text:
Fax: (585) 275-1531
Original Article
Definitive radiotherapy for stage I nonsmall cell lung cancer
A population-based study of survival
Article first published online: 27 APR 2012
DOI: 10.1002/cncr.27589
Copyright © 2012 American Cancer Society
Volume 118, Issue 22, pages 5572–5579, 15 November 2012
Additional Information
How to Cite
Milano, M. T., Zhang, H., Usuki, K. Y., Singh, D. P. and Chen, Y. (2012), Definitive radiotherapy for stage I nonsmall cell lung cancer. Cancer, 118: 5572–5579. doi: 10.1002/cncr.27589
Publication History
- Issue published online: 30 OCT 2012
- Article first published online: 27 APR 2012
- Manuscript Revised: 6 MAR 2012
- Manuscript Accepted: 6 MAR 2012
- Manuscript Received: 9 FEB 2012
- Abstract
- Article
- References
- Cited By
- nonsmall cell lung cancer;
- population-based;
- radiotherapy;
- tumor size;
- American Joint Committee on Cancer staging
The current study characterizes the overall survival (OS) and cause-specific survival (CSS) of patients with stage I nonsmall cell lung cancer (NSCLC) who were treated with radiotherapy alone, and analyzes the variables potentially affecting survival outcomes.
A total of 8524 patients with stage I NSCLC (according to the sixth edition of the American Joint Committee on Cancer staging manual) who were diagnosed between 1988 and 2008 were retrospectively analyzed using the population-based Surveillance, Epidemiology, and End Results database. Cox regression analysis was used to calculate hazard ratios (HR) from multivariate analyses.
The 1-year, 2-year, and 5-year OS rates were 62%, 37%, and 11%, respectively; the corresponding lung cancer CSS survival rates were 68%, 45%, and 20%, respectively. Approximately 77% of deaths were from lung cancer (5292 of 6891 total deaths). Cardiac (n = 477 deaths) and pulmonary (other than lung cancer deaths; n = 475 deaths) deaths accounted for 14% of deaths. From Cox proportional hazards analyses, male sex (HR, 1.2) and squamous cell carcinoma histology (HR, > 1.1) were found to be significantly (P < .0001) adverse prognostic factors for both OS and lung cancer CSS. A more recent calendar year of diagnosis was associated with significantly (P < .0001) improved OS (HR, 0.84 per decade) and lung cancer CSS. This trend was also significant (P < 0.0001) when restricting analyses to those patients with tumors measuring ≤ 5 cm (n = 5402 patients). T1 classification (vs T2 or T unknown) and smaller tumor size were found to be significantly (P < .0001) favorable factors.
From a population-based registry analysis of patients with stage I NSCLC, significant (albeit modest) improvements in survival in more recent years were appreciated, which likely reflect technologic advances in the diagnosis of, staging of, and radiotherapy for NSCLC. Cancer 2012. © 2012 American Cancer Society.
Surgical resection remains the standard treatment of patients with stage I nonsmall cell lung cancer (NSCLC). For patients who are medically inoperable or decline surgical resection, definitive radiotherapy is an effective alternative. In these patients, the lack of surgical staging and death from comorbid conditions (more common in medically inoperable patients) have historically resulted in survival outcomes inferior to those of patients who undergo surgical resection. In a landmark pooled analysis from Sibley, published in 1998 in Cancer, approximately 15% of medically inoperable patients with stage I NSCLC were long-term survivors after radiotherapy; approximately 30% of deaths were from intercurrent illness and approximately 70% of deaths were from lung cancer, one-half of which were the result of distant metastases and one-half of which were the result of local disease recurrence.1 Higher prescribed doses were found to be correlated with better outcomes, whereas prophylactic lymph node irradiation was not.1
Since Sibley's article was published in 1998, radiotherapy planning and delivery have become more sophisticated, evolving from 2-dimensional (2D) anteroposterior/posteroanterior fields to 3D conformal radiotherapy, and more recently to novel modalities such as stereotactic body radiotherapy (SBRT)/stereotactic ablative body radiotherapy (SABR), image-guided radiotherapy, and 4D planning and delivery. These developments, particularly SBRT/SABR, have resulted in improved survival compared with historical outcomes, which is attributable to more accurate tumor targeting and the delivery of higher biologically effective doses.2 Furthermore, lung cancer staging with positron emission tomography/computed tomography (PET/CT) has become an accepted standard, reducing the risk of understaging patients with occult distant and/or lymph node metastases3 and aiding in radiotherapy planning. Although not diagnostic, PET/CT does help guide tissue biopsy, which has also recently become more sophisticated. Although minimally invasive bronchoscopy and CT-guided biopsies have been used for many years, recent advancements in endobronchial ultrasound-guided biopsy4 and navigational bronchoscopic biopsy5 can improve diagnostic yield.
