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  1. Article ; Online: Genomic and Clinical Significance of Multiple Primary Lung Cancers as Determined by Next-Generation Sequencing.

    Goodwin, Daryn / Rathi, Vivek / Conron, Matthew / Wright, Gavin M

    Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer

    2021  Volume 16, Issue 7, Page(s) 1166–1175

    Abstract: Introduction: Marked variations in survival rates have brought into question whether standard clinicopathologic classification should be applied to patients presenting with multiple primary lung cancers (MPLCs). This study investigated the genetic ... ...

    Abstract Introduction: Marked variations in survival rates have brought into question whether standard clinicopathologic classification should be applied to patients presenting with multiple primary lung cancers (MPLCs). This study investigated the genetic profiles of MPLCs in a cohort of patients using next-generation sequencing and correlated results to clinicopathologic data and patient outcome.
    Methods: Patients treated surgically with curative intent for two putative primaries of similar histopathology from January 2000 to December 2019 at St Vincent's Hospital Melbourne. DNA and RNA was extracted from formalin-fixed, paraffin-embedded tumor tissue and sequenced on an Ion Torrent Personal Genome Machine system. Patient outcome was determined by overall survival and disease-free survival.
    Results: A total of 40 cases fulfilled the inclusion criteria. Mutational profiling was concordant with clinicopathologic diagnosis in most cases; however, seven cases (17.5%) revealed shared mutations suggesting metastatic disease and this was associated with a substantial reduction in overall survival (p < 0.05).
    Conclusions: Our results suggest that gene sequencing technologies are potentially a more accurate diagnostic and prognostic tool compared with traditional histopathologic evaluation in patients presenting with suspected MPLCs, which could better guide management and predict outcomes.
    MeSH term(s) DNA Mutational Analysis ; Genomics ; High-Throughput Nucleotide Sequencing ; Humans ; Lung Neoplasms/genetics ; Mutation ; Neoplasms, Multiple Primary
    Language English
    Publishing date 2021-05-10
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2432037-7
    ISSN 1556-1380 ; 1556-0864
    ISSN (online) 1556-1380
    ISSN 1556-0864
    DOI 10.1016/j.jtho.2021.03.018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Improving outcomes in lung cancer: the value of the multidisciplinary health care team.

    Denton, Eve / Conron, Matthew

    Journal of multidisciplinary healthcare

    2016  Volume 9, Page(s) 137–144

    Abstract: Lung cancer is a major worldwide health burden, with high disease-related morbidity and mortality. Unlike other major cancers, there has been little improvement in lung cancer outcomes over the past few decades, and survival remains disturbingly low. ... ...

    Abstract Lung cancer is a major worldwide health burden, with high disease-related morbidity and mortality. Unlike other major cancers, there has been little improvement in lung cancer outcomes over the past few decades, and survival remains disturbingly low. Multidisciplinary care is the cornerstone of lung cancer treatment in the developed world, despite a relative lack of evidence that this model of care improves outcomes. In this article, the available literature concerning the impact of multidisciplinary care on key measures of lung cancer outcomes is reviewed. This includes the limited observational data supporting improved survival with multidisciplinary care. The impact of multidisciplinary care on other benchmark measures of quality lung cancer treatment is also examined, including staging accuracy, access to diagnostic investigations, improvements in clinical decision making, better utilization of radiotherapy and palliative care services, and improved quality of life for patients. Health service research suggests that multidisciplinary care improves care coordination, leading to a better patient experience, and reduces variation in care, a problem in lung cancer management that has been identified worldwide. Furthermore, evidence suggests that the multidisciplinary model of care overcomes barriers to treatment, promotes standardized treatment through adherence to guidelines, and allows audit of clinical services and for these reasons is more likely to provide quality care for lung cancer patients. While there is strengthening evidence suggesting that the multidisciplinary model of care contributes to improvements in lung cancer outcomes, more quality studies are needed.
    Language English
    Publishing date 2016-03-30
    Publishing country New Zealand
    Document type Journal Article ; Review
    ZDB-ID 2453343-9
    ISSN 1178-2390
    ISSN 1178-2390
    DOI 10.2147/JMDH.S76762
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Recurrent lung nodules as a presentation of ventricular septal defect-related endocarditis.

    Trytell, Adam / Darby, Jonathan / Conron, Matthew / Newcomb, Andrew / Burns, Andrew

    Respirology case reports

    2019  Volume 7, Issue 6, Page(s) e00446

    Abstract: Infective endocarditis is an uncommon microbial infection of the endocardial surface of the heart. Patients with structural heart disease, such as a ventricular septal defect, are at higher risk for infective endocarditis and clinicians must have a high ... ...

