[Health-Related Quality of Life in Patients with Non-Small Cell Lung Cancer before and after Surgery - a Comparison between Thoracotomy and Video-Assisted Thoracoscopic Surgery]. / Untersuchungen zum Verlauf der Lebensqualität vor und bis 2 Jahre nach anatomischer Resektion bei Patienten mit Lungenkarzinom ­ ein Vergleich zwischen anterolateraler Thorakotomie und videoassistierter Thorakoskopie.

BACKGROUND: Earlier studies have proven that in patients with non-small cell lung cancer video-assisted thoracoscopic surgery is functionally superior to thoracotomy in terms of perioperative and postoperative complications. The objective of this work was to determine whether there is a difference in health-related quality of life (HRQoL) of patients with non-small cell lung cancer - compared to the German normal population - before and after surgery. Moreover, HRQoL after thoracotomy was compared to HRQoL after video-assisted thoracoscopic surgery (VATS). MATERIAL AND METHODS: Based on retrospective data generated during a 7-year period (2010 - 2017), 327 patients with non-small cell lung cancer who underwent therapy were examined. Patients either underwent thoracotomy or video-assisted thoracoscopic surgery. 456 of short form 12 questionnaires were analysed. Via norm-based scoring, and physical and mental component summaries (PCS and MCS) were calculated before and 6, 12, and 24 months after treatment. Using t tests, potential differences in physical and mental component summaries were evaluated between patients and the German normal population as well as between patients after thoractomy and after VATS. RESULTS: Up to 24 months after surgery, the physical dimension of HRQoL is significantly reduced, while the mental component summary does not significantly differ from the German population. Moreover, thoracotomy and VATS gave equivalent values for health-related quality of life. CONCLUSION: With respect to health-related quality of life, thoracotomy and video-assisted thorascopic surgery are equivalent in the long term. But there was a trend to improvement with both summary scores that might indicate superiority of video-assisted thoracoscopic surgery.

Generation of coherent radiation in the vacuum ultraviolet using randomly quasi-phase-matched strontium tetraborate.

Tunable coherent radiation is generated in the vacuum ultraviolet down to 121 nm using random quasi-phase matching in strontium tetraborate, the shortest wavelength ever produced with a second-order nonlinear optical process in a solid-state material. Relevant properties of this radiation, the nonlinear process, and the nonlinear crystal are investigated.

Men and women differ in their diurnal expression of monocyte peroxisome proliferator-activated receptor-α in the fed but not in the fasted state.

Peroxisome proliferator-activated receptor-α (PPARα) plays a pivotal role in regulating metabolic response to fasting and is an inhibitor of inflammatory pathways in immune cells. It represents a therapeutic target for treatment of several diseases, mainly hyperlipidemia. To shed light on PPARα expression changes in response to fasting, young healthy male and female volunteers were fed or fasted for 24 hours. Monocytes were analyzed every 2 hours to compile both profiles of mRNA and protein expression of PPARα and its interactive partner, the circadian pacemaker brain and muscle aryl hydrocarbon receptor nuclear translocator like-1 (BMAL1). We found that women change their diurnal expression profiles of PPARα and BMAL1 when switching from the fed to the fasted state, whereas men do not. Interestingly, the PPARα and BMAL1 profiles of men and women in the fed state are different, whereas the profiles in the fasted state are virtually identical. The finding of diametrically opposite responses of male and female PPARα expression in the fed state might have practical implication in human medicine as PPARα activators like fibrates are used for the therapy of chronic lymphocytic leukemia, microvascular complications in diabetes, and kidney diseases.

High-average-power, 50-fs parametric amplifier front-end at 1.55 µm.

An average-power-scalable, two-stage optical parametric chirped pulse amplifier is presented providing 90-µJ signal pulses at 1.55 µm and 45-µJ idler pulses at 3.1 µm at a repetition rate of 100 kHz. The signal pulses were recompressible to within a few percent of their ~50-fs Fourier limit in anti-reflection coated fused silica at negligible losses. The overall energy conversion efficiency from the 1030-nm pump to the recompressed signal reached 19%, significantly reducing the cost per watt of pump power compared to similar systems. The two-stage source will serve as the front-end of a three-stage system permitting the development of novel experimental strategies towards laser-based imaging of molecular structures and chemical reactivity.

Spectral fringes in non-phase-matched SHG and refinement of dispersion relations in the VUV.

