Explore the vast range of titles available.

Even after resection of early-stage non-small-cell lung cancer (NSCLC), patients have a high risk of developing recurrence and second primary lung cancer. We aimed to assess efficacy of a follow-up approach including clinic visits, chest x-rays, chest CT scans, and fibre-optic bronchoscopy versus clinical visits and chest x-rays after surgery for resectable NSCLC. In this multicentre, open-label, randomised, phase 3 trial (IFCT-0302), patients aged 18 years or older and after complete resection of pathological stage I–IIIA NSCLC according to the sixth edition of the TNM classification were enrolled within 8 weeks of resection from 122 hospitals and tertiary centres in France. Patients were randomly assigned (1:1) to CT-based follow-up (clinic visits, chest x-rays, thoraco-abdominal CT scans, and fibre-optic bronchoscopy for non-adenocarcinoma histology) or minimal follow-up (visits and chest x-rays) after surgery for NSCLC, by means of a computer-generated sequence using the minimisation method. Procedures were repeated every 6 months for the first 2 years and yearly until 5 years. The primary endpoint was overall survival analysed in the intention-to-treat population. Secondary endpoints, also analysed in the intention-to-treat population, included disease-free survival. This trial is registered with ClinicalTrials.gov, NCT00198341, and is active, but not enrolling. Between Jan 3, 2005, and Nov 30, 2012, 1775 patients were enrolled and randomly assigned to a follow-up group (888 patients to the minimal follow-up group; 887 patients to the CT-based follow-up group). Median overall survival was not significantly different between follow-up groups (8·5 years [95% CI 7·4–9·6] in the minimal follow-up group vs 10·3 years [8·1–not reached] in the CT-based follow-up group; adjusted hazard ratio [HR] 0·95, 95% CI 0·83–1·10; log-rank p=0·49). Disease-free survival was not significantly different between follow-up groups (median not reached [95% CI not estimable–not estimable] in the minimal follow-up group vs 4·9 [4·3–not reached] in the CT-based follow-up group; adjusted HR 1·14, 95% CI 0·99–1·30; log-rank p=0·063). Recurrence was detected in 246 (27·7%) of 888 patients in the minimal follow-up group and in 289 (32·6%) patients of 887 in the CT-based follow-up group. Second primary lung cancer was diagnosed in 27 (3·0%) patients in the minimal follow-up group and 40 patients (4·5%) in the CT-based follow-up group. No serious adverse events related to the trial procedures were reported. The addition of thoracic CT scans during follow-up, which included clinic visits and chest x-rays after surgery, did not result in longer survival among patients with NSCLC. However, it did enable the detection of more cases of early recurrence and second primary lung cancer, which are more amenable to curative-intent treatment, supporting the use of CT-based follow-up, especially in countries where lung cancer screening is already implemented, alongside with other supportive measures. French Health Ministry, French National Cancer Institute, Weisbrem-Benenson Foundation, La Ligue Nationale Contre Le Cancer, and Lilly Oncology. For the French translation of the abstract see Supplementary Materials section.

This study assesses marine community production based on the diel variability of bio-optical properties monitored by two BioGeoChemical-Argo (BGC-Argo) floats. Experiments were conducted in two distinct Mediterranean systems, the northwestern Ligurian Sea and the central Ionian Sea, during summer months. We derived particulate organic carbon (POC) stock and gross community production integrated within the surface, euphotic and subsurface chlorophyll maximum (SCM) layers, using an existing approach applied to diel cycle measurements of the particulate beam attenuation (cp) and backscattering (bbp) coefficients. The diel cycle of cp provided a robust proxy for quantifying biological production in both systems; that of bbp was comparatively less robust. Derived primary production estimates vary by a factor of 2 depending upon the choice of the bio-optical relationship that converts the measured optical coefficient to POC, which is thus a critical step to constrain. Our results indicate a substantial contribution to the water column production of the SCM layer (16 %–42 %), which varies largely with the considered system. In the Ligurian Sea, the SCM is a seasonal feature that behaves as a subsurface biomass maximum (SBM) with the ability to respond to episodic abiotic forcing by increasing production. In contrast, in the Ionian Sea, the SCM is permanent, primarily induced by phytoplankton photoacclimation, and contributes moderately to water column production. These results clearly demonstrate the strong potential for transmissometers deployed on BGC-Argo profiling floats to quantify non-intrusively in situ biological production of organic carbon in the water column of stratified oligotrophic systems with recurring or permanent SCMs, which are widespread features in the global ocean.