    Abstract Infective endocarditis is an uncommon microbial infection of the endocardial surface of the heart. Patients with structural heart disease, such as a ventricular septal defect, are at higher risk for infective endocarditis and clinicians must have a high index of suspicion in such patients presenting with recurrent fevers. We present a patient with a known ventricular septal defect presenting with recurrent fevers associated with migratory lung nodules following a "low-risk" dental procedure without antibiotic prophylaxis. The unusual presentation delayed the diagnosis of the migratory lung lesions as septic pulmonary emboli and consequentially the diagnosis of ventricular septal defect related infective endocarditis. The patient made an uneventful recovery following antibiotic therapy and surgical intervention.
    Language English
    Publishing date 2019-06-01
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2750180-2
    ISSN 2051-3380
    ISSN 2051-3380
    DOI 10.1002/rcr2.446
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Excess mortality and undertreatment in elderly lung cancer patients: treatment nihilism in the modern era?

    Pham, Jonathan / Conron, Matthew / Wright, Gavin / Mitchell, Paul / Ball, David / Philip, Jennifer / Brand, Margaret / Zalcberg, John / Stirling, Rob G

    ERJ open research

    2021  Volume 7, Issue 2

    Abstract: Treatment of elderly patients with lung cancer is significantly hindered by concerns about treatment tolerability, toxicity and limited clinical trial data in the elderly; potentially giving rise to treatment nihilism amongst clinicians. This study aims ... ...

    Abstract Treatment of elderly patients with lung cancer is significantly hindered by concerns about treatment tolerability, toxicity and limited clinical trial data in the elderly; potentially giving rise to treatment nihilism amongst clinicians. This study aims to describe survival in elderly patients with lung cancer and explore potential causes for excess mortality. Patients diagnosed with lung cancer in the Victorian Lung Cancer Registry between 2011-2018 were analysed (n=3481). Patients were age-categorised and compared using Cox-regression modelling to determine mortality risk, after adjusting for confounding. Probability of being offered cancer treatments was also determined, further stratified by disease stage. The eldest patients (≥80 years old) had significantly shorter median survival compared with younger age groups (<60 years: 2.0 years; 60-69 years: 1.5 years; 70-79 years: 1.6 years; ≥80 years: 1.0 years; p<0.001). Amongst those diagnosed with stage 1 or 2 lung cancer, there was no significant difference in adjusted-mortality between age groups. However, in those diagnosed with stage 3 or 4 disease, the eldest patients had an increased adjusted-mortality risk of 28% compared with patients younger than 60 years old (p=0.005), associated with markedly reduced probability of cancer treatment, after controlling for sex, performance status, comorbidities and histology type (OR 0.24, compared with <60 years old strata; p<0.001). Compared to younger patients, older patients with advanced-stage lung cancer have a disproportionately higher risk of mortality and lower likelihood of receiving cancer treatments, even when performance status and comorbidity are equivalent. These healthcare inequities could be indicative of widespread treatment nihilism towards elderly patients.
    Language English
    Publishing date 2021-05-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 2827830-6
    ISSN 2312-0541
    ISSN 2312-0541
    DOI 10.1183/23120541.00393-2020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Physiotherapy-assisted prone or modified prone positioning in ward-based patients with COVID-19: a retrospective cohort study.

    Tatlow, Claudia / Heywood, Sophie / Hodgson, Carol / Cunningham, Georgina / Conron, Matthew / Ng, Hui Yi / Georgiou, Harry / Pound, Gemma

    Physiotherapy

    2021  Volume 114, Page(s) 47–53

    Abstract: Objectives: To evaluate short-term change in oxygenation and feasibility of physiotherapy-assisted prone or modified prone positioning in awake, ward-based patients with COVID-19.: Design: Retrospective observational cohort study.: Setting: ... ...

