This paper presents an alternate development of the invasion percolation in a gradient model of (drainage) two-phase flow in porous media. The result is an integral formulation for the percolation parameter Ψ that allows simulation of transient flow conditions and the incorporation of a compressible nonwetting fluid. This study focuses on the effects of compressibility for "pseudo" steady-state, one-dimensional flow in a three-dimensional porous medium. It is demonstrated that while the effects of compressibility on the buoyancy-related Bond number can be neglected, the compressibility must still be addressed because it has a significant impact on the local volume flow rates (Capillary numbers) and thus the nonwetting fluid displacement pattern.

Background: Stereotactic body radiation therapy (SBRT) has become increasingly accepted as a treatment for patients with inoperable early stage lung cancer. We studied the patterns of treatment utilization for stage I non-small cell lung cancer (NSCLC) in three European countries in patients diagnosed in 2015-2016. Methods: Information from population-based registries in England, Norway and the Netherlands were retrieved, and treatment patterns and two-year survival for patients with clinical stage I were analysed. Results: Resection rates were higher in Norway (55%) and England (53%) than in the Netherlands (47%). SBRT use was highest in the Netherlands (41%), followed by Norway (29%) and England (12%). Failure to perform curative intent treatment was more common in England (26%) than either Norway (13%) or the Netherlands (9%). In patients treated with SBRT, pathology confirmation of diagnosis was more common in Norway (70-73%) than in England (44-51%) or the Netherlands (47-50%). Two-year survival rates were better for surgery than for SBRT or conventional radiotherapy and treatment-specific survival was higher in Norway than in the other two countries. Conclusions: For clinical stage I NSCLC, SBRT has largely replaced conventional radiotherapy in both Norway and the Netherlands, while just 67% of radiotherapy patients in England receive SBRT. The proportion of patients not receiving any curative treatment was higher in England, especially in the elderly. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: S. Senan: Research grants: Varian Medical Systems, ViewRayInc; Membership of advisory boards: AstraZeneca, MSD. All other authors have declared no conflicts of interest.

Our study describes the new seventh edition of the TNM system for lung cancer in a national population and its clinical implications. We classified 1,885 operated patients with lung cancer, reported to the Cancer Registry of Norway (Oslo, Norway) from 2001 to 2005, according to the sixth and the seventh edition of the TNM system. We compared survival differences adjusting for known prognostic factors. Furthermore, we evaluated the overall predictive ability of both editions using Harrell's concordance index. Survival curves by stage for each of the editions were similar; however, a better description of stage IIIB was observed in the seventh edition. Survival rates of T1b and T2a tumours were similar (log rank p = 0.94). The concordance index was 0.68 for both editions, indicating no overall difference in their predictive accuracy. In the seventh edition, 211 (29%) stage IB patients migrated to stage II and 161 (48%) patients migrated from stage IIB to IIA. Stage migrations could change the treatment for up to 326 (17.3%) of the study patients. The seventh edition did not improve the overall predictive ability of the TNM system; however, the new classification implies changes in treatment for nearly one-fifth of the cases. The implications of the seventh TNM edition for the outcomes of patients should be studied further.

