detailed medical chart review from January 1 st to February 10 th , 2020 at the Renmin Hospital of Wuhan University. All the peripheral venous blood samples were collected on admission and were examined at the laboratory following standard procedures. Multivariable logistic regression analyses with the stepwise procedure were used to estimate odds ratios (OR) and 95% confidence intervals (CI). Then, the subgroup and interaction analyses for NLR were conducted according to statistically significant variables in former logistic regression analyses. A cohort of 140 patients with the confirmed disease was identified. 52 patients had severe diseases and 32 patients eventually died. Compared to the lower NLR group, patients with higher NLR in this study were 29 years older, more likely to have current smoking, had more comorbidities such as diabetes, hypertension, cardiovascular and chronic obstructive pulmonary disease (COPD), and had various symptoms, especially sputum production, headache, upper airway symptoms, and dyspnea (Table 1). It was consistent with the baseline characteristic of the study by Liu et al. 1 Table 2 shows the correlation of NLR with severe disease and death in the final analysis. Upon multivariate adjustment, most of the estimated correlations were attenuated. Increased NLR

The large Surveillance, Epidemiology, and End Results results support that radiotherapy might improve the survival of patients with metastatic cervical cancer. It might be prudent to carefully select suitable patients for radiation therapy for metastatic cervical cancer.

Background and Aims The incidence of HCC has recently been consistently reported to decline in the United States. However, decreased overall mortality of HCC has just been suggested and needs further examination. Approach and Results Using data from the Surveillance, Epidemiology, and End Results databases, we assessed HCC incidence, incidence‐based mortality (IBM), and 1‐year survival rates from 1992 through 2017 in the United States. These secular trends were analyzed using the National Cancer Institute’s Joinpoint Regression Program. Age‐period‐cohort analyses were performed to address underlying reasons for the observed temporal trends. The incidence and mortality of liver cancer in the United States by different etiologies were acquired from the Global Burden of Disease study (1990–2019) as a likely validation set. Joinpoint and age‐period‐cohort analyses were performed by etiologies. The incidence rates of HCC increased during 1992–2011 and sharply decreased thereafter by −2.3% annually (95% CI: −3.5% to −1.1%). IBM peaked in 2013 (age‐standardized mortality rate: 6.98 per 100,000 person‐years) in the US population. IBM started to decrease significantly in 2013 by −3.2%/year (95% CI: −5.4% to −1.1% per year) after a continuous increase of 3.5% annually during 1993–2013. Overall, the 1‐year survival of HCC improved from 21.4% to 56.6% over the study period. However, the highest HCC incidence and mortality risk for patients aged 60–69 and born between 1952–1957 were found. Conclusions We found significantly decreased overall HCC‐specific mortality since 2013 in the US population, along with decreased incidence and continuously improved survival. The changing etiologies, advances in screening and diagnosis, and improved treatment modality and allocation might all contribute to the downward trends of the disease burden of HCC in the United States.

OBJECTIVES: The role of palliative gastrectomy in the management of metastatic gastric cancer remains inadequately clarified. METHODS: We analyzed patients with metastatic gastric cancer enrolled in the Surveillance, Epidemiology, and End Results registry from January 2004 to December 2012. Propensity score (PS) analysis with 1:1 matching and the nearest neighbor matching method was performed to ensure well-balanced characteristics of the groups of patients who undergone gastrectomy and those without gastrectomy. Data were analyzed by Kaplan-Meier and Cox proportional hazards regression models to evaluate the overall survival and cancer-specific survival rates with corresponding 95% confidence intervals (CIs). RESULTS: In general, receiving any kind of gastrectomy was associated with an improvement in survival in the multivariate analyses (hazard ratio [HR] os = 0.64, 95% CI = 0.59–0.70, HR css = 0.63, 95% CI = 0.57–0.68) and PS matching (PSM) analyses (HR os = 0.63, 95% CI = 0.56–0.70, HR css = 0.62, 95% CI = 0.55–0.70). After PSM, palliative gastrectomy was found to be associated with remarkably improved survival for patients with stage M1 with only 1 metastasis but not associated with survival of patients with stage M1 with extensive metastasis (≥2 metastatic sites). DISCUSSION: The results obtained from the Surveillance, Epidemiology, and End Results database suggest that patients with metastatic gastric cancer might benefit from palliative gastrectomy on the basis of chemotherapy. However, a PSM cohort study of this kind still has a strong selection bias and cannot replace a properly conducted randomized controlled trial.