    Abstract Objectives: To evaluate short-term change in oxygenation and feasibility of physiotherapy-assisted prone or modified prone positioning in awake, ward-based patients with COVID-19.
    Design: Retrospective observational cohort study.
    Setting: General wards, single-centre tertiary hospital in Australia.
    Participants: Patients were included if ≥18 years, had COVID-19, required FiO
    Main outcome measures: Feasibility measures included barriers to therapy, assistance required, and comfort. Short-term change in oxygenation (SpO
    Results: Thirteen patients, mean age 75 (SD 14) years; median Clinical Frailty Scale score 6 (IQR 4 to 7) participated in 32 sessions of prone or modified prone positioning from a total of 125 ward-based patients admitted with COVID-19 who received physiotherapy intervention. Nine of thirteen patients (69%) required physiotherapy assistance and modified positions were utilised in 8/13 (62%). SpO2 increased in 27/32 sessions, with a mean increase from 90% (SD 5) pre-positioning to 94% (SD 4) (mean difference 4%; 95%CI 3 to 5%) after 15 minutes. Oxygen requirement decreased in 14/32 sessions, with a mean pre-positioning requirement of 8 l/minute (SD 4) to 7 l/minute (SD 4) (mean difference 2 l/minute; 95%CI 1 to 3 l/minute) after 15 minutes. In three sessions oxygen desaturation and discomfort occurred but resolved immediately by returning supine.
    Conclusion: Physiotherapy-assisted prone or modified prone positioning may be a feasible option leading to short-term improvements in oxygenation in awake, ward-based patients with hypoxemia due to COVID-19. Further research exploring longerterm health outcomes and safety is required.
    MeSH term(s) Aged ; COVID-19 ; Humans ; Physical Therapy Modalities ; Prone Position ; Retrospective Studies ; SARS-CoV-2
    Language English
    Publishing date 2021-09-24
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 391109-3
    ISSN 1873-1465 ; 0031-9406
    ISSN (online) 1873-1465
    ISSN 0031-9406
    DOI 10.1016/j.physio.2021.09.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Multidisciplinary team discussion: the emerging gold standard for management of cardiopulmonary complications of connective tissue disease.

    Fairley, Jessica L / Ross, Laura / Burns, Andrew / Prior, David / Conron, Matthew / Rouse, Hannah / McDonald, Julie / MacIsaac, Andrew / La Gerche, André / Morrisroe, Kathleen / Ferdowsi, Nava / Quinlivan, Alannah / Brown, Zoe / Stevens, Wendy / Nikpour, Mandana

    Internal medicine journal

    2023  Volume 53, Issue 10, Page(s) 1919–1924

    Abstract: Cardiopulmonary complications of connective tissue diseases (CTDs), particularly pulmonary arterial hypertension (PAH) and interstitial lung disease (ILD), are major determinants of morbidity and mortality. Multidisciplinary meetings may improve ... ...

    Abstract Cardiopulmonary complications of connective tissue diseases (CTDs), particularly pulmonary arterial hypertension (PAH) and interstitial lung disease (ILD), are major determinants of morbidity and mortality. Multidisciplinary meetings may improve diagnostic accuracy and optimise treatment. We review the literature regarding multidisciplinary meetings in CTD-ILD and PAH and describe our tertiary centre experience of the role of the multidisciplinary meeting in managing CTD-PAH.
    MeSH term(s) Humans ; Prognosis ; Connective Tissue Diseases/complications ; Connective Tissue Diseases/diagnosis ; Connective Tissue Diseases/therapy ; Lung Diseases, Interstitial/diagnosis ; Lung Diseases, Interstitial/etiology ; Lung Diseases, Interstitial/therapy ; Patient Care Team
    Language English
    Publishing date 2023-09-29
    Publishing country Australia
    Document type Review ; Journal Article
    ZDB-ID 2045436-3
    ISSN 1445-5994 ; 1444-0903
    ISSN (online) 1445-5994
    ISSN 1444-0903
    DOI 10.1111/imj.16233
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Impacts of lung cancer multidisciplinary meeting presentation: Drivers and outcomes from a population registry retrospective cohort study.

    Lin, Tiffany / Pham, Jonathan / Paul, Eldho / Conron, Matthew / Wright, Gavin / Ball, David / Mitchell, Paul / Atkin, Nicola / Brand, Margaret / Zalcberg, John / Stirling, Robert G

    Lung cancer (Amsterdam, Netherlands)

    2021  Volume 163, Page(s) 69–76

    Abstract: Introduction: Multidisciplinary Meetings (MDM) are recommended in routine lung cancer care, however its broader impacts demand further evaluation. We assessed the drivers and impacts of MDM presentation in the Victorian Lung Cancer Registry (VLCR).: ... ...