In the current study, patients with stage I NSCLC based on the sixth edition of the American Joint Committee on Cancer (AJCC) staging manual6 who were treated with radiotherapy alone and registered in the population-based Surveillance, Epidemiology, and End Results (SEER) database were retrospectively analyzed to better understand the risk factors affecting their overall survival (OS) and cause-specific survival (CSS). There have been many SEER studies analyzing survival outcomes after resection of stage I NSCLC,7-12 although to our knowledge few SEER studies have focused on outcomes after radiotherapy alone. Two recent SEER studies demonstrated a significant benefit of radiotherapy (vs no radiotherapy) among patients with unresected, early stage NSCLC.13, 14 To our knowledge, this is the first analysis from SEER data focusing on prognostic factors in patients treated with radiotherapy alone for stage I NSCLC. We assessed whether survival outcomes improved over time with better lung cancer staging and radiotherapy treatment technology in recent years, and analyzed the clinicopathologic factors affecting survival after definitive radiotherapy.
Patient Database
Patients were selected from the SEER 17 registries using the SEER*Stat case listing session with the following criteria: first or only primary cancer; "lung and bronchus" site; localized stage I disease, based on SEER historical and AJCC stage (third and sixth editions of the AJCC staging manual, abbreviated herein as AJCC-third and AJCC-sixth) database fields; treatment with beam radiotherapy, without cancer-directed surgery; and having the following histologies: nonsmall cell carcinoma (according to the third edition of International Classification of Diseases for Oncology [ICD-O-3] 8046/3; used from 1997-present, although infrequently before 2000), squamous cell carcinoma (ICD-O-3 8050-8084/3), adenocarcinoma (ICD-O-3 8140/3, 8255/3, 8260/3, and 8310/3), bronchioloalveolar adenocarcinoma (ICD-O-3 8250-8254/3), adenosquamous carcinoma (ICD-O-3 8560/3), and large cell carcinoma (ICD-O-3 8012/3). Patients with neuroendocrine, carcinoid, small cell carcinoma, oat cell carcinoma, sarcoma, and mesothelioma histologies were excluded. Patients with unspecified lung neoplasms (those that could not be distinguished from excluded histologies) were also excluded.
