2011 Sep/Oct - Update on the management of malignant pleural effusions
Dr. Chee-Wung CHOW, Dr. Maureen ML WONG
Department of Medicine &Geriatrics , Caritas Medical Centre
Malignant pleural effusion (MPE) is a common and devastating complication of advanced malignancy, with an estimated annual incidence in the United States of over 150,000 patients [1]. Lung cancer is the most common metastatic tumour to the pleura in men while breast cancer is the most common cause of MPE in women. Both malignancies account for 50-65% of all malignant pleural effusions. Other common primaries are lymphoma, gastrointestinal cancer and mesothelioma [2]. The presence of MPEs in patients with non-small cell lung cancer (NSCLC) signify grave prognosis and upstage the classification from T4 (stage IIIB) to M1a (stage IV); patients with stage IV NSCLC has a median survival time of 6 months and a 5 year survival of 2% [3].
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2011 Sep/Oct - Lung Cancer: The Basics
Dr. James Chung-man Ho, Prof. Wah-kit Lam
Department of Medicine, The University of Hong Kong
Burden of lung cancer in Hong Kong
Lung cancer has been the top cancer killer in Hong Kong over the past decade. From the Hong Kong Cancer Registry, lung cancer was the commonest cancer type in men (2,793 cases) and third commonest in women (1,443 cases) in 2008. Alarmingly, lung cancer accounted for the most common cancer mortality in both men (2,302 deaths) and women (1,195 deaths). The male to female ratio has remained 2:1, with median age at around 70 years old. Based on a local study conducted by the Hong Kong Thoracic Society, respiratory tract cancers ranked second highest as a cause of respiratory mortality (33.2%), and third highest for respiratory hospitalization (5.7%) and inpatient bed-days (9.2%) in 2005. 1 There was a modest reduction of age standardized mortality between 1997 and 2005 in both genders.
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2011 Sep/Oct - To induce in order to reduce? – Controversies of Stage IIIA Disease
Dr Stephanie Chu
Department of Medicine, Queen Elizabeth Hospital
Introduction
Despite the recent advances in the treatment of metastatic non-small cell lung cancer, management of Stage IIIA disease remains controversial. Patients with Stage IIIA tumours represent a heterogeneous group, which fit between the generally resectable stages I to II and the unresectable stage III disease. Treatment modalities include surgery, radiotherapy, and chemotherapy and often involve a combination of these. The debate is about the exact choice and sequence of different therapies. Large randomised studies are challenging to carry out due to the limited number of patients with wide variations of clinical presentation and prognosis within the Stage IIIA classification.
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2011 Sep/Oct - Novel targeted therapies in the treatment of advanced stage non-small cell lung cancer
Drs Hoi-Yee Kwan1 and Tim Benepal2;
Department of Medicine, North District Hospital1; Department of Medical Oncology, St George’s Hospital and Medical School, London, UK2
Introduction
Lung cancer is the most common and is the leading cause of cancer-related mortality(1, 2). It is estimated that approximately 221,000 new cases (including both non-small cell and small cell lung cancers) will be diagnosed in the United States in 2011, and approximately 157,000 people will die of the disease(1). The International Agency for Research on Cancer of the World Health Organization (WHO) suggests that the disease accounts for more than 300,000 deaths in China every year(3). In Hong Kong, lung cancer is the commonest cancer in men and the third commonest in women. It is also the first leading cause of cancer deaths(4).
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Obituary - Dr Chan Yuk Choi 陳育才醫生 (1950 - 2011)
The Hong Kong Lung Foundation, the Hong Kong Thoracic Society and the American College of Chest Physicians (Hong Kong and Macau Chapter) mourn the loss of Dr Chan Yuk-Choi who passed away peacefully on 22nd October, 2011 at Queen Mary Hospital in Hong Kong.
Dr Chan was born on 11th April, 1950 in Hong Kong. He went to St Paul's College before qualifying from the University of Hong Kong in 1973. Prior to serving at the Tuberculosis Unit of Wong Tai Sin Hospital in 1990, Dr Chan also worked at the Department of Health and the Tuberculosis and Chest Unit of Grantham Hospital. He pursued further specialist training in Respiratory Medicine at the Royal Brompton National Heart and Lung Hospital in London. As the Chief for over a decade, Dr Chan had successfully transformed the Tuberculosis Unit at Wong Tai Sin Hospital to a modern multi-disciplinary Department of Tuberculosis and Chest. He had served as Consultant Physician at Kwong Wah Hospital, upon integration with Wong Tai Sin Hospital, until his retirement in April, 2010. Dr Chan’s leadership, clinical acumen, and personal participation during the SARS outbreak were crucial in coalescing at the frontline and beyond. Dr Chan was also prolific in his service to the professional respiratory societies in Hong Kong. He was the Honorary Treasurer for Hong Kong Lung Foundation (1999 – 2003) and a Council member to Hong Kong Thoracic Society for over a decade. He acted as a judge for the Hong Kong Lung Foundation Tse Yuen Man Memorial Scholarship.