    Abstract Introduction: Multidisciplinary Meetings (MDM) are recommended in routine lung cancer care, however its broader impacts demand further evaluation. We assessed the drivers and impacts of MDM presentation in the Victorian Lung Cancer Registry (VLCR).
    Methods: We examined the effect of MDM presentation on receipt of treatment and survival in VLCR patients diagnosed between 2011 and 2020. We compared patient characteristics, drivers of MDM discussion and survival between the two groups.
    Results: Of 9,628 patients, 5,900 (61.3%) were discussed at MDM, 3,728 (38.7%) were not. In the non-MDM group, a lower proportion received surgery (22.1% vs. 31.2%), radiotherapy (34.2% vs. 44.4%) and chemotherapy (44.7% vs. 49.0%). Patients were less likely to be discussed if ≥80 years (OR 0.73, p < 0.001), of ECOG performance status (PS) 4 (OR 0.23, p < 0.001), clinical stage IV (OR 0.34, p < 0.001) or referred from regional (OR 0.52, p < 0.001) or private hospital (OR 0.18, p < 0.001). MDM-presented patients had better median survival (1.70 vs 0.75 years, p < 0.001) and lower adjusted mortality risk (HR 0.75; 0.71-0.80, p < 0.001), a protective effect consistent across all hospital types. Undocumented PS, histopathology and clinical stage were associated with lower likelihood of MDM discussion and worse mortality.
    Conclusions: In the VLCR, being male, ≥80 years, of poorer PS, advanced clinical stage and poor clinical characterisation significantly disadvantaged patients in relation to MDM discussion. MDM-discussed patients were more likely to undergo treatment and had a 25% lower risk of mortality. This study supports the use of MDMs in lung cancer and identifies areas of inequity to be addressed.
    MeSH term(s) Humans ; Interdisciplinary Communication ; Lung Neoplasms/epidemiology ; Lung Neoplasms/therapy ; Male ; Radiation Oncology ; Registries ; Retrospective Studies
    Language English
    Publishing date 2021-12-10
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 632771-0
    ISSN 1872-8332 ; 0169-5002
    ISSN (online) 1872-8332
    ISSN 0169-5002
    DOI 10.1016/j.lungcan.2021.12.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Lung cancer and socio-economic status: inextricably linked to place of residence.

    Denton, Eve J / Hart, David / Russell, Prue A / Wright, Gavin / Conron, Matthew

    Internal medicine journal

    2017  Volume 47, Issue 5, Page(s) 563–569

    Abstract: Background: The association between socio-economic status (SES) and lung cancer is internationally established, but in Australia this relationship remains ill defined.: Aims: To examine the association between SES, place of residence and lung cancer ... ...

    Abstract Background: The association between socio-economic status (SES) and lung cancer is internationally established, but in Australia this relationship remains ill defined.
    Aims: To examine the association between SES, place of residence and lung cancer outcomes in a large Australian cohort.
    Methods: A total of 2369 consecutive lung cancer patients managed by St Vincent's Hospital lung multidisciplinary meeting between 2001 and 2014 were included. Postcode data stratified participants by Socio-economic indexes for areas, a validated measure of SES, and by geographical location, an important socio-economic factor in Australia.
    Results: There was no difference between socio-economic groups in age (68 years), sex (63% males) or presentation (75% symptomatic). Low socio-economic patients had increased smoking rates and a trend towards less adenocarcinoma. More low SES patients were from rural locations, had a greater frequency of earlier stage disease and curative treatment with higher overall survival even after multivariate analysis. When stratified for SES, overall 5-year survival was significantly better in the low SES group (33 vs 24%, n = 2275, P = 0.02), although stage-stratified survival was similar in all socio-economic groups.
    Conclusions: Low SES patients were more frequently from rural locations and unexpectedly had earlier stage disease and higher overall survival. The excellent outcomes in rural and lower SES patients are reassuring, but suggest that there is a population of these patients with advanced lung cancer who are not referred for multidisciplinary care. Further studies are required to define this group better and determine the barriers to referral to improve overall lung cancer outcomes.
    Language English
    Publishing date 2017-05
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2045436-3
    ISSN 1445-5994 ; 1444-0903
    ISSN (online) 1445-5994
    ISSN 1444-0903
    DOI 10.1111/imj.13376
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Patterns of care for people with small cell lung cancer in Victoria, 2011-19: a retrospective, population-based registry data study.

    Huang, Joanna / Faisal, Wasek / Brand, Margaret / Smith, Shantelle / Alexander, Marliese / Briggs, Lisa / Conron, Matthew / Duffy, Mary / John, Thomas / Langton, David / Lesage, Jacqueline / MacManus, Michael / Mitchell, Paul / Olesen, Inger / Parente, Phillip / Philip, Jennifer / Samuel, Evangeline / Torres, Javier / Underhill, Craig R /
    Zalcberg, John R / Harden, Susan / Stirling, Rob

    The Medical journal of Australia

    2023  Volume 219, Issue 3, Page(s) 120–126

    Abstract: Objectives: To report stage-specific patterns of treatment and the influence of management and treatment type on survival rates for people newly diagnosed with small cell lung cancer (SCLC).: Design: Cross-sectional patterns of care study; analysis ... ...