Beginning in 1988, the SEER registry recorded lung cancer stage and primary tumor size; those patients registered between 1973 and 1987 did not have their NSCLC stage recorded and therefore were excluded. For the current study, T1N0 NSCLC (stage IA) tumors measure ≤ 3 cm and are confined to the lung, whereas T2N0 NSCLC (stage IB) tumors measure > 3 cm and/or involve the mainstem bronchus ≥ 2 cm from the carina and/or with atelectasis that does not involve the entirety of the lung (based on AJCC-sixth). For patients diagnosed between 1988 and 2003, stage grouping (based on AJCC-third) and clinical tumor extent were recorded for the majority of patients by the SEER registry. For most patients diagnosed after 2003, the T classification was explicitly recorded. For patients for whom the T classification or stage grouping was not explicitly recorded by the SEER registries, primary lung cancers measuring ≤ 3 cm and confined to the lung were classified as T1, and lesions measuring > 3 cm in size and/or with T2-defining clinical extension (as per above) were classified as T2. Patients were assigned an "unknown" T classification (T1 or T2) if 1) the size of the tumor was ≤ 3 cm or not recorded and the extent of disease was not recorded (1988-2003); or 2) the T classification was not recorded, size was ≤ 3 cm or not recorded, and the extent of disease was not recorded (after 2003). It is important that lung cancer staging from the seventh edition of the AJCC staging manual (AJCC-seventh)15 differs from that of the AJCC-sixth in that T2 no longer includes tumors of any size measuring > 3 cm (without regional extension). Instead, lymph node-negative NSCLC with a primary tumor site measuring > 5 cm to 7 cm (without regional extension) is now staged as T2bN0, Stage IIA disease and a primary tumor site measuring > 7 cm is now staged as T3N0, Stage IIB disease.15 We opted not to exclude patients based on the size of their primary tumor, because those patients classified as having an "unknown" T classification (T1 or T2) and those patients with an unknown tumor size, classified as T2 based on the extent of disease, may include patients now classified as having T2b to T3 disease by AJCC-seventh. Instead, we performed separate analyses accounting for tumor size, as well as separate analyses excluding those patients with a tumor size > 5 cm, which represents an adverse prognostic group,16 prompting the change in AJCC staging.15
Statistical Analysis
Stata version 9.2 statistical software (StataCorp, College Station, Tex) was used for data analysis. Actuarial overall survival (OS) and cause-specific survival (CSS) were calculated using the Kaplan-Meier method. Survival times were calculated from the date of diagnosis to the date of last recorded follow-up. For lung cancer CSS, death from lung cancer was considered an event, whereas those patients who died of other causes were censored at the time of death. For all other CSS, death from any cause other than lung cancer was considered an event, whereas those patients who died of lung cancer were censored at the time of death. Cardiac CSS reflects deaths from heart disease only, and pulmonary CSS reflects deaths only from pulmonary causes other than lung cancer (ie, chronic obstructive disease or pneumonia). For univariate analyses comparing survival outcomes between subgroups, the log-rank test was used for discrete variables, and Cox regression analysis was used for continuous variables. For multivariate analyses (MVA) assessing the significance and hazards ratios (HR) of prognostic variables, Cox proportional hazards models were used.
