This intensive multimodality treatment is feasible and demonstrates high efficacy in prognostically unfavorable LAD-NSCLC subgroups with high R0 rates and improved long-term survival compared with historical controls

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Ventricular assist device (VAD) implantation is associated with impaired primary hemostasis and thromboembolic complications. Recently, a new generation of implantable continuous flow axial pumps was introduced into clinical application. To study the potential thrombogenic properties of this type of pump, we applied extensive platelet monitoring was applied. In our institution, 13 patients received the MicroMed DeBakey VAD as a bridge to transplantation. Routine coagulation tests (platelet count, activated partial thromboplastin time, prothrombin time, antithrombin III activity) and platelet function tests (whole blood aggregometry, thrombelastography, flow cytometry) were performed. No clinically relevant thromboembolic events were detected. No correlation was found between global function tests, platelet aggregation, and thrombelastography. No correlation was detected between platelet activation and hemolysis parameters. Platelet aggregation and coagulation index were significantly suppressed early after operation. A subsequent phase of hyper-aggregability, starting around day 6, suggested the initiation of antiaggregation therapy. Platelet activation markers were upregulated in the postoperative period but were returned to preoperative levels after initiation of aspirin. In contrast to routine coagulation monitoring, platelet function tests reflect in detail the coagulation status of blood pump recipients and the efficiency of antiaggregation therapy. Aspirin and dipyridamole therapy in addition to oral anticoagulation using phenprocoumon may contribute to platelet function and clot mechanics restoration and is, therefore, recommended for patients after VAD implantation.

Epidemiologie (Inzidenzen, Mortalität, Überlebensraten), Risikofaktoren, Vorbeugung (Screening) Zusammenfassung. Grundlagen: Das Lungenkarzinom verursacht weltweit den weitaus grössten Anteil aller Karzinomtodesfälle in beiden Geschlechtern. Methodik: Zusammenfassung der aktuellen Literatur. Ergebnisse: Die mittlere Fünfjahres-Überlebensrate nach Diagnosestellung von Lungenkrebs beträgt 15 %, nach Kolonkarzinom 61 %, Mammakarzinom 86 % und Prostatakarzinom 96 %. Die Heilungsaussicht bei Lungenkarzinom ist streng stadienabhängig und beträgt 67 % im Stadium IA, 57 % im Stadium IB, 55 % bei IIA, 39 % bei IIB und 23 % im Stadium IIIA. Da Zigarettenrauchen als der wesentlichste Risikofaktor für die Entwicklung von Lungekrebs erkannt wurde, könnten Inzidenz und Mortalität mit Sicherheit durch geeignete Maßnahmen zur positiven Beeinflussung des Rauchverhaltens verbessert werden. Bislang konnte für keine Substanz ein eindeutiger unterstützender Effekt in dieser Hinsicht bewiesen werden. Abgesehen davon, dass gegenwärtig große Screeningprogramme durch keine Daten aus randomisierten Studien gerechtfertig werden, sollten Personen mit besonderem Erkrankungsrisiko durch die Etablierung von geeigneten molekularen Markern identifiziert werden, um die Sterblichkeit an Lungenkrebs wesentlich zu beeinflussen.Schlussfolgerungen: Eine Reihe von Risikofaktoren wird für die Entwicklung von Lungenkrebs angeschuldigt, wobei das Zigarettenrauchen (aktiv und passiv) als der weitaus bedeutendste angesehen wird.Schlüsselwörter: Lungenkarzinom, Epidemiologie, Rauchen, Screening.Summary. Background: Lung cancer is currently the main cause of cancer deaths in both men and women worldwide.Methods: Review of recent literature. Results: The expected 5-year survival rate for all patients in whom lung cancer is diagnosed is 15 %, com-pared with 61 % for colon cancer, 86 % for breast cancer, and 96 % for prostate cancer. The 5-year survival rate for patients with potentially resectable lung cancer is significant < 100 % (stage IA, 67 %; stage IB, 57 %; stage IIA, 55 %; stage IIB, 39 %; and stage IIIA, 23 %). Since cigarette smoking is known as the main risk factor, incidence, mortality and risk of lung cancer development can be certainly reduced by means of smoking cessation as well as prevention of smoking initiation among non-smokers. Regarding chemoprevention, currently there are no agents that have been proven to be effective for preventing lung cancer. Despite the fact that data from randomised studies which would support large screening programs are still not available, mortality from lung cancer could be reduced greatly through the development of molecular markers for identification of individuals at the earliest stages of lung cancer when curative resection is feasible.Conclusions: Cigarette smoking (active or passive) represents the leading risk factor and the main cause for lung cancer.