Survival and outcomes of surgical treatment of the elderly NSCLC in China: a retrospective matched cohort study.

AIM: To compare survival and outcomes of pulmonary resection for elderly NSCLC patients with that of younger controls in China. METHODS: A database which included 4792 NSCLC patients who received complete surgery from 1985 to 2005 was used. The elderly patients (>or=70) were matched 1:1 to controls (<70) by 5 variables: gender; stage; histology; pulmonary resection types; adjuvant chemotherapy. The long-term survival rates, the operative mortality and short-term death after surgery were compared. RESULTS: There were 1304 patients: 652 cases were >or=70. The 5-year OS of elderly was 39%; that of the controls was 45% (p=0.06). Operative mortality rate between elderly and the controls was similar (9/652 vs 4/652 p=0.16) but the short-term death within 2 months after the surgeries were different (23/652 vs 7/652 p=0.003). The elderly with lobectomy had a worse 5-year OS than controls (42% vs 46% p=0.05), but the 5-year OS was similar for patients who received pneumonectomy (24% vs 36% p=0.40) and the limited resections (46% vs 39% p=0.27). The 5-year OS in patients who received adjuvant chemotherapy were similar (49% vs 44% p=0.10). CONCLUSION: Elderly have the similar long-term OS with the controls. They should not be denied the curative surgery and adjuvant chemotherapy based on their chronologic age. However, elderly patients had a higher risk of short-term death after the surgery, which suggests that elderly be given more intensive care after the surgery.

The E1 functional epitope of the human interferon gamma is a nuclear targeting signal-like element. Mapping of the E1 epitope.

Eight neutralizing monoclonal antibodies (mAbs) directed against the human interferon gamma (HuIFN-gamma) that were classified in the E1 epitope group were mapped by the synthetic peptide approach. A set of 136 octapeptide homologs of the 143-residue primary sequence of the HuIFN-gamma, each one with a 7-residue sequence overlap with successive peptide, was synthesized. Based on the similar reactivity patterns of all the mAbs with this set of synthetic peptides, the E1 functional epitope was localized to residues 84-94 on the HuIFN-gamma. The epitope sequence is: Ser-Asn-Lys-Lys-Lys-Arg-Asp-Asp-Phe-Gln-Lys. The fact that eight independently isolated mAbs binding to the same domain can neutralize the HuIFN-gamma activity suggests that the E1 domain must be at or adjacent to a functional site. Within this domain is a sequence element, Lys-Lys-Lys-Arg, that resembles the nuclear location signals known to effect the intracellular transportation of a number of nuclear proteins, such as the large tumor antigen (T antigen) of simian virus 40 (SV40) and polyoma virus and steroid hormone receptors. This observation suggests that the HuIFN-gamma molecule and/or its complex with the receptor must function in the nucleus to effect transcription regulation that results in the various biological activities. The signal for that intracellular transportation must be provided by the HuIFN-gamma molecule.