Patient and Tumor Characteristics
Only 1.4% of patients were diagnosed without histologic or cytologic confirmation. Table 1 summarizes the patient and tumor characteristics of the study patients, grouped by 4 eras: 1988 to 1995, 1996 to 2000, 2001 to 2004, and 2005 to 2008. The median age of the patients at the time of diagnosis was 74 years. Although age at diagnosis significantly increased with a more recent calendar year of NSCLC diagnosis, this change was modest. Other significant changes observed with a more recent year of diagnosis include relatively more female patients, fewer squamous cell carcinomas relative to adenocarcinomas, more T1 (vs T2) tumors, and smaller tumor size.
|8524 (100%)
|2204 (26%)
|1585 (19%)
|2357 (28%)
|2378 (28%)
|Age, y
|688 (8%)
|209 (9%)
|126 (8%)
|188 (8%)
|165 (7%)
|2104 (25%)
|682 (31%)
|354 (22%)
|523 (22%)
|545 (23%)
|3547 (42%)
|902 (41%)
|703 (44%)
|1006 (43%)
|936 (39%)
|2185 (26%)
|411 (19%)
|402 (25%)
|640 (27%)
|732 (31%)
|Median [range]
|74 [27-98]
|72 [36-98]
|74 [27-93]
|74 [29-95]
|75 [41-98]
|946 (11%)
|261 (12%)
|169 (11%)
|252 (11%)
|264 (11%)
|7133 (84%)
|1833 (83%)
|1316 (83%)
|1995 (85%)
|1989 (84%)
|440 (5%)
|109 (5%)
|100 (6%)
|109 (5%)
|122 (5%)
|5 (<1%)
|1 (<1%)
|1 (<1%)
|3 (<1%)
|4643 (54%)
|1366 (62%)
|841 (53%)
|1225 (52%)
|1211 (51%)
|3881 (46%)
|838 (38%)
|744 (47%)
|1132 (48%)
|1167 (49%)
|Squamous cell carcinoma
|3825 (45%)
|1235 (56%)
|837 (53%)
|884 (38%)
|869 (37%)
|2402 (28%)
|611 (28%)
|525 (33%)
|608 (26%)
|658 (28%)
|Squamous cell carcinoma: adenocarcinoma
|Bronchioloalveolar carcinoma
|209 (2%)
|46 (2%)
|40 (3%)
|53 (2%)
|70 (3%)
|Adenosquamous carcinoma
|65 (1%)
|18 (1%)
|10 (1%)
|13 (<1%)
|24 (1%)
|Large cell carcinoma
|637 (7%)
|294 (13%)
|151 (10%)
|136 (6%)
|56 (2%)
|Nonsmall cell carcinoma
|1386 (16%)
|22 (1%)
|663 (28%)
|701 (29%)
|T classificationb
|2735 (32%)
|405 (18%)
|435 (27%)
|817 (35%)
|1078 (45%)
|3687 (43%)
|870 (39%)
|705 (44%)
|1059 (45%)
|1053 (44%)
|Unknown (T1 or T2)
|2102 (25%)
|929 (42%)
|445 (28%)
|481 (20%)
|247 (10%)
|Size, cmb
|Median [range]
|3.2 [0.1-20.0]
|3.5 [0.1-15.0]
|3.5 [0.1-20.0]
|3.0 [0.1-15.0]
|3.0 [0.1-14.8]
|141 (2%)
|33 (1%)
|25 (2%)
|35 (1%)
|48 (2%)
|>1 to ≤3
|3082 (36%)
|580 (26%)
|518 (33%)
|929 (39%)
|1055 (44%)
|>3 to ≤5
|2179 (26%)
|479 (22%)
|428 (27%)
|627 (27%)
|645 (27%)
|>5 to ≤7
|808 (9%)
|193 (9%)
|155 (10%)
|232 (10%)
|228 (10%)
|>7 cm
|358 (4%)
|87 (4%)
|67 (4%)
|95 (4%)
|109 (5%)
|1956 (23%)
|832 (38%)
|392 (25%)
|439 (19%)
|293 (12%)
Among 3223 patients with a recorded tumor size ≤ 3 cm, 84% (n = 2722), 3% (n = 99), and 12% (n = 402) were classified as having T1, T2, and unknown disease, respectively.
Patient Survival
The 6-month, 1-year, 2-year, and 5-year OS rates were 83%, 62%, 37%, and 11%, respectively. The 6-month, 1-year, 2-year, and 5-year lung cancer CSS rates were 86%, 68%, 45%, and 20%, respectively (Fig. 1). Significantly favorable prognostic factors for OS and lung cancer CSS included female sex, histology other than squamous cell carcinoma, more recent calendar year of diagnosis, T1 classification (vs others), and smaller tumor size (P < .00001 for all) (Table 2). For the eras between 1988 and 1995, 1996 and 2000, and 2001 and 2004, the 5-year OS rates were 7%, 11%, and 13%, respectively; for the years between 2005 and 2008, the 5-year OS was not reached, but was estimated (from 3-year and 4-year OS rates of 30% and 23%) to be between 17% and 18%.