    Abstract Objectives: To report stage-specific patterns of treatment and the influence of management and treatment type on survival rates for people newly diagnosed with small cell lung cancer (SCLC).
    Design: Cross-sectional patterns of care study; analysis of data prospectively collected for the Victorian Lung Cancer Registry (VLCR).
    Setting, participants: All people diagnosed with SCLC in Victoria during 1 April 2011 - 18 December 2019.
    Main outcome measures: Stage-specific management and treatment of people with SCLC; median survival time.
    Results: During 2011-19, 1006 people were diagnosed with SCLC (10.5% of all lung cancer diagnoses in Victoria); their median age was 69 years (interquartile range [IQR], 62-77 years), 429 were women (43%), and 921 were current or former smokers (92%). Clinical stage was defined for 896 people (89%; TNM stages I-III, 268 [30%]; TNM stage IV, 628 [70%]) and ECOG performance status at diagnosis for 663 (66%; 0 or 1, 489 [49%]; 2-4, 174 [17%]). The cases of 552 patients had been discussed at multidisciplinary meetings (55%), 377 people had received supportive care screening (37%), and 388 had been referred for palliative care (39%). Active treatment was received by 891 people (89%): chemotherapy, 843 (84%); radiotherapy, 460 (46%); chemotherapy and radiotherapy, 419 (42%); surgery, 23 (2%). Treatment had commenced within fourteen days of diagnosis for 632 of 875 patients (72%). Overall median survival time from diagnosis was 8.9 months (IQR, 4.2-16 months; stage I-III: 16.3 [IQR, 9.3-30] months; stage IV: 7.2 [IQR, 3.3-12] months). Multidisciplinary meeting presentation (hazard ratio [HR], 0.66; 95% CI, 0.58-0.77), multimodality treatment (HR, 0.42; 95% CI, 0.36-0.49), and chemotherapy within fourteen days of diagnosis (HR, 0.68; 95% CI, 0.48-0.94) were each associated with lower mortality during follow-up.
    Conclusion: Rates of supportive care screening, multidisciplinary meeting evaluation, and palliative care referral for people with SCLC could be improved. A national registry of SCLC-specific management and outcomes data could improve the quality and safety of care.
    MeSH term(s) Humans ; Female ; Middle Aged ; Aged ; Male ; Small Cell Lung Carcinoma/drug therapy ; Retrospective Studies ; Cross-Sectional Studies ; Routinely Collected Health Data ; Lung Neoplasms/epidemiology ; Lung Neoplasms/therapy
    Language English
    Publishing date 2023-06-26
    Publishing country Australia
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 186082-3
    ISSN 1326-5377 ; 0025-729X
    ISSN (online) 1326-5377
    ISSN 0025-729X
    DOI 10.5694/mja2.52017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Nephrology: Instructive case haemorrhagic cystitis due to BK virus in an adult with cardiac & pulmonary sarcoidosis.

    Martin, William G / Clarke, David / Conron, Matthew / MacIsaac, Andrew / Hill, Prue / Goodman, David J

    Nephrology (Carlton, Vic.)

    2016  Volume 21, Issue 9, Page(s) 793

    MeSH term(s) BK Virus/immunology ; BK Virus/pathogenicity ; Cardiomyopathies/diagnosis ; Cardiomyopathies/drug therapy ; Cystitis/diagnosis ; Cystitis/immunology ; Cystitis/virology ; Hematuria/virology ; Hemorrhage/diagnosis ; Hemorrhage/immunology ; Hemorrhage/virology ; Humans ; Immunocompromised Host ; Immunosuppressive Agents/adverse effects ; Male ; Middle Aged ; Polyomavirus Infections/diagnosis ; Polyomavirus Infections/immunology ; Polyomavirus Infections/virology ; Risk Factors ; Sarcoidosis/diagnosis ; Sarcoidosis/drug therapy ; Sarcoidosis, Pulmonary/diagnosis ; Sarcoidosis, Pulmonary/drug therapy ; Tumor Virus Infections/diagnosis ; Tumor Virus Infections/immunology ; Tumor Virus Infections/virology ; Virus Activation
    Chemical Substances Immunosuppressive Agents
    Language English
    Publishing date 2016-09
    Publishing country Australia
    Document type Case Reports ; Letter
    ZDB-ID 1303661-0
    ISSN 1440-1797 ; 1320-5358
    ISSN (online) 1440-1797
    ISSN 1320-5358
    DOI 10.1111/nep.12696
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