We consider second harmonic generation (SHG) of ultrashort pulses in the case of strong phase- and group-velocity mismatch. Spectral fringes appear in the second harmonic related to two delayed replicas of the fundamental pulse in the time domain. The fringe separation can be used to evaluate the group-velocity and refractive index of nonlinear crystals at extreme wavelengths. Experimental results with femtosecond pulses in SrB(4)O(7) (SBO) are used to refine the Sellmeier equation describing the n(c) refractive index down to 160 nm, essential for the use of this unique nonlinear crystal for random quasi-phase-matching in the VUV.

Evaluation of the prognostic role of tumor cell podoplanin expression in locally advanced squamous cell carcinoma of the head and neck.

BACKGROUND AND PURPOSE: To investigate the potential prognostic role of tumor cell podoplanin expression in patients treated with resection followed by irradiation or chemoradiotherapy for locally advanced squamous cell carcinoma of the head and neck (SCCHN). MATERIALS AND METHODS: Podoplanin expression (≤10 % versus > 10 %) and 12 other factors were evaluated in 160 patients for their association with locoregional control (LRC), metastases-free (MFS) and overall survival (OS). Other factors were age, gender, Eastern Cooperative Oncology Group (ECOG) performance status, preradiotherapy (pre-RT) hemoglobin level, tumor site, histological grading, T category, N category, American Joint Committee on Cancer (AJCC) stage, human papillomavirus (HPV) status, extent of resection and concurrent chemotherapy. RESULTS: In multivariate analysis, ECOG performance status 0-1 (risk ratio, RR: 3.01; 95 % confidence interval, CI: 1.42-7.14; p = 0.003), pre-RT hemoglobin levels ≥ 7.45 mmol/l (12 g/dl; RR: 2.03; 95 % CI: 1.04-3.94; p = 0.038), oropharyngeal cancer (RR: 1.25; 95 % CI: 1.01-1.55; p = 0.038) and T category T1-2 (RR: 1.81; 95 % CI: 1.24-2.79; p = 0.002) were significantly associated with improved LRC. T category T1-2 (RR: 1.90; 95 % CI: 1.25-3.06; p = 0.002) and N category N0-2a (RR: 5.22; 95 % CI: 1.96-18.09; p < 0.001) were significantly associated with better MFS. Pre-RT hemoglobin levels ≥ 7.45 mmol/l (RR: 2.44; 95 % CI: 1.27-4.74; p = 0.007), T category T1-2 (RR: 1.97; 95 % CI: 1.36-3.04; p < 0.001) and N category N0-2a (RR: 2.87; 95 % CI: 1.37-6.61; p = 0.005) were significantly associated with improved OS. Podoplanin expression ≤ 10 % showed a trend towards improved OS on both univariate (p = 0.050) and multivariate analysis (RR: 1.86; 95 % CI: 0.96-3.59; p = 0.07). CONCLUSION: Treatment outcomes were significantly associated with performance status, pre-RT hemoglobin level, tumor site and tumor stage. Tumor cell expression of podoplanin ≤ 10 % showed a trend towards improved OS when compared to podoplanin expression of > 10 %.

Generation of tunable sub-45 femtosecond pulses by noncollinear four-wave mixing.

Generation of sub-45 fs vacuum UV (VUV) pulses tunable across the spectral range of 146-151 nm at 1 kHz repetition rate is reported. The pulses are produced using noncollinear difference-frequency four-wave mixing between the third-harmonic of an amplified Ti:sapphire laser and the signal wavelength of an infrared optical parametric amplifier (ω(VUV)=2ω(TH)-ω(IR)) in krypton and argon. The generated VUV pulses have energies as high as 90 nJ. Pulse duration measurements are realized by cross correlation between the VUV pulses and the laser fundamental wavelength using pump-probe ionization in xenon.

Pathological complete remission in patients with oesophagogastric cancer receiving preoperative 5-fluorouracil, oxaliplatin and docetaxel.