|2-Year OS (Median)
|2-Year Lung Cancer CSS (Median)
|5-Year All Other CSS
|5-Year Pulmonary CSS
|5-Year Cardiac CSS
|37% (16.6%)
|42% (18.7% )
|40% (17.6%)
|47% (22.3%)
|35% (15.9%)
|44% (19.9%)
|36% (16.4%)
|45% (20.1%)
|P (log-rank test)
|P (Cox regression analysis)
|38% (17.6%)
|46% (20.9%)
|37% (16.3%)
|45% (20.3%)
|32% (14.9%)
|41% (18.3%)
|42% (18.9%)
|50% (24.1%)
|Squamous cell carcinoma
|33% (15.0%)
|41% (18.3%)
|42% (18.8%)
|50% (24.2%)
|31% (14.6%)
|37% (16.8%)
|34% (15.4%)
|43% (19.5%)
|38% (16.7%)
|47% (21.3%)
|45% (20.5%)
|55% (27.4%)
|T classification
|51% (24.4%)
|62% (33.8%)
|30% (14.0%)
|37% (16.2%)
|Unknown (T1 or T2)
|31% (14.3%)
|38% (17.0%)
|Size, cm
|53% (25.6%)
|58% (28.8%)
|>1 to ≤3
|49% (23.4%)
|60% (32.4%)
|>3 to ≤5
|34% (15.7%)
|41% (18.7%)
|>5 to ≤7
|27% (12.7%)
|33% (14.6%)
|21% (10.6%)
|24% (11.7%)
|27% (12.8%)
|33% (14.8%)
|P (log-rank test)b
|P (Cox regression analysis)b
Approximately 77% of deaths were from lung cancer (5292 of 6891 total deaths). Cardiac (n = 477) and pulmonary (other than lung cancer; n = 475) deaths accounted for 14% of deaths reported. The 1-year, 2-year, and 5-year CSS rates from any cause other than lung cancer were 91%, 82%, and 57%, respectively. Table 2 also shows the 5-year CSS rate from any cause other than lung cancer, pulmonary CSS, and cardiac CSS. Deaths from other causes were found to be significantly increased in older patients and male patients. Patients with larger tumors were more likely to die of lung cancer and less likely to die of other causes.
Figure 2 depicts the 2-year OS and lung cancer CSS for patients, relative to the calendar year of diagnosis. Amid fluctuations from year to year, there was a significant (P < .0001 using Cox regression analysis) increase in OS and lung cancer CSS with a more recent year of diagnosis. Also shown in Figure 2 is the 2-year OS and lung cancer CSS, including only those patients with a tumor measuring ≤ 5 cm (n = 5402, representing T1-T2aN0 NSCLC in AJCC-seventh). A similarly significant (P < .0001 with Cox regression analysis) improvement in OS and lung cancer CSS was noted with a more recent year of diagnosis.
All variables potentially impacting OS were analyzed using multivariate Cox proportional hazards analyses (Table 3). Male gender, T classification other than T1 (ie, T2 or unknown) and treatment in earlier decades, each resulted in a 1.2- to 1.3-fold significantly (P < .0001) increased risk of death. Older age at the time of diagnosis, squamous cell carcinoma histology, and tumor size (per cm) were also found to be significant factors. The MVAs shown Table 3 include only those patients whose tumor size was recorded. Omitting tumor size from the MVA allowed for analysis of all 8524 patients and did not appreciably change the HRs, with the exception of T classification (T1 vs others), for which the HR for OS was 0.67 (95% confidence interval, 0.64-0.71). For 2378 patients diagnosed between 2005 and 2008, older age, male sex, squamous cell histology, T classification other than T1, and increased tumor size were also found to be adverse prognostic factors for OS (Table 3). Table 3 also shows the Cox regression analyses, restricted to only those 5402 patients with a tumor size ≤ 5 cm. Aside from T classification being a less significant prognostic factor, with a slightly less pronounced HR, the outcomes are similar to those for all 8524 patients. The MVA models using the variable T1 versus T2 disease (n = 6166 patients, including all patients with obtainable T classification, and n = 5000 patients when including only those with tumors measuring ≤ 5 cm) compared with T1 disease versus all others did not appreciably change the HRs or P values (data not shown). The HRs and P values for lung cancer CSS were very similar with regard to magnitude and significance to the HRs and P values for OS (data not shown).
