Background: Detection of the epidermal growth factor receptor (EGFR) T790M mutation using plasma samples has been considered simple and non-invasive, but the relatively high false negative results lead to additional tissue sampling in some patients. Until now, the characteristics of patients who prefer liquid biopsy have not yet been established. Methods: To evaluate the favorable conditions for the detection of T790M mutations using plasma samples, a multicenter retrospective study was performed between May 2018 and December 2021. Patients whose T790M mutation was detected in a plasma sample were classified as the plasma positive group. Study subjects with a T790M mutation not detected in a plasma sample but only in a tissue sample were grouped as the plasma false negative group. Results: Plasma positive and plasma false negative groups were found in 74 and 32 patients, respectively. As a result, 40% of patients with one or two metastatic organs at the time of re-biopsy had false negative plasma sample results, and 69% of patients with three or more metastatic organs at the time of re-biopsy had positive plasma results. In multivariate analysis, three or more metastatic organs at initial diagnosis were independently associated with the detection of a T790M mutation using plasma samples. Conclusion: Our results demonstrated that the detection rate of a T790M mutation using plasma samples was related to the tumor burden, particularly to the number of metastatic organs.

The main purpose of this study was to develop a model predictive of dysphagia in hospital survivors with severe pneumonia who underwent tracheostomy during their hospital stay. The present study included 175 patients (72% male; mean age, 71.3 years) over 5 years. None of these patients had a history of deglutition disorder before hospital admission. Binary logistic regression analysis was performed to identify factors predicting dysphagia at hospital discharge. Dysphagia scores were calculated from β-coefficients and by assigning points to variables. Of the enrolled patients, 105 (60%) had dysphagia at hospital discharge. Factors prognostic of dysphagia at hospital discharge included being underweight (body mass index < 18.5 kg/m²), non-participation in a dysphagia therapy program, mechanical ventilation ≥ 15 days, age ≥ 74 years, and chronic neurologic diseases. Underweight and non-participation in a dysphagia therapy program were assigned +2 points and the other factors were assigned +1 point. Dysphagia scores showed acceptable discrimination (area under the receiver operating characteristic curve for dysphagia 0.819, 95% confidence interval: 0.754–0.873, p < 0.001) and calibration (Hosmer–Lemeshow chi-square = 9.585, with df 7 and p = 0.213). The developed dysphagia score was predictive of deglutition disorder at hospital discharge in tracheostomized patients with severe pneumonia.

The present study evaluated the impact of prior radiotherapy (RT) on patients with advanced non-small cell lung cancer (NSCLC) receiving therapy with immune checkpoint inhibitors (ICIs) and further assessed the prognostic factors in patients receiving both RT and ICI. Patients diagnosed with NSCLC at the Catholic Medical Center and Asan Medical Center between January 2016 and October 2020 and who received immunotherapy were retrospectively reviewed. Among 240 patients, poor Eastern Cooperative Oncology Group (ECOG) score, high PD-L1 expression, and ICI-related adverse events (AE) were significantly associated with progression-free survival (PFS) (HR, 2.654; 95% CI, 1.484–4.749; p = 0.001; HR, 0.645; 95% CI, 0.449–0.926, p = 0.017; HR, 0.430; 95% CI, 0.229–0.808; p = 0.009, respectively). Among patients who received both RT and immunotherapy, poor ECOG status, squamous cell carcinoma, and ICI-related AE were significant factors associated with poor PFS (HR, 2.430; 95% CI, 1.464–4.034; p = 0.001; HR, 0.667; 95% CI, 0.455–0.978, p = 0.038; HR, 0.520; 95% CI, 0.284–0.953, p = 0.034, respectively). The present study showed that prior RT showed no significant independent association with primary outcomes in patients with advanced NSCLC receiving immunotherapy. In patients who received both RT and immunotherapy, clinical parameters, including ICI-related AEs, were independently predictive of PFS.

Background and Objectives: This study aimed to assess the value of a novel prognostic model, based on clinical variables, comorbidities, and demographic characteristics, to predict long-term prognosis in patients who received mechanical ventilation (MV) for over 14 days and who underwent a tracheostomy during the first 14 days of MV. Materials and Methods: Data were obtained from 278 patients (66.2% male; median age: 71 years) who underwent a tracheostomy within the first 14 days of MV from February 2011 to February 2021. Factors predicting 1-year mortality after the initiation of MV were identified by binary logistic regression analysis. The resulting prognostic model, known as the tracheostomy-ProVent score, was computed by assigning points to variables based on their respective ß-coefficients. Results: The overall 1-year mortality rate was 64.7%. Six factors were identified as prognostic indicators: platelet count < 150 × 10³/μL, PaO₂/FiO₂ < 200 mmHg, body mass index (BMI) < 23.0 kg/m², albumin concentration < 2.8 g/dL on day 14 of MV, chronic cardiovascular diseases, and immunocompromised status at admission. The tracheostomy-ProVent score exhibited acceptable discrimination, with an area under the receiver operating characteristic curve (AUC) of 0.786 (95% confidence interval: 0.733–0.833, p < 0.001) and acceptable calibration (Hosmer–Lemeshow chi-square: 2.753, df: 8, p = 0.949). Based on the maximum Youden index, the cut-off value for predicting mortality was set at ≥2, with a sensitivity of 67.4% and a specificity of 76.3%. Conclusions: The tracheostomy-ProVent score is a good predictive tool for estimating 1-year mortality in tracheostomized patients undergoing MV for >14 days. This comprehensive model integrates clinical variables and comorbidities, enhancing the precision of long-term prognosis in these patients.

Background: Clarithromycin (CLR) and azithromycin (AZM) are the cornerstones in the treatment of Mycobacterium avium complex lung disease (MAC-LD). It has been recommended that either drug can be used without preference because no data are available to suggest the superiority of CLR or AZM. Aims: To compare CLR and AZM in terms of severe adverse event (SAE) rate and treatment outcomes in MAC-LD patients Methods: Among the patients diagnosed with MAC-LD in 2001–2013, 560 who received at least one dose of the standard regimen until May 2018 were selected for the adverse events analysis. Of them, 316 patients who underwent standard treatment for ≥12 months were selected for the treatment outcome analysis. The medical records were retrospectively analyzed. Results: Among the 560 patients, 466 (83.2%) and 94 (16.8%) were started on CLR and AZM containing regimen, respectively. The SAE rate, which led to permanent drug discontinuation, was significantly higher in CLR than in AZM (24.2% vs 9.6%, P=0.002). The overall treatment success rate of the 316 patients who received the standard regimen for ≥12 months was 83.2%. No difference of treatment success rate was observed between the CLR and AZM containing regimens (82.9% vs 84.3%, P=0.788). The one- and three-year recurrence rates were similar for the two drugs (6.8% vs 6.0%, P>0.999 and 31.0% vs 37.5%, P=0.482). Conclusions: These findings suggest that AZM containing regimen may be the better initial choice for the treatment of MAC-LD as it results in lesser SAE while offering similar patient outcomes when compared with the CLR containing regimen.