The aim of this study was to determine the pathological complete remission (pCR) rate, and its relationship to clinical outcome, in patients with adenocarcinoma of the stomach or oesophagogastric junction receiving preoperative 5-fluorouracil, leucovorin, oxaliplatin and docetaxel (FLOT) every 2 weeks. Data from these patients who received at least one cycle of preoperative FLOT followed by surgery were prospectively collected in three German centres. Outcome analyses were conducted and tumour samples were evaluated for pathological remission by a central pathologist. A total of 46 patients were included in this analysis. All patients had clinical T3- and/or N+-stages and 11 (23.9%) had distant metastases (M1). After a median of 4 (range 2-8) preoperative cycles, 8 of 46 patients (17.4%) achieved a pCR. The pCR rate was highest in tumours of intestinal type histology (30.8%) and in those located in the oesophagogastric junction (30.4%) and lowest in patients with diffuse/mixed type tumours (0%) or tumours located in the stomach (4.3%; p < 0.05 for both comparisons). Patients with pCR had 100% probability of overall and disease-free survival (DFS) during the observation period, which was significantly higher (p = 0.037 and p = 0.009, respectively) than the survival probability in patients without pCR. In conclusion, treatment intensification using FLOT was associated with significant pCR rates in patients with oesophagogastric cancer. The distribution of pCR appeared to be significantly different according to histological type and location of the tumours.

The prognostic impact of tumor cell expression of estrogen receptor-α, progesterone receptor, and androgen receptor in patients irradiated for nonsmall cell lung cancer.

BACKGROUND: The current study was performed to investigate the potential impact of tumor cell expression of estrogen receptor-α (ER-α), progesterone receptor (PR), and androgen receptor (AR) on the outcomes of patients who received radiotherapy (RT) for non-small cell lung cancer (NSCLC). METHODS: Tumor cell expression of ER-α, PR, and AR as well as 9 additional potential prognostic factors were retrospectively evaluated in 64 patients who underwent RT for AJCC stage II/III NSCLC. The endpoints investigated were locoregional control, metastases-free survival, and overall survival. The additional potential prognostic factors were age, gender, Karnofsky performance score, histology, T classification, N classification, surgery, smoking during RT, and hemoglobin levels during RT. Subgroup analyses were performed for women and men. RESULTS: On univariate analysis, locoregional control was not found to be associated with expression of PR or AR. ER-α expression demonstrated a strong trend toward worse locoregional control. On multivariate analysis, ER-α expression was found to be significantly associated with worse locoregional control (risk ratio [RR], 3.12; P = .035). On univariate analysis, metastases-free survival was not associated with expression of ER-α, PR, or AR. On univariate analysis, survival was found to be negatively associated with expression of ER-α (P = .003) but not with PR or AR expression. On multivariate analysis, ER-α expression maintained significance (RR, 2.73; P = .022). CONCLUSIONS: Tumor cell expression of ER-α was found to be a negative prognostic factor for treatment outcomes in both women and men. Expression of PR and AR was not associated with outcomes.

Primary metastasized extraskeletal Ewing sarcoma of the vulva: report of a case and review of the literature.

PURPOSE: Ewing's sarcoma (ES) and primitive neuroectodermal tumor (PNET) are closely related malignant neoplasms, usually affecting the skeletal system. Extraosseous ES/PNETs are uncommon, with occasional reports of tumors affecting the genitourinary tract. Only few cases of primary vulvar Ewing's sarcoma/PNET have previously been reported. METHODS: We present a patient with primary vulvar Ewing's sarcoma with pulmonary metastasis who presented at the Department of Gynecology and Obstetrics, University of Schleswig-Holstein, Campus Luebeck. RESULTS: The present report is the third case of a primary vulvar Ewing's sarcoma and the first constellation with pulmonary metastasis at diagnosis in the current literature. We present the diagnostic and therapeutic management including surgery, chemotherapy and radiation. CONCLUSION: The treatment of the Ewing's sarcomas and PNETs requires a multidisciplinary systemic approach. Despite its rarity, the differential diagnosis of vulvar sarcoma must be considered in young women.

Laryngeal chondrosarcoma with unusual dissemination to the humerus.

We report the case of an 81-year-old woman admitted to our clinic with a 16-month history of hoarseness due to unilateral vocal cord immobilization, slowly progressive dysphagia and an episode of painless swelling of the right arm. Radiological and histological workup revealed a medium-grade conventional chondrosarcoma of the cricoid cartilage with paratracheal spread and dissemination to the lung and the humeral bone. To our knowledge, this is the first humeral bone metastasis of laryngeal chondrosarcoma reported in the literature. The course of the presented case underlines the need for an early and detailed clinical and radiological workup of vocal cord immobilization.

Elevation of matrix metalloproteinases in different areas of ascending aortic aneurysms in patients with bicuspid and tricuspid aortic valves.

