Pulmonary thromboembolism (PTE) after surgery is a life-threating event, so detecting PTE and deep vein thrombosis (DVT) is very important. We check plasma concentration of soluble fibrin (SF) and D-dimer in a protocol designed to detect PTE and DVT after respiratory surgery. To examine the usefulness of this protocol, we studied the detection rate of postoperative DVT/PTE in 237 patients who received the protocol between March 2020 and March 2021. Among 237 patients, 25 were detected as suspected postoperative DVT/PTE in accordance with the protocol and, out of those 25, 12 patients actually had DVT/PTE (enhanced computed tomography 7/13 54％, ultrasonography 5/12 41％). The frequency is relatively high and the result suggests that our postoperative DVT/PTE detecting protocol may be potentialy useful.

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The COVID-19 pandemic has continued since January 2020 and affected cancer diagnosis and treatment. The aim of this study was to examine the impact of the pandemic on cancer patients in Nagano Prefecture, using data from the 2018-2020 hospital-based cancer registry (HBCR). The numbers and stage of cancer diagnosis in the HBCR from January 2018 to December 2020 in Nagano Prefecture were analyzed in this study.
A total of 14,034 cancer patients in 2020 were registered. The number declined for the first time since HBCR system started in Nagano prefecture, and the rate of decline was 6.4％ (958 cases) compared with 2019. The decrease in number was remarkablc in colon, gastric and cervical carcinoma. The decrease in early detection cases targeted for open blood treatment in cancer treatment was also remarkable in gastric carcinoma and colon carcinoma, and among them, the decrease was remarkable in endoscopic surgery cases compared with the national data. We should continue this monitoring during the COVID-19 pandemic.
Hospital-based cancer registries can be powerful tools for evaluating the epidemiology of cancer in Nagano Prefecture.

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Background : This study was performed to evaluate clinical practices in patients with atypical epidermal growth factor receptor (EGFR)-positive inoperable non-small cell lung cancer (NSCLC) in Nagano Prefecture, Japan.
Patients and methods : Patients with newly diagnosed atypical EGFR-positive inoperable NSCLC in 14 hospitals in Nagano, Japan, between May 2016 and March 2019 were enrolled in this study. Atypical EGFR mutations included G719X, S768I, L861Q, compound mutations, and coexistence of de novo T790N in this study. After registering baseline clinical characteristics and initial treatment, serial data were recorded every 4 months in each patient. Initial and serial therapies were at the discretion of the attending physician.
Results : The study population consisted of 24 patients with atypical EGFR-positive NSCLC (12 men and 12 women ; median age : 78.5 years ; range : 49-89 years). Fourteen patients had single G719X, S768I, or L861Q mutation and 10 had compound EGFR mutations. Performance statuses 0/1/2/3/4 were seen in 11/7/3/2/1 cases and clinical stage I/II/III/IV/ recurrence occurred in 1/0/0/15/8 cases, respectively. One patient with clinical stage IA was treated with radiotherapy. Other patients were treated with EGFR-tyrosine kinase inhibitors (TKIs) as first (n＝21) or second (n＝2)-line therapy, and the response rate to TKIs was 56.5％. Median overall survival was 23.9 months (95％ confidence interval［ CI］: 10.2 months to NA) in atypical EGFR-positive cases.
Conclusion : The present results reveal that clinical outcomes in patients with atypical EGFR- positive NSCLCs in Nagano prefecture were comparable with those in other clinical trials and studies.

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