|All Patients (n = 6568)
|Patients Diagnosed From 2005-2008 (n = 2378)
|Patients With Tumors ≤5 cm (n=5402)
|Age, yb
|1.13 (1.10-1.17)
|1.09 (1.01-1.17)
|1.09 (1.05-1.13)
|1.21 (1.14-1.28)
|1.37 (1.20-1.56)
|1.22 (1.14-1.29)
|Histology (SCC vs others)
|1.14 (1.08-1.21)
|1.26 (1.10-1.44)
|1.13 (1.06-1.21)
|Year of diagnosisb
|0.84 (0.80-0.89)
|Not run
|0.82 (0.77-0.87)
|T classification (T1 vs others)
|0.83 (0.77-0.89)
|0.84 (0.69-1.006)
|0.92 (0.84 to <1.00)
|1.08 (1.07-1.10)
|1.14 (1.09-1.19)
|1.15 (1.11-1.19)
Major findings from the current study of patients treated with radiotherapy alone for T1-2N0 NSCLC (AJCC-sixth) include a significantly, albeit modestly, improved OS and lung cancer CSS associated with a more recent calendar year of diagnosis, female sex, non-squamous cell carcinoma histology, earlier T classification, and smaller tumor size. The 5-year OS rate of 11%, with the majority of deaths (77%) attributed to lung cancer, are consistent with the pooled analysis published by Sibley in 1998,1 although squamous cell histology was a favorable prognostic factor in that study, versus unfavorable in the current study.
Several recent SEER studies examining surgical resection for patients with stage I NSCLC have also demonstrated male sex,8, 10, 12 older age,8-10, 12 and larger tumor size9, 10, 12 to be significantly adverse risk factors for OS8-10, 12 and lung cancer CSS.8, 12 Extent of resection8, 12 and number of lymph nodes examined7, 9-12 have also been shown to be significant prognostic factors after surgical resection. It is interesting to note that, unlike our cohort of patients with stage I NSCLC (AJCC-sixth) who were treated with radiotherapy alone, some studies have indicated that black race is associated with significantly worse survival outcomes after surgical resection,12 and squamous cell carcinoma histology is not significant for lung cancer CSS12 or OS9, 10 after resection. In these studies,7-12 the calendar year of NSCLC diagnosis was not analyzed.
A population-based trend toward improved survival in patients with lung cancer with a more recent year of diagnosis has been described in the United States,17 although to our knowledge, this has not been previously reported among those patients treated with radiotherapy alone for localized NSCLC. A Dutch population-based study of 875 elderly patients (aged ≥ 75 years) treated with radiotherapy for stage I NSCLC from 1999 to 2007 demonstrated an increasing use of definitive radiotherapy after SBRT was introduced in 2003, and an improved survival that was correlated with SBRT use; younger age, earlier T classification, and more recent era (2005-2007) of diagnosis were found to be significantly favorable prognostic factors for OS.18
As described earlier, the survival improvement noted in the current study (with patients registered from 1988-2008) is likely multifactorial, and partly the result of advancements in lung cancer diagnostic methods, staging techniques, radiotherapy technology, and salvage therapy (radiotherapy or chemotherapy). PET imaging was unlikely to have been used in patients treated before the mid-2000s. Although the SEER database does not provide information regarding the radiotherapy technique used, patients treated in the late 1980s to the early 1990s were much less likely to have undergone 3D planning, and patients treated in the 1990s and early 2000s were much less likely to have been treated with more modern radiation planning and delivery techniques such as SBRT/SABR, 4D planning, or respiratory gating. In fact, Pan et al have shown that SBRT/SABR have become increasingly more commonly adopted in the United States since 2000, with the lung representing the most commonly treated site.19 The reported survival outcomes after SBRT/SABR for patients with stage I NSCLC2 are far superior to those reported by Sibley in 1998.1 As SBRT/SABR becomes used more frequently, it is anticipated that survival outcomes will continue to improve. It is interesting to note that technologic advances have been shown to improve the OS of patients with advanced NSCLC.20 It also will be intriguing to discover how the survival of patients with early stage NSCLC is impacted over the next years to decades with the anticipated increased rate of CT screening.21
Although a continued trend toward improved survival can be readily explained by medical advances, the year-to-year fluctuations (eg, the sharp decrease in OS and lung cancer CSS noted in 2004 [Fig. 2]), are more difficult to explain. In 2004, the SEER program underwent major coding changes (available at http://seer.cancer.gov/tools/codingmanuals/historical.html) and began to capture AJCC lung cancer T classification (based on AJCC-sixth, which had not changed from prior editions). The percentage of patients with an unknown T classification dropped from 21% in 2003 to 14% in 2004, the ratio of T1 to T2 cancers increased from 0.6 to 1.0 (a substantial change), and the median tumor size dropped from 3.4 cm to 3 cm (data not shown). Perhaps these coding changes impacted which patients were reported to the SEER program and thus the calculated survival, although it is not readily explained how this may have occurred, or why in 2005 survival increased again.