Our aim is to investigate the elevation of matrix proteins in tissues obtained from distal, above the sinotubular junction (proximal), concave, and convex sites of aneurysms in the ascending aorta using a simultaneous multiplex protein detection system. Tissues were collected from 41 patients with ascending aortic aneurysms. A total of 31 patients had a bicuspid aortic valve (BAV), whereas 10 had a tricuspid aortic valve (TAV). Concave and convex aortic site samples were collected from all patients, whereas proximal and distal convexity samples were obtained from 19 patients with BAV and 7 patients with TAV. Simultaneous detection of matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) was performed at each of the four aortic sites. MMP-2 levels were higher in the concave aortic sites than in the convex aortic sites. In contrast, MMP-8 levels were higher in the convex sites than in the concave sites, as were MMP-9 levels. In both BAV and TAV patients, TIMP-3 levels were higher in the concave sites than in the convex sites. However, TIMP-2 and TIMP-4 levels were significantly elevated in the sinotubular proximal aorta of BAV patients. Simultaneous detection of MMPs and TIMPs revealed different levels at different aortic sites in the same patient.

Prognostic factors (including HPV status) for irradiation of locally advanced squamous cell carcinoma of the head and neck (SCCHN).

BACKGROUND AND PURPOSE: The prognosis of patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) is generally poor. However, prognostic factors can help optimize the care for the individual patient. This study investigated potential prognostic factors, including HPV status, for locoregional control (LRC), metastases-free survival (MFS), and survival (OS). PATIENTS AND METHODS: Twelve potential prognostic factors were investigated in 170 patients irradiated for stage III or IV SCCHN, including age (≤ 60 vs > 60 years), gender, ECOG performance score (0-1 vs 2), preradiotherapy hemoglobin level (< 12 vs ≥ 12 g/dl), tumor site (oropharynx, oral cavity, hypopharynx, or larynx), histological grade (G1-2 vs G3), T category (T1-T2 vs T3-T4), N category (N0-N1 vs N2-N3), AJCC stage (III vs IV), surgery (no vs yes), and chemotherapy (no vs yes). RESULTS: On multivariate analysis, positive HPV status (RR 2.34; p = 0.014), ECOG performance score 0-1 (RR 1.94; p = 0.017), preRT hemoglobin ≥ 12 g/dl (RR 1.88; p = 0.018), T category T1-T2 (RR 2.72; p < 0.001), and surgery (RR 2.29; p = 0.007) were significantly associated with improved LRC. PreRT hemoglobin ≥ 12 g/dl (RR 1.98; p = 0.040) and T category T1-T2 (RR 3.33; p < 0.001) were significantly associated with improved MFS. Positive HPV status (RR 2.19; p = 0.019), pre-RT hemoglobin ≥ 12 g/dl (RR 2.15; p = 0.002), T category T1-T2 (RR 2.31; p = 0.002), and AJCC stage III (RR 1.91; p = 0.034) were significantly associated with improved OS. CONCLUSION: Improved treatment outcomes were significantly associated with positive HPV status, better performance status, lower tumor stage, and pretreatment hemoglobin levels ≥ 12 g/dl. These factors should be considered in future trials.

High-efficiency single-crystal third-harmonic generation in BiB3O6.

Third-harmonic generation of high-intensity, sub-100-fs idler pulses from a Ti:sapphire-laser-pumped optical parametric amplifier is demonstrated by using a single nonlinear crystal of BiB3O6 (BIBO). Maximum internal energy conversion as high as 11% from the fundamental to the third harmonic is achieved by phase- and group-velocity matching for the direct cubic nonlinear process together with the velocity-mismatched cascading quadratic processes.

Generation of intense sub-20-fs vacuum ultraviolet pulses compressed by material dispersion.

We present our latest results on the generation of ultrashort vacuum UV (VUV) pulses by nonresonant four-wave mixing of chirped broadband pulses generated by filamentation of the fundamental of a Ti:sapphire laser with relatively narrowband pulses at the third harmonic. Positive chirp at the broadband idler yields negatively chirped VUV pulses necessary to compensate for material dispersion of a MgF(2) window in the VUV beam path. Pulse energies exceeding 400 nJ are available for time-resolved experiments. Pulse duration is measured by pump-probe ionization of Xe gas, providing the cross correlation between the fifth harmonic and the fundamental.

Local calprotectin production in colorectal cancer and polyps--active neutrophil recruitment in carcinogenesis.

