J Thorac Cardiovasc Surg 2007;134:856
© 2007 The American Association for Thoracic Surgery
Discussion
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Dr Alex G. Little
(Dayton, Ohio). I think we would all agree that any collection of this large number of patients deserves to be analyzed and thought about carefully. That said, I am going to get to three areas in which I have some questions. One is to make a statement with which I know you agree because of having had the opportunity to read your manuscript and your identification of the limitations. The statement is that the validity of any clinical review of patients with IA disease really is dependent on the accuracy of the staging process that classified those patients. That being said, I do not think the concern of some patients with actual stage III or II disease being included weakens your conclusions, because presumably on a random basis the patients would have been evenly distributed. However, I think it really undermines to the point of negating any observations about long-term survival of patients with IA disease because we just do not know that this is really a clean collection of patients with stage IA disease. Would you comment on that, please?
Dr Chang. Yes, I agree. If you look at the entire cohort, it is difficult to reach the conclusion that 5-year survival is 58% because of this issue of understaging. I think some of the predictors we looked at probably are valid. For example, . . . [Full Text of this Article]
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J. Thorac. Cardiovasc. Surg. 2007 134: 850-856.
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Copyright © 2007 by The American Association for Thoracic Surgery.