Background: To investigate whether the introduction of modern third-generation chemotherapy was associated with survival benefits in a national population of patients with advanced non-small cell lung cancer (ANSCLC) and to explore geographical and temporary variations in the utilisation of chemotherapy.Methods: All patients with ANSCLC in the Cancer Registry of Norway during 1994-2005 were included. Using sales of vinorelbine as an indicator for chemotherapy, annual county utilisation rates were calculated. Survival before and after the general introduction of vinorelbine and associations between survival and variations in utilisation in counties were investigated. In a subgroup, the predictors of having received chemotherapy were explored.Results: Of 24 875 registered patients with lung cancer, 13 757 had ANSCLC. The annual utilisation of the indicator drug in Norway increased from 3.7 to 184.2 g (1998-2005). Median survival increased from 149 to 176 days (p<0.001). The adjusted hazard ratio (HR) for a diagnosis after the introduction was 0.93 (95% CI 0.88 to 0.99). County utilisation rates of vinorelbine (increments of 100 mg/1000 inhabitants) were inversely associated with the risk of death (HR 0.84, 95% CI 0.73 to 0.98). County of residence predicted chemotherapy utilisation with odds ratios in the range 0.13 (95% CI 0.1 to 0.19) to 1.04 (95% CI 0.64 to 1.69), a county with traditionally high utilisation as reference.Conclusion: Utilisation of third-generation chemotherapy was associated with slightly increased survival of patients with ANSCLC. Geographical and temporal differences in utilisation indicate variable quality of delivered care.

Background: Very few population based results have been presented for survival after resection for lung cancer. The purpose of this study was to present long term survival after resection and to quantify prognostic factors for survival.Methods: All lung cancer patients diagnosed in Norway in 1993-2002 were reported to the Cancer Registry of Norway (n = 19 582). A total of 3211 patients underwent surgical resection and were included for analysis. Supplementary information from hospitals ( including co-morbidity data) was collected for patients diagnosed in 1993-8. Five year observed and relative survival was analysed for patients diagnosed and operated in 1993-9. Factors believed to influence survival were analysed by a Cox proportional hazard regression model.Results: Five year relative survival in the period 1993-9 was 46.4% (n = 2144): 58.4% for stage I disease ( n = 1375), 28.4% for stage II ( n = 532), 15.1% for IIIa ( n = 133), 24.1% for IIIb ( n = 63), and 21.1% for stage IV disease ( n = 41). The high survival in stage IIIb and IV was due to the contribution of multiple tumours. Cox regression analysis identified male sex, higher age, procedures other than upper and middle lobectomy, histologies such as adenocarcinoma and large cell carcinoma, surgery on the right side, infiltration of resection margins, and larger tumour size as non-favourable prognostic factors.Conclusions: Survival was favourable for resected patients in a population based group including subgroups such as elderly patients, those with advanced stage, small cell lung cancer, tumours with nodal invasion, and patients with multiple tumours. These results question the validity of the current TNM system for lung cancer with regard to tumour size and categorization of multiple tumours.

Objective: The postoperative mortality following lung cancer surgery is relatively high. The purpose of the present study was to identify preoperative risk factors as well as fatal complications in 27 Norwegian hospitals. Methods: In Norway, all clinical and pathologic departments submit reports on cancer patients to the Cancer Registry of Norway. The Registry also has a law-regulated authority to collect supplemental information regarding diagnosis, treatment, and outcome for all cancer patients from the hospitals in charge. This investigation included all patients who died within 30 and 60 days after resection of lung cancer in the period 1993-2002. Results: During the investigation lung cancer was diagnosed in 19,582 patients, 3224 (16.5%) were treated by surgery. The resection rate was almost similar in the two sexes, but postoperative mortality in women was less than half compared to men. Total mortality was 5% and 8% after 30 and 60 days, respectively. Bilobectomy and pneumonectomy were most risky with a mortality rate of about 10% within 60 days. In patients more than 70 years of age, there was a considerably higher frequency of pneumonectomy in men compared to women. Dominating causes of death were pneumonia with respiratory failure and cardiac events. Other identifiable causes were surgical hemorrhage and bronchopleural fistula. Conclusions: In this population-based, unselected series, the postoperative mortality was relatively high, and increased markedly in patients older than 70 years. Pneumonectomy in patients older than 70 years should only be performed when heart-lung function is found to be acceptable following full pulmonary function testing and thorough preoperative assessment of cardiovascular risk factors. (c) 2006 Elsevier B.V. All rights reserved.