AIM: The aim of this study is to examine the expression level and localization of calprotectin in cancer tissue, tumor-adjacent mucosa, and polyps in colonic biopsies. Calprotection expression was correlated with neutrophil infiltration, markers of bacteremia, and systemic inflammation. MATERIALS AND METHODS: Patients with colorectal cancer (n = 28) and adenoma (n = 38) were compared with healthy controls (n = 33). Calprotectin expression levels were measured by ELISA, and its localization was visualized by immunohistochemistry and correlated with the degree of neutrophil infiltration (visualized by Esterase staining). The expression of tumor necrosis factor (TNF)-alpha, procalcitonin, endotoxemia, carcinoembryonic antigen (CEA), and C-reactive protein was also investigated. RESULTS: Mucosal calprotectin was expressed in significantly higher concentrations in carcinoma (94.2 ± 31.2 ng/mg total protein) and adenoma (122.8 ± 60.3 ng/mg total protein) in comparison with mucosal biopsies from healthy controls (20.4 ± 5.4 ng/mg total protein), tumor-adjacent mucosa from patients with colorectal carcinoma (21.6 ± 5.1 ng/mg total protein), and adenoma (45 ± 14.6 ng/mg total protein, all p < 0.05). Immunohistochemistry showed calprotectin reactivity mainly in granulocytes and macrophages with only singular reactive epithelial cells. Positive staining (quantified by the number of positive cells per square millimeter) was markedly increased in carcinoma tissue (85 ± 21.5) and in adenoma (67.5 ± 20) as compared with tumor-adjacent epithelia (18.8 ± 4.3, p = 0.0007, p = 0.003, respectively), and there was a highly significant correlation, r = 0.89, p = 0.001) between calprotectin staining and neutrophil infiltration. No significant differences were found in the systemic levels of TNF-alpha, procalcitonin, and endotoxemia, whereas CEA and C-reactive protein levels were significantly higher in the cancer group (p < 0.05). CONCLUSION: Our results support the evidence that increased calprotectin expression is an early step in the neoplastic transformation during colorectal carcinogenesis. Moreover, its expression is closely related to an inflammatory response and points out a possible biological link between inflammation and neoplastic transformation in colorectal cancer.

miRNA expression profiling in formalin-fixed and paraffin-embedded placental tissue samples from pregnancies with severe preeclampsia.

AIMS: Micro RNAs (miRNAs) are small, single-strand RNAs, playing an important role in post-transcriptional gene regulation. The placenta is considered to play a key role in pathogenesis of preeclampsia. The purpose of this study was to demonstrate deregulation of miRNAs in placentas with preeclampsia using formalin-fixed and paraffin-embedded (FFPE) tissues. METHODS: Expression levels of 162 miRNAs were measured in FFPE placental tissues (5 with severe preeclampsia, 5 from a control group) using a quantitative qPCR based technique. RESULTS: Six miRNAs were more than 2-fold over-expressed in severe preeclampsia: let-7b, miRNA-302*, miRNA-104, miRNA-128a, miRNA-182* and miRNA-133b. Gene ontology analyses were performed using the algorithms "TargetScanS", "microRNA", and "PicTar". CONCLUSIONS: Two of the up-regulated miRNAs (miRNA-182* and miRNA-133b) are putative regulators of the transcript variants 1 and 2 of the BCL2-like gene, which controls apoptosis. miRNA-182* is also a probable angiogenesis regulator via angiogenin and VEGF-B. Apoptosis and angiogenesis are major mechanisms presumed to be involved in the pathogenesis of preeclampsia. Moreover, usability of qPCR technique based miRNA profiling for FFPE tissues was proofed. Hence FFPE tissue is the most widely used material for retrospective clinical studies, this method has a great property for future investigations in placenta research.

Patients with Heart Failure During and After Inpatient Cardiac Rehabilitation.

BACKGROUND: Heart failure is the third most fatal disease in Germany and generates considerable treatment costs. The multimodal program of inpatient rehabilitation can improve the symptoms and prognosis of these patients. At the present time, however, only few data are available on the effectiveness of rehabilitation for heart failure patients. METHODS: After receiving study approval from the ethics committee of the Saxony-Anhalt Medical Association, 200 patients with a primary or secondary diagnosis of heart failure were prospectively included in the study at Paracelsus-Harz-Clinic Bad Suderode, Quedlinburg, Germany. Baseline parameters such as age, gender, and BMI were documented. Outcome variables included NYHA classifications, quality of life, and mortality. For follow-up, the patients were contacted again by mail or phone after three and 12 months and, data on symptoms and serious events were recorded. RESULTS: The proportion of patients with a highly reduced ejection fraction (HFrEF) was 13.5%, with a midrange reduced ejection fraction (HFmrEF) 33%, and with preserved ejection fraction (HFpEF) 53.5%. The mean age was 64 ± 11.9 years, the proportion of women 24.1%. The effects of rehabilitation were documented by low overall mortality (no patient died during the stay, only 4% of the patients died in the 12-month follow-up) and an improvement in NYHA classification during and after the inpatient rehabilitation. CONCLUSION: This monocentric study showed effects both for symptoms (improvement in NYHA classifications) and prognosis (overall mortality) after rehabilitation. These data reflect the effectiveness of multimodal rehabilitation and underscore the need for rehabilitation in patients diagnosed with heart failure after an acute event and hospital stay or who present with chronic deterioration.

