History and present status of pulmonary metastasectomy in colorectal cancer

Clinical practice with respect to metastatic colorectal cancer differs from the other two most common cancers,breast and lung,in that routine surveillance is recommended with the specific intent of detecting liver and lung metastases and undertaking liver and lung resections for their removal.We trace the history of this approach to colorectal cancer by reviewing evidence for effectiveness from the 1950s to the present day.Our sources included published citation network analyses,the documented proposal for randomised trials,large systematic reviews,and meta-analysis of observational studies.The present consensus position has been adopted on the basis of a large number of observational studies but the randomised trials proposed in the 1980s and 1990s were either not done,or having been done,were not reported.Clinical opinion is the mainstay of current practice but in the absence of randomised trials there remains a possibility of selection bias.Randomised controlled trials(RCTs)are now routine before adoption of a new practice but RCTs are harder to run in evaluation of already established practice.One such trial is recruiting and shows that controlled trial are possible.

手术切除结直肠癌复发转移灶：我们的选择是否正确？

一项20年前未发表的随机对照试验结果质疑了结直肠癌根治性手术后再次手术治疗的生存获益。Tom Treasure和他的团队在恢复隐形与被废弃试验的倡议下重塑了第一项试验，并讨论了该试验结果在今天的意义。

戒烟：戒烟永不嫌晚，即使他们患有肺癌

我们是否需要吸烟有害的更多证据？对于心脏疾病、卒中、周围血管疾病和慢性阻塞性肺疾病等常见疾病，吸烟是一个重要因素。此外，大多数肺癌均由吸烟引起，吸烟也是乳腺癌和肠道癌症的危险因素。去年曾有博客称禁烟令是狭隘的和“合理的废话科学”，得到的支持甚微。吸烟损耗生命和身体；吸烟甚至导致过早衰老。

胸腔镜与开胸肺叶切除的长期生存比较：基于SEER数据库的倾向匹配比较分析

目的比较微创肺叶切除和开胸肺叶切除术后的远期生存。方法倾向匹配比较分析。背景监测、流行病学及最终结果（SEER）数据库。参与者2007至2009年所有接受肺叶切除的肺癌患者。主要结局测量微创胸腔镜手术对总生存率、无病生存率和肿瘤特异生存率的影响。结果从2007至2009年，共6008例患者接受了肺叶切除，其中开胸手术4715例（78％）。总体中位年龄74（四分位数间距70～78）岁，中位随访时间为40个月。通过匹配分析，两组均纳入1195例患者，结果提示两组患者的3年总生存率、无病生存率和肿瘤相关生存率均没有统计学差异（总生存率：70．6％比68．1％，P=0．55；无病生存率：86．2％比85．4％，P=0．46；肿瘤相关生存率：92．0％比89．5％，P=0．05）。结论本研究通过倾向匹配分析提示胸腔镜肺叶切除术与开胸肺叶切除术在总生存、无病生存和肿瘤特异生存方面没有显著差异。胸腔镜肺叶切除术后的结局不劣于开胸手术。