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2012 Jan-8 A practical molecular assay to predict survival in resected non-squamous, non-small-cell lung cancer: development and international validation studies
Johannes R Kratz, Jianxing He, Stephen K Van Den Eeden , Zhi-Hua Zhu , Wen Gao , Patrick T Pham , Michael S Mulvihill , Fatemeh Ziaei, Huanrong Zhang , Bo Su , Xiuyi Zhi , Charles P Quesenberry , Laurel A Habel , Qiuhua Deng, Zongfei Wang, Jiangfen Zhou , Huiling Li , Mei-Chun Huang , Che-Chung Yeh , Prof Mark R Segal , M Roshni Ray , Prof Kirk D Jones , Dan J Raz , Zhidong Xu , Thierry M Jahan , David Berryman , Biao He PhD , Michael J Mann, David M Jablons.
The Lancet, Early Online Publication, 27 January 2012doi:10.1016/S0140-6736(11)61941-7
Background
The frequent recurrence of early-stage non-small-cell lung cancer (NSCLC) is generally attributable to metastatic disease undetected at complete resection. Management of such patients depends on prognostic staging to identify the individuals most likely to have occult disease. We aimed to develop and validate a practical, reliable assay that improves risk stratification compared with conventional staging.
Last Updated on Monday, 30 January 2012 16:57
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Editorial of the Newsletter - A trimonthly joint communiqué of Hong Kong Thoracic Society & American College of Chest Physicians (Hong Kong and Macau Chapter)
Volume 21, Number 3, Sep/Oct 2011, Editorial by David CL Lam (October, 2011)
It was heart-breaking for me to report to you in this issue the lost of Dr CHAN Yuk Choi. With his great contribution and dedication, the Hong Kong Thoracic Society and the Hong Kong Lung Foundation have taken their shapes today.
It was a sad moment for the respiratory community.
Last Updated on Tuesday, 31 January 2012 21:26
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2012 Jan-8 Engineered H5N1: A Rare Time for Restraint in Science
Thomas V. Inglesby. Annals of Internal Medicine January 17, 2012, 156 (2)
Two scientific teams have recently engineered the H5N1 virus to make it readily transmissible between ferrets. Given that ferrets are considered the most reliable animal surrogate for human influenza infection, the newly engineered H5N1 strain is probably transmissible between humans as well. The potential consequences of an engineered human transmissible H5N1 strain are stunning.
Last Updated on Monday, 30 January 2012 16:58
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2012 Jan-8 Laboratory Creation of a Highly Transmissible H5N1 Influenza Virus: Balancing Substantial Risks and Real Benefits
Andrew T. Pavia. Annals of Internal Medicine January 17, 2012, 156(2)
Controversy erupted when influenza researchers announced that they had created an H5N1 influenza virus that was transmissible between ferrets. The controversy escalated when the National Science Advisory Board for Biosecurity (NSABB) recommended that the work be published but recommended significant voluntary redactions.
Last Updated on Monday, 30 January 2012 16:58
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2012 Jan-8 Increasing Physical Activity in Patients With Asthma Through Positive Affect and Self-affirmation
Carol A. Mancuso, Tiffany N. Choi, Heidi Westermann, Suzanne Wenderoth, James P. Hollenberg, Martin T. Wells, Alice M. Isen, Jared B. Jobe, John P. Allegrante, Mary E. Charlson. Arch Intern Med. Published online January 23, 2012. doi:10.1001/archinternmed.2011.1316
Background
Patients with asthma engage in less physical activity than peers without asthma. Protocols are needed to prudently increase physical activity in asthma patients. We evaluated whether an educational intervention enhanced with positive affect induction and self-affirmation was more effective than the educational protocol alone in increasing physical activity in asthma patients.
Last Updated on Monday, 30 January 2012 16:58
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2012 Jan-8 Surgical treatment of drug-resistant tuberculosis
Russell R Kempker, Sergo Vashakidze, Nelly Solomonia, Nino Dzidzikashvili, M Blumberg. The Lancet Infectious Diseases, Volume 12, Issue 2, Pages 157 - 166, February 2012 doi:10.1016/S1473-3099(11)70244-4
The global emergence and spread of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis has led to the re-examination of surgery as a possible adjunctive treatment. We present the case of a 26-year-old HIV-seronegative patient with XDR pulmonary tuberculosis refractory to medical therapy. Surgical resection of the patient's solitary cavitary lesion was done as adjunctive treatment, and a successful outcome with a combination of surgery and drug therapy was achieved.