Patient and Tumor Characteristics
Among patients treated with radiotherapy alone for stage I NSCLC (AJCC-sixth), a more recent calendar year of diagnosis was found to be significantly associated with slightly older age, a reduction in male preponderance (nearly 50:50 among patients diagnosed between 2005-2008), a greater likelihood of adenocarcinoma histology, and a smaller reported tumor size. The data from the current study are consistent with the previously described increased incidence of adenocarcinoma (vs squamous cell carcinoma) NSCLC22 and an increase in the diagnosis of NSCLC in females.17 The increased age at the time of diagnosis likely reflects a more aging population. The slightly reduced tumor size noted over the past few decades may reflect earlier diagnosis, or the relatively more indolent disease progression associated with adenocarcinoma.
The strengths of the current study include the sizable number (> 8000) of patients identified from a large population-based setting. Substantial patient numbers allowed for analyses of outcomes by age, year of diagnosis, sex, NSCLC tumor size, and histology. Known limitations of SEER data include a lack of detailed information regarding radiotherapy (dose or dose fractionation, field, technique), and an absence of chemotherapy data (including salvage chemotherapy after disease recurrence) and tobacco history. Furthermore, SEER registries do not collect data concerning prognostic factors such as weight loss and performance status. Other weaknesses include the retrospective nature of the current study, a lack of pathologic or radiologic review to verify diagnosis and staging, and a lack of information regarding curative-intent versus palliative-intent therapy (likely relevant for the largest tumors). Presumably, the vast majority of patients received curative-intent therapy. Finally, the SEER program does not record dates of cancer progression or patterns of disease recurrence. With more sophisticated radiotherapy planning and delivery technology, it is expected that the predominant pattern of failure will be distant disease progression.23-25
From a hypothesis-generating, retrospective, population-based registry analysis of patients with lymph node-negative, early stage NSCLC (T1-T2N0 from AJCC-sixth), it was learned that a more recent calendar year of diagnosis, female sex, non-squamous cell carcinoma histology, earlier T classification, and smaller tumor size were associated with significantly more favorable (albeit modest) OS and lung cancer CSS rates. Improvements in survival in more recent years, even when correcting for other prognostic factors in Cox regression analyses, likely reflect technologic improvements in lung cancer diagnosis, staging, and radiotherapy delivery.
No specific funding was disclosed.
The authors made no disclosures.
- 1Radiotherapy for patients with medically inoperable Stage I nonsmall cell lung carcinoma: smaller volumes and higher doses-a review. Cancer. 1998; 82: 433-438..
- 2Stereotactic ablative radiation therapy for primary lung tumors. Cancer J. 2011; 17: 28-32., , .
- 3PET scan in lung cancer: current recommendations and innovation. J Thorac Oncol. 2006; 1: 71-73., .
- 4Endobronchial ultrasound guided transbronchial needle aspiration for staging of lung cancer. Lung Cancer. 2005; 50: 347-354., , , et al.
- 5Electromagnetic navigation diagnostic bronchoscopy: a prospective study. Am J Respir Crit Care Med. 2006; 174: 982-989., , , , .
- 6AJCC Cancer Staging Handbook: TNM Classification of Malignant Tumors. 6th ed. New York, NY: Springer-Verlag; 2002., , , et al, eds.
- 7Postoperative survival and the number of lymph nodes sampled during resection of node-negative nonsmall cell lung cancer. Chest. 2005; 128: 1545-1550., , , .
- 8Similar long-term survival of elderly patients with nonsmall cell lung cancer treated with lobectomy or wedge resection within the surveillance, epidemiology, and end results database. Chest. 2005; 128: 237-245., , , et al.