Evaluation of the Aortopathy in the Ascending Aorta: The Novelty of Using Matrix-Assisted Laser Desorption/Ionization Imaging.

PURPOSE: Histopathological evaluation presents conflicting reports regarding aortic abnormalities. The authors aim to present proof-of-concept study to explore the feasibility of matrix-assisted laser desorption/ionization imaging mass spectrometry (MALDI-IMS) in combination with histopathology for characterizing alterations in the aneurysmal ascending formalin-fixed paraffin-embedded (FFPE) aorta tissue. EXPERIMENTAL DESIGN: The authors assess FFPE specimens from patients with a dilated aorta and bicuspid aortic valve (BAV), those with a standard tricuspid aortic valve (TAV), and those with Marfan syndrome (MFS) via histopathology and grade the conditions for elastic fiber fragmentation (EFF) and MALDI-IMS. The proteins using liquid chromatographic-mass spectrometry are identified and the results are confirmed by immunohistochemistry. RESULTS: There is significant difference in terms of EFF between MFS and BAV, and TAV and BAV. Characteristic peptide signatures and m/z values in the EFF facilitate the characterization among the aortic specimens of BAV, MFS, and TAV. The m/z values from the aortic alpha smooth muscle actin and myosin heavy chains significantly increase in BAV compared with MFS and TAV. These findings are confirmed by immunohistochemistry. CONCLUSION: The results represent a strategy that uses MALDI-IMS in combination with histopathology as promising approaches to characterize spatial alteration in the structure of the aneurysmal ascending aorta.

Prognostic impact of VEGF and VEGF receptor 1 (FLT1) expression in patients irradiated for stage II/III non-small cell lung cancer (NSCLC).

BACKGROUND AND PURPOSE: The prognostic value of the tumor expression of vascular endothelial growth factor (VEGF) and VEGF receptor 1 (FLT1) is still unclear. This study investigated the impact of tumor expression of VEGF and FLT1 on outcomes in 61 patients irradiated for stage II/III non-small cell lung cancer (NSCLC). MATERIAL AND METHODS: The impact of tumor VEGF and FLT expression and twelve additional potential prognostic factors on locoregional control (LC), metastases-free survival (MFS), and overall survival (OS) were retrospectively evaluated. These factors included age, gender, performance status, histology, histological grade, T-category, N-category, surgery, chemotherapy, pack-years, smoking during radiotherapy, and hemoglobin levels during radiotherapy. RESULTS: On univariate analysis, improved LC was associated with lower T-category (p = 0.046), lower N-category (p = 0.047), and not smoking during radiotherapy (p = 0.012). VEGF (p = 0.26) and FLT1 expression (p = 0.70) had no significant impact. On multivariate analysis, lower N-category (p = 0.037) maintained significance; not smoking during radiotherapy was almost significant (p = 0.052). On univariate analysis, improved MFS was associated with lower T-category (p = 0.034) and lower N-category (p = 0.027), and almost with hemoglobin >or= 12 g/dl during radiotherapy (p = 0.053). VEGF (p = 0.80) and FLT1 expression (p = 0.61) had no significant impact. On multivariate analysis, lower N-category (p = 0.040) maintained significance. On univariate analysis, improved OS was associated with lower T-category (p = 0.028), lower N-category (p = 0.003), not smoking during radiotherapy (p = 0.047), and hemoglobin levels >or= 12 g/dl during radiotherapy (p = 0.019). VEGF (p = 0.59) and FLT1 expression (p = 0.85) had no significant impact. On multivariate analysis, lower N-category (p = 0.011) maintained significance. CONCLUSION: Tumor expression of VEGF and FLT1 appear to have no significant impact on LC, MFS, or OS in patients irradiated for NSCLC.