Objective: Surgical resection for lung cancer is the mainstay of curative treatment, but studies regarding postoperative results and long term outcome in the elderly have differed. The purpose of the present study was to assess the early and long-term results of surgical resection in patients more than 70 years of age. Methods: In Norway all clinical and pathologic departments submit reports on cancer patients to the Cancer Registry of Norway. This investigation included all patients more than 70 years of age resected for lung cancer in the time period 1993-2000. For results of long-time follow-up only patients operated on between 1993 and 1998 were included. Results: A total of 763 patients (541 men) were identified aged 71-87 years. Postoperative mortality rate was 9%, highest after bilobectomy and pneumonectomy. The most commonly reported causes of postoperative death were pneumonia and cardiac complications. The majority of patients had tumor categorized as clinical stage (cStage) Ia and Ib. More than 100 in each of these groups proved to have more advanced disease postoperatively (pStage). The 5-year relative survival rate was significantly better in patients with disease in pStage I compared to higher stages. Women had a significantly better 5-year survival rate compared to men, 62.8 and 35.7%, respectively. Conclusions: Lung cancer surgery appears to be a relatively safe procedure even in the elderly. There is a high postoperative mortality after bilobectomy and pneumonectomy. However, when old people survive the postoperative period the long term prognosis seems favorable. (C) 2004 Elsevier B.V. All rights reserved.

Objective: The final outcome of patients with small cell lung cancer (SCLC) is poor with an overall 5-year survival rate of less than 10%. Therefore, the question of surgery in patients with a technically-operable solitary tumor has been raised. The purpose of this study was to identify the proportion of patients with operable SCLC and to assess the prognosis of different treatment strategies. For patients who were operated, we compared the resection specimens from patients with more than 5-year survival with those with shorter survival to see whether the specimens belonged to different subclasses of SCLC.Methods: In Nor-way all clinical and pathologic departments submit reports on cancer patients to the Cancer Registry. The Registry also has a law-regulated authority to collect supplemental information regarding diagnosis, treatment and outcome for all cancer patients from the hospitals in charge. All reports on patients diagnosed as having SCLC in limited disease or unknown stage during the time interval 1993-1999 were reviewed. Patients with a T2-tumor, in whom a pneumonectomy would have to be performed, were classified as potentially operable. Five-year relative survival was calculated for patients diagnosed in 1993-1997.Results: During the actual period 2442 individuals with SCLC were identified. The majority was treated with conventional chemotherapy or concurrent chemoradiotherapy while 38 underwent surgical therapy. Following reclassification of 697 patients reported to have limited disease or unknown stage 180 were judged to be in stage I. In addition to the 38 resected patients 14 were considered fit for surgery technically and medically while 97 were found to be potentially operable treatment modalities apart from surgery yielded a 5-year survival rate < 7%. For stage I (N = 96) the rate was 11.3% in conventionally treated patients compared to 44.9% for those who underwent surgical resection. By pathological review of surgical specimens a diagnosis of SCLC was confirmed in all patients treated by surgery in the groups with long and short survival.Conclusion: This investigation demonstrates that patients with SCLC having a peripherally located tumor should be referred to surgery, as long time survival is far better than for conventionally treated patients. (C) 2004 Elsevier B.V. All rights reserved.

A pore-scale, percolation model coupled with a continuum model for water vapor diffusion (Prat 1993,2002) has been implemented to simulate evaporative drying of a rock core. Effective elastic con- stants at high-frequency are estimated from the assumption that water-filled pores at the air-water in- terface behave in a drained manner. As drying proceeds for smaller grain sizes, the initial, continuous, water cluster breaks up into smaller and smaller clusters with an increasing surface area to volume ratio. For water saturations between zero and 40%, over 90% of water-filled cells are at the air-water interface leading to overall drained behavior over this saturation range. For larger grain sizes, the percentage of water-filled cells at the air-water interface decreases rapidly with water saturation between zero and 40% leading to effective elastic behavior that is reasonably represented by a patchy saturation model.