Long-Term Survival of American Joint Committee on Cancer 8th Edition Staging Descriptors for Clinical M1a Non-Small Cell Lung Cancer.

BACKGROUND: The American Joint Committee on Cancer (AJCC) 8th edition TNM staging manual for non-small cell lung cancer (NSCLC) M1a descriptors includes tumors presenting with malignant pleural or pericardial effusion (ie, M1a-Effusion), pleural or pericardial nodule(s) (ie, M1a-Pleural), or separate tumor nodule(s) in a contralateral lobe (ie, M1a-Contralateral). RESEARCH QUESTION: Is M1a NSCLC presenting with malignant pleural or pericardial effusion associated with worse survival compared with other types of M1a NSCLC? STUDY DESIGN AND METHODS: Patients with cT1-4, N0-3, M1a NSCLC (satisfying a single M1a descriptor of M1a-Effusion, M1a-Pleural, or M1a-Contralateral), according to AJCC eighth edition staging criteria, in the National Cancer Database from 2010 to 2015 were included. Overall survival was evaluated by using Kaplan-Meier analysis, multivariable-adjusted Cox proportional hazards modeling, and propensity score matching. RESULTS: Of the 25,716 patients who met study eligibility criteria, 12,756 (49.6%) presented with M1a-Effusion tumors, 3,589 (14.0%) with M1a-Pleural tumors, and 9,371 (36.4%) with M1a-Contralateral tumors. In multivariable-adjusted analysis, compared to M1a-Effusion tumors, both M1a-Pleural tumors (hazard ratio, 0.68; 95% CI, 0.64-0.71; P < .001) and M1a-Contralateral tumors (hazard ratio, 0.66; 95% CI, 0.64-0.69; P < .001) were associated with better overall survival. No significant differences were found in overall survival between patients with M1a-Pleural tumors vs M1a-Contralateral tumors. In a propensity score-matched analysis of 5,581 patients with M1a-Effusion tumors and 5,581 patients with other M1a tumors (ie, M1a-Contralateral or M1a-Effusion), those with M1a-Effusion tumors had worse 5-year overall survival than patients with other M1a tumors (M1a-Effusion 6.4% [95% CI, 5.7-7.1] vs M1a-Other 10.6% [95% CI, 9.7-11.5]; P < .001). INTERPRETATION: In this national analysis of AJCC 8th edition cT1-4, N0-3, M1a NSCLC, tumors with malignant pleural or pericardial effusion were associated with worse overall survival than tumors with either pleural or contralateral pulmonary nodules. These findings may be taken into consideration for the upcoming ninth edition of the AJCC lung cancer staging guidelines.

Effects of electron-ion temperature equilibration on inertial confinement fusion implosions.

The electron-ion temperature relaxation essentially affects both the laser absorption in coronal plasmas and the hot-spot formation in inertial confinement fusion (ICF). It has recently been reexamined for plasma conditions closely relevant to ICF implosions using either classical molecular-dynamics simulations or analytical methods. To explore the electron-ion temperature equilibration effects on ICF implosion performance, we have examined two Coulomb logarithm models by implementing them into our hydrocodes, and we have carried out hydrosimulations for ICF implosions. Compared to the Lee-More model that is currently used in our standard hydrocodes, the two models predict substantial differences in laser absorption, coronal temperatures, and neutron yields for ICF implosions at the OMEGA Laser Facility [Boehly et al. Opt. Commun. 133, 495 (1997)]. Such effects on the triple-picket direct-drive design at the National Ignition Facility (NIF) have also been explored. Based on the validity of the two models, we have proposed a combined model of the electron-ion temperature-relaxation rate for the overall ICF plasma conditions. The hydrosimulations using the combined model for OMEGA implosions have shown ∼6% more laser absorption, ∼6%-15% higher coronal temperatures, and ∼10% more neutron yield, when compared to the Lee-More model prediction. It is also noticed that the gain for the NIF direct-drive design can be varied by ∼10% among the different electron-ion temperature-relaxation models.