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The use of internal fixation for the treatment of a distal radial fracture differs widely among geographical regions and patient populations. Such variations highlight the need for improved comparative-effectiveness data to guide the treatment of this fracture.

Background Since anaplastic thyroid cancer is a rare malignancy with a high mortality rate, we evaluated the benefit of multimodality treatment. Methods Overall survival was determined in the 2,742 patients captured by the National Cancer Database who were diagnosed with anaplastic thyroid cancer between 1998-2008. We performed Kaplan Meier and then Cox Proportional Hazard Regression controlling for patient characteristics and treatment. Results Only older age [adjusted hazard ratio for ≥ 85 (AHR) 3.43 (95% CI 2.34-5.03), for 75-84 AHR 2.85 (95% CI 1.97-4.11), for 65-74 AHR 2.20 (95% CI 1.53-3.15), for 45-64 AHR 2.08 (95% CI 1.47-2.95)] and omission of treatment were associated with greater mortality [omission of surgery AHR 1.79 (95% CI 1.61-1.99), omission of radiation therapy AHR 1.56 (95% CI 1.41-1.73), and omission of chemotherapy AHR 1.28 (95% CI 1.15-1.43)]. In subgroup analysis of patients with AJCC Stage IVA, IVB and IVC anaplastic thyroid cancer, combination therapy with surgery, radiation, and chemotherapy was associated a difference in median survival of months. Conclusion Multimodality management of anaplastic thyroid cancer results in a marginal treatment benefit. The poor overall survival of all anaplastic thyroid cancer patients, regardless of treatment, emphasizes the need for informed patients whose preferences are incorporated into treatment decision making.

Surgical complications are independently associated with omission of chemotherapy for stage III colorectal cancer and with a delay in adjuvant chemotherapy. These data suggest that complications of colorectal surgery may affect both short- and long-term cancer outcomes. Thus, the implementation of quality improvement measures that effectively reduce perioperative complications may also provide a long-term cancer survival benefit.

The number of lymph node metastases should be incorporated into MTC staging. The extent of surgery in patients with MTC should be tailored to tumor size and distant metastases.

The study included 905 patients with esophageal cancer, 12,395 patients with lung cancer, and 1966 patients with pancreatic cancer. The serious complication rates were respectively 17.4, 9.5 and 11.8 %. The patients with serious complications had lower 5-year survival rates than those with no complications even if they were rescued and survived 30 days (20 vs 43 % for esophagus, 29 vs 54 % for lung, and 10 vs 21 % for pancreas cancer). Even after patients who died within 180 days after surgery were excluded from the analysis, a decrement in risk-adjusted long-term survival was observed among the patients with serious complications after all three procedures. The association between complications and long-term survival was not explained by differences in receipt of adjuvant chemotherapy CONCLUSION: Patients who undergo complex cancer resection and experience serious complications have diminished long-term survival, even if they are "rescued" from their complications. This finding persists even when deaths within 6 months after surgery are excluded from the analysis. Metrics of surgical success should consider terms beyond 30 and even 90 days as well as the long-term consequences of surgical complications.

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