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EP is superior to CEV in LD-SCLC patients. In ED-SCLC patients, the benefits of EP and CEV chemotherapy seem equivalent, with similar survival time and quality of life.

Background. A retrospective study of long term outcome after the development of metastases from osteosarcoma was performed, with emphasis on the impact of different treatment strategies and the identification of prognostic factors. Methods. From 1975 to 1993, a population‐based series of 60 patients with distant metastases (relapse) from high grade, extremity‐localized osteosarcoma was treated at The Norwegian Radium Hospital. Six patients relapsed after surgery alone, 28 patients relapsed after primary chemotherapy of low potency, and 26 patients after modern, intensive chemotherapy. Lung metastases were present in 88% of the patients, 52% had bilateral lesions, and the median number of lesions was three (range, 1‐25 lesions). Forty‐seven percent of patients had complete surgical excision of all identifiable metastatic nodules and 54% of these had additional second line chemotherapy defined as adequate. Adequate chemotherapy included further dose escalations of methotrexate in approximately half of the patients, usually from 8 to 12 g. The rest were exposed to novel agents such as cisplatin, etoposide, and ifosfamide. Of the operated patients, 43% had additional thoracotomies after subsequent relapses. Results. The projected 5‐year survival rate from the first metastatic event was 24% for all patients and 50% for patients who underwent complete metastasectomy. In a multivariate analysis, the factors with independent predictive value for improved overall survival were the presence of a solitary metastasis, the accomplishment of complete metastasectomy, and the administration of adequate salvage chemotherapy. Conclusions. Complete metastasectomy is mandatory for long term survival of patients with metastatic osteosarcoma, and repeated lung resections are necessary in nearly half the patients. Second line chemotherapy and following primary treatment with modern intensive chemotherapy protocols may improve survival further. Cancer 1995;75:1084–93.

Summary To assess the levels of psychological distress and identify predictors of anxiety/depression caseness after cancer cure, a national population of 557 Hodgkin's disease (HD) survivors was surveyed. The respondents [204 women, 255 men, mean age 44 years (SD = 12)] returned a mailed questionnaire including The Hospital Anxiety and Depression Scale (HADS). Disease and treatment variables were based on the hospital records. A total of 27% had caseness scores (anxiety, 14.5%; depression, 4%; anxiety and depression, 8.5%). In a multiple logistic regression analysis, anxiety caseness was predicted by low educational status [OR (odds ratio) = 2.07, 95% Cl = 1.02-4.22], observational period 7 years or longer (7-10 years: OR = 3.07, 95% Cl = 1.26-7.47), combined irradiation and chemotherapy treatment (OR = 2.77, 95% Cl = 1.17-6.54) and psychiatric symptoms before HD (OR = 2.55, 95% Cl = 1.40-4.65) or during treatment (OR = 3.51, 95% Cl = 2.08-5.90). Depression caseness was predicted by age (OR = 1.03, 95% Cl = 1.00-1.06) and psychiatric symptoms before HD (OR = 5.1, 95% Cl = 2.55-10.31) Anxiety cases are more prevalent than in the general Norwegian population, and were found to be most common 7-10 years after treatment. The most intensive treatment was associated with increased risk for anxiety caseness. The subjects experienced distress during treatment precedes difficulties in long-term adjustment. Focusing on these predictors during treatment and follow-up controls may improve long-term outcome.

Neoadjuvant chemotherapy seems to improve long-term survival after cystectomy in patients with stages T3 to T4a bladder carcinoma, while no survival benefit was found for stages T1 to T2 disease.

Objective The aim of the study was to explore experiences from the next of kin’s perspective of a new involvement method in the regulatory investigation process of adverse events causing patient death. Methods The study design was a qualitative process evaluation of the new involvement method in two Norwegian counties. Next of kin who had lost a close family member in an adverse event were invited to a 2-hour face-to-face meeting with regulatory inspectors to shed light on the event from the next of kin’s perspective. Data collection involved 18 interviews with 29 next of kin who had participated in the meeting and observations (20 hours) of meetings from 2017 to 2018. Data were analyzed using a thematic content analysis. Results Next of kin wanted to be involved and had in-depth knowledge about the adverse event and the healthcare system. Their involvement extended beyond sharing information, and some experienced it as having a therapeutic effect and contributing to transparency and trust building. The inspectors’ professional, social, and human skills determined the experiences of the involvement and were key for next of kin’s positive experiences. The meeting was emotionally challenging, and some next of kin found it difficult to understand the regulators’ independent role and suggested improving information given to the next of kin before the meeting. Conclusions Although the meeting was emotionally challenging, the next of kin had a positive experience of being involved in the investigation and believed that their information contributed to improving the investigation process.

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The 1-month postoperative combination regimen improved treatment results in patients with Dukes B and C rectal cancer, in terms of local recurrence rate, recurrence-free survival and overall survival, without serious side-effects.