Real-world evidence of the safety and effectiveness of regorafenib in Taiwanese patients with metastatic colorectal cancer: CORRELATE Taiwan.

BACKGROUND/PURPOSE: This analysis reports safety and effectiveness data from the Taiwanese cohort of the CORRELATE study. METHODS: CORRELATE was a prospective, observational study to assess the safety and effectiveness of regorafenib for the treatment of metastatic colorectal cancer (CRC) in real-world clinical practice that was conducted in 13 different countries in Asia, Europe and Latin America. The primary endpoint of the study was incidence of all treatment-emergent AEs (TEAEs), and secondary endpoints included overall survival (OS), progression-free survival (PFS), and disease control rate (DCR). RESULTS: The global study population (N = 1037) included 128 Taiwanese patients with a median age of 64 years, median weight of 62.02 kg and 66.41% were male. Reduced initiating doses of regorafenib and dose interruptions were common in Taiwanese patients (71.87% and 50.00%, respectively). The safety profile of regorafenib was consistent with that seen in Asian patients in the clinical development trials, including the CORRECT and CONCUR studies, with hand-foot-skin reactions (HFSR) of any grade occurring in 33.59% of patients. Median OS was 11.64 months in the Taiwanese patients (95% confidence interval [CI], 8.36-13.82) and median PFS was 2.17 months (95% CI, 1.97-2.89). CONCLUSION: The safety and effectiveness of regorafenib in this real-world study was generally consistent with the known efficacy and safety profile in Asian patients in clinical trials. TRIAL REGISTRATION: NCT02042144.

Successful percutaneous tracheostomy via puncture through the thyroid isthmus.

Tracheostomy is one of the most frequently performed procedures in intensive care units. Bedside percutaneous tracheostomy has become an increasingly popular option to standard open tracheostomy. Several contraindications for percutaneous tracheostomy, including an enlarged thyroid isthmus, have been described. However, as experience with this technique has increased, most of the described contraindications appear to be relative rather than absolute, provided the procedure is performed by an experienced practitioner. Herein we present a case of an unavoidable direct puncture of the thyroid isthmus during a percutaneous tracheostomy. The procedure was performed smoothly, and no complications occurred.

Surgical outcomes in lung cancer presenting as ground-glass opacities of 3 cm or less: a review of 5 years' experience.

BACKGROUND: High-resolution computed tomography (HRCT) has become increasingly popular recently and more pulmonary ground-glass opacities (GGOs) are being identified. However, the treatment for these GGOs remains controversial. The purpose of this study was to retrospectively review the clinical and pathological characteristics and to demonstrate the longterm surgical outcomes in patients undergoing resection for GGOs in our institute. METHODS: From January 2004 to December 2008, we enrolled 50 patients undergoing resection for solitary pulmonary GGOs of 3 cm or less at Taipei Veterans General Hospital. Patients with a past history of lung cancer, or multiple GGOs at presentation, or GGOs accompanied by a solid component of more than 50 percent were excluded. The patients were retrospectively reviewed and the rate and circumstances of survival were analyzed. RESULTS: Of the 50 patients, 43 (86%) patients underwent surgery immediately after the GGO lesions were detected by the initial HRCT. Forty-six (92.0%) patients were diagnosed with lung cancer. Of this group, there were 8 (17.4%) adenocarcinomas with lepidic predominant pattern, 13 (28.3%) adenocarcinomas with acinar predominant pattern, and 24 (52.2%) adenocarcinomas with papillary predominant pattern. There was one adenocarcinoma that was mixed with small cell carcinoma. There was no surgical mortality overall, and the 5-year overall and disease-specific survival rates were 97.5% and 100%, respectively. CONCLUSION: The percentage of malignancy is high in pulmonary GGOs. Surgery results in an excellent prognosis in these patients.