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We aimed to investigate the pattern of regional lymph node (LN) metastasis of early-stage non-small cell lung cancer (NSCLC) to provide novel rationale for surgical choice (lobectomy, segmentectomy, or wedge resection) for these patients. We retrospectively collected clinical data of patients undergoing lobectomy with systematic mediastinal LN dissection or sampling for cT1N0M0 peripheral NSCLC from January 2015 to December 2018. The regional LN metastasis pattern was analyzed based on tumor size. We included a total of 354 patients for analysis. The rate of hilar or intrapulmonary LN metastasis was 13.6%. When stratified by tumor size, NSCLC less than or equal to 1 cm had no hilar or intrapulmonary LN metastasis (0%) while NSCLC greater than 2 cm but less than or equal to 3 cm had a significantly high rate of hilar or intrapulmonary LN metastasis (18.4%) and the rates of hilar, interlobar, and peripheral LN metastasis were also relatively high (5.4%, 5.4%, and 12.2%, respectively). NSCLC greater than 1.5 cm but less than or equal to 2 cm also had relatively high rates of hilar (6.5%) and peripheral (18.3%) LN metastasis, while NSCLC greater than 1 cm but less than or equal to 1.5 cm had significantly low rates of hilar or intrapulmonary (2.5%) and peripheral (2.5%) LN metastasis. Radiographic feature and histology were found to be independent predictors of regional LN metastasis. The pattern of regional LN metastasis in clinical stage IA peripheral NSCLC was significantly influenced by tumor size, which may provide evidence on surgical choice (lobectomy, segmentectomy, or wedge resection) for these early-stage NSCLC patients based on tumor size. [ABSTRACT FROM AUTHOR]

• Supervised therapeutic exercise has a beneficial effect in patients with knee osteoarthritis. • Active video game playing had the same effect as therapeutic exercise for pain. • Active video game playing improved balance, physical functional performance and physical health as compared with therapeutic exercise. • Active video game playing may be an alternative supplementary therapy to therapeutic exercise. Active video games (AVGs) have become popular and have been investigated for their therapeutic purposes. However, the effect of AVGs on patients with knee osteoarthritis (OA) remains uncertain. We aimed to compare the effects of AVGs with those of traditional therapeutic exercise on patients with knee OA. This was a prospective single-blind, randomized controlled trial. Participants (n = 80) with knee OA were allocated to the AVGs group (n = 40) or therapeutic exercise group (n = 40). Both groups received treatment 3 times a week for 4 weeks. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and secondary outcome measures were the World Health Organization Quality of Life-Brief Vision, Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, physical functional performance (including time for 10-m walking and for ascending and descending stairs), Biodex Stability System, Chronic Pain Grade Questionnaire, and Work Ability Index. The patients were evaluated at baseline, 2 and 4 weeks after treatment, and 1 and 3 months after treatment completion. Both groups showed significant time effect in the pain subcategory of the WOMAC (P = 0.047). However, we found no significant group × time interaction effect between the groups at any follow-up assessments for pain (P = 0.066), stiffness (P = 0.284), or physical function (P = 0.179) for the WOMAC. Among the secondary outcomes, we found significant group × time effects favoring the AVG group in dynamic balance (P = 0.020), and physical functional performance including 10-m walking time (P = 0.002) and stair ascent time (P = 0.005), and the physical domain of health (P = 0.032). Therapeutic exercises and playing AVGs similarly improved the pain of patients with knee OA; however, playing AVGs improved dynamic balance, physical functional performance, and physical health more than therapeutic exercises did. [ABSTRACT FROM AUTHOR]