Showing papers by "Thomas W. Rice published in 1995"
TL;DR: The strongest predictor of long-term survival after thoracotomy was absence of tumor in the mediastinal nodes at surgery, and this trimodality approach was feasible in this Southwest Oncology Group (SWOG) study.
Abstract: PURPOSETo assess the feasibility of concurrent chemotherapy and irradiation (chemoRT) followed by surgery in locally advanced non-small-cell lung cancer (NSCLC) in a cooperative group setting, and to estimate response, resection rates, relapse patterns, and survival for stage subsets IIIA(N2) versus IIIB.PATIENTS AND METHODSBiopsy proof of either positive N2 nodes (IIIAN2) or of N3 nodes or T4 primary lesions (IIIB) was required. Induction was two cycles of cisplatin and etoposide plus concurrent chest RT to 45 Gy. Resection was attempted if response or stable disease occurred. A chemoRT boost was given if either unresectable disease or positive margins or nodes was found.RESULTSThe median follow-up time for 126 eligible patients [75 stage IIIA(N2) and 51 IIIB] was 2.4 years. The objective response rate to induction was 59%, and 29% were stable. Resectability was 85% for the IIIA(N2) group eligible for surgery and 80% for the IIIB group. Reversible grade 4 toxicity occurred in 13% of patients. There were ...
845 citations
TL;DR: In this article, a randomized study was carried out to define the advantages of video-assisted thoracic surgery over muscle-sparing thoracotomy and lobectomy, and the authors concluded that video assisted lobectomy was not associated with a significant decrease in duration of chest tube drainage, length of hospital stay, postthoracotomy pain, or, in this group of patients, a faster recovery time and return to work.
393 citations
TL;DR: For the evaluation of suspected malignant pleural disease, thoracoscopy has its greatest diagnostic yield in older patients who have a history of malignancy and who present with a lymphocytic, hemorrhagic, high LDH effusion.
128 citations
123 citations
TL;DR: In this article, an epithelioid angiosarcoma was reported from the right pulmonary artery with pulmonary parenchymal invasion, which is a rare entity.
48 citations
TL;DR: EUS is more sensitive than upper endoscopy and CT scan for the evaluation of anastomotic recurrence of esophageal carcinoma and should be considered as an adjunctive modality to conventional endoscope for the postoperative surveillance of these patients.
47 citations
TL;DR: In this article, the authors assess toxicity, response, and survival of an accelerated induction regimen and resection in poor prognosis stage III non-small cell lung cancer, at the cost of significant treatment prolongation.
43 citations
TL;DR: Congress enacted legislation in 1990 that dramatically changed the rules for selling supplemental health insurance, or "Medigap" policies, to the elderly, and also offers lessons for U.S. health care reform.
Abstract: Congress enacted legislation in 1990 that dramatically changed the rules for selling supplemental health insurance, or "Medigap" policies, to the elderly. Most notably, policy coverage was standardized. Insurance carriers are allowed to sell only the ten specified packages of benefits, which reduces consumer choice but facilitates comparison shopping. This legislation is important in its own right and also offers lessons for U.S. health care reform. To examine the changes brought about by this legislation and analyze their implications for health care reform, we conducted site visits to nine states and interviewed insurer representatives, executive branch officials, congressional staff, and various interest groups for two years.
23 citations
TL;DR: To clarify the significance of blood group antigen A (BAA) expression by neoplastic cells, patients who had curative resections of stage I non-small cell lung carcinomas were studied, andcinoma recurrence, overall survival, and event-free survival were not related to secretor status, BAA expression, or pattern of staining.
14 citations
TL;DR: In this patient with postoperative, recurrent hyperparathyroidism, Tc-99m sestamibi SPECT demonstrated abnormal focal accumulation in a mediastinal location, which correlated with a surgically proven parathyroid adenoma.
Abstract: The preoperative localization of abnormal parathyroid tissue in patients with persistent or recurrent hyperpara-thyroidlsm after previous surgical neck exploration has been a difficult diagnostic problem. As a complicating factor, approximately 20% of parathyroid glands are found in ectopic locations, the mediastinum being the most frequent of these sites. Recently, Tc-99m sestamibi has been reported to successfully detect and localize parathyroid adenomas preoperativeiy. In this patient with postoperative, recurrent hyperparathyroidism, Tc-99m sestamibi SPECT demonstrated abnormal focal accumulation in a mediastinal location, which correlated with a surgically proven parathyroid adenoma.
11 citations
TL;DR: Using survey and claims data, it is found that the poor have lower balance billing expenditures for services provided by primary care physicians, but that there is no relationship between poverty status and balance billing expenditure for services of nonprimary care physicians.
Abstract: Medicare's experience with balance billing provides valuable lessons for policy making for national or state health care reform. Medicare developed several policies to encourage physicians to become participating providers who accept Medicare-allowed charges as payment in full. Only nonparticipating physicians are permitted to bill for additional amounts beyond that paid by Medicare, and there are limits on the amount of balance billing per claim. As shown by the analysis of claims presented in this article, Medicare has successfully provided financial protection to beneficiaries. In 1986, more than 60 percent of expenditures for physician services were on assigned claims for which there could be no balance billing; by 1990, 80 percent of expenditures were on assigned claims. Balance billing decreased by about 30 percent during the same period. Although these policies have been successful in reducing total expenditures for balance billing, they may not provide financial protection to the most economically vulnerable beneficiaries. Using survey and claims data, we found that the poor have lower balance billing expenditures for services provided by primary care physicians, but that there is no relationship between poverty status and balance billing expenditures for services of nonprimary care physicians. In addition, most low-income beneficiaries are liable for balance bills. Under health care reform, adoption of Medicare's incentive-based approach with mandatory assignment for the poor would allow for some choice based on price and would provide financial protection for all consumers.