Last Updated on Monday, 30 January 2012 16:58
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2012 Jan-8 Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial
Rafael Rosell, Enric Carcereny, Radj Gervais, Alain Vergnenegre, Bartomeu Massuti, Enriqueta Felip, Ramon Palmero, Ramon Garcia-Gomez, Cinta Pallares, Jose Miguel Sanchez, Rut Porta , Manuel Cobo, Pilar Garrido Mn, Flavia Longo, Teresa Moran , Amelia Ins, Filippo De Marinis , Romain Corre , Isabel Bover , Alfonso Illiano , Eric Dansin , Javier de Castro , Michele Milella , Noemi Reguart , Giuseppe Altavilla , Ulpiano Jimenez, Mariano Provencio, Miguel Angel Moreno , Josefa Terrasa , Jose Muñoz-Langa , Javier Valdivi, Dolores Isla , Manuel Domine , Olivier Molinier, Julien Mazieres , Nathalie Baize, Rosario Garcia-Campelo , Gilles Robinet , Delvys Rodriguez-Abreu , Guillermo Lopez-Vivanco , Vittorio Gebbia , Lioba Ferrera-Delgado , Pierre Bombaron , Reyes Bernabe , Alessandra Bearz , Angel Artal MD , Enrico Cortesi, Christian Rolfo , Maria Sanchez-Ronco , Ana Drozdowskyj , Cristina Queralt, Itziar de Aguirre Jose Luis Ramirez , Jose Javier Sanchez , Miguel Angel Molina , Miquel Taron , Luis Paz-Are The Lancet Oncology, Early Online Publication, 26 January 2012 doi:10.1016/S1470-2045(11)70393-X
Background
Erlotinib has been shown to improve progression-free survival compared with chemotherapy when given as first-line treatment for Asian patients with non-small-cell lung cancer (NSCLC) with activating EGFR mutations. We aimed to assess the safety and efficacy of erlotinib compared with standard chemotherapy for first-line treatment of European patients with advanced EGFR-mutation positive NSCLC.
Last Updated on Monday, 30 January 2012 16:57
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2012 Jan-8 Beyond first-line NSCLC therapy: chemotherapy or erlotinib?
Luis Paz-Areshe TLancet Oncology, Early Online Publication, 24 January 2012 doi:10.1016/S1470-2045(12)70001-3
The EGFR signalling pathway is relevant in many tumour types and is a successful exploitable target for anticancer treatment, including for non-small-cell lung cancer (NSCLC). Erlotinib, a tyrosine kinase inhibitor (TKI), has shown efficacy, although of limited magnitude, compared with placebo in unselected patients with NSCLC in the second-line or third-line settings. 1 The discovery of EGFR-activating mutations in NSCLC and their implications in the biology of the underlying disease, including s ...
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Last Updated on Monday, 30 January 2012 16:57
2012 Jan-22 Risk of pulmonary embolism in patients with autoimmune disorders: a nationwide follow-up study from Sweden
Bengt Zöller, Xinjun Li, Jan Sundquist, Kristina Sundquist.The Lancet, Volume 379, Issue 9812, Pages 244 - 249, 21 January 2012 doi:10.1016/S0140-6736(11)61306-8
Background
Some autoimmune disorders have been linked to venous thromboembolism. We examined whether there is an association between autoimmune disorders and risk of pulmonary embolism.
Last Updated on Friday, 27 January 2012 23:23
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2012 Jan-22 Cardiovascular Mortality in Women With Obstructive Sleep Apnea With or Without Continuous Positive Airway Pressure Treatment: A Cohort Study
Francisco Campos-Rodriguez, Miguel A. Martinez-Garcia, Ines de la Cruz-Moron, Carmen Almeida-Gonzalez, Pablo Catalan-Serra, Josep M. Montserrat. Ann Intern Med January 17, 2012 156:115-122
Background:
Obstructive sleep apnea (OSA) is a risk factor for cardiovascular death in men, but whether it is also a risk factor in women is unknown.
Objective:
To investigate whether OSA is a risk factor for cardiovascular death in women and assess whether continuous positive airway pressure (CPAP) treatment is associated with a change in risk.
Last Updated on Friday, 27 January 2012 23:22
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2012 Jan-22 Severe Vitamin D Deficiency: A Prerequisite for COPD Responsiveness to Vitamin D Supplementation?
Diane R. Gold, MD, JoAnn E. Manson Ann Intern Med January 17, 2012 156:156-157
Chronic obstructive pulmonary disease (COPD) ranks in the top 10 causes of morbidity and mortality in the United States and in affluent and middle-income countries worldwide. According to the Global Initiative for Chronic Obstructive Lung Disease (www.goldcopd.org), extrapulmonary manifestations of COPD include muscle weakness, osteoporotic fractures, deep venous thrombosis, systemic inflammation, cardiovascular disease, and lung cancer and often contribute to disease severity and poor prognosis. Three-year follow-up in the TORCH (Towards a Revolution in COPD Health) study demonstrated that only one third of deaths were due to respiratory failure; the majority was attributed to lung cancer or cardiovascular events. Unfortunately, COPD therapies other than smoking cessation have limited efficacy in reducing COPD-associated mortality.
Last Updated on Friday, 27 January 2012 23:22
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