- 9Prognosis of patients with resected nonsmall cell lung cancer: impact of clinical and pathologic variables. Lung Cancer. 2006; 52: 207-212., .
- 10Survival following sublobar resection for early-stage nonsmall cell lung cancer with or without adjuvant external beam radiation therapy: a population-based study. Chest. 2010; 137: 362-368., , , et al.
- 11Extent of lymphadenectomy and outcome for patients with stage I nonsmall cell lung cancer. Cancer. 2009; 115: 851-858., , , , .
- 12Survival after lobectomy versus segmentectomy for stage I nonsmall cell lung cancer: a population-based analysis. Ann Thorac Surg. 2011; 92: 1943-1950., , , , , .
- 13Radiation therapy for the treatment of unresected stage I-II nonsmall cell lung cancer. Chest. 2005; 128: 1461-1467., , , , .
- 14Effectiveness of radiation therapy for elderly patients with unresected stage I and II nonsmall cell lung cancer. Am J Respir Crit Care Med. 2010; 181: 264-269., , , , .
- 15AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer; 2010., , , , , , eds.
- 16International Staging Committee; Cancer Research and Biostatistics; Observers to the Committee; Participating Institutions. The IASLC Lung Cancer Staging Project: proposals for the revision of the T descriptors in the forthcoming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol. 2007; 2: 593-602., , , et al;
- 17Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin. 2011; 61: 212-236., , , .
- 18Impact of introducing stereotactic lung radiotherapy for elderly patients with stage I nonsmall-cell lung cancer: a population-based time-trend analysis. J Clin Oncol. 2010; 28: 5153-5159., , , , , .
- 19A survey of stereotactic body radiotherapy use in the United States. Cancer. 2011; 117: 4566-4572., , , , .
- 20Influence of technologic advances on outcomes in patients with unresectable, locally advanced nonsmall-cell lung cancer receiving concomitant chemoradiotherapy. Int J Radiat Oncol Biol Phys. 2010; 76: 775-781., , , et al.
- 21National Lung Screening Trial Research Team, , , et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011; 365: 395-409.
- 22Is there a common etiology for the rising incidence of and decreasing survival with adenocarcinoma of the lung? Epidemiology. 2001; 12: 256-258., , , , , .
- 23Stereotactic body radiation therapy for early-stage nonsmall-cell lung cancer: the pattern of failure is distant. Int J Radiat Oncol Biol Phys. 2010; 77: 1146-1150., , , , , .
- 24Locoregional and distant failure following image-guided stereotactic body radiation for early-stage primary lung cancer. Radiother Oncol. 2011; 99: 12-17., , , et al.
- 25Patterns of failure and predictive value of PET-CT after stereotactic radiotherapy for stage I lung cancer. Int J Radiat Oncol Biol Phys. 2009; 75: S453., , .


text:
tag:blogger.com,1999:blog-19929098.comments2014-11-25T14:43:29.393-08:00CRIME, GUNS, AND VIDEOTAPECrimefilehttp://firstname.lastname@example.com:blogger.com,1999:blog-19929098.post-6466753152535119442014-11-25T12:51:02.199-08:002014-11-25T12:51:02.199-08:00This is a simple case - a young, very big and stro...This is a simple case - a young, very big and strong man (Brown) commits a strong armed robbery in a store - YES this is a FELONY, and police have authority to use deadly force if necessary. The robber, (Brown) flees the scene and Officer comes in contract with him. Brown does NOT want to go to jail so he disobeys the officer, he then attacks the officer, and he is shot and killed. The officer felt that his life was in danger, Brown is one big Bully, look at his height, weight, etc. Too bad the bum got killed for the parents sake, BUT it is NOT the officers fault. End of story. email@example.com:blogger.com,1999:blog-19929098.post-25621914301163256922014-11-25T12:17:28.140-08:002014-11-25T12:17:28.140-08:00I love the commentary, you had me cracking up towa...I love the commentary, you had me cracking up towards the end.
Im wondering about the guy that returned it?....White?Brooklyn Bobhttp://firstname.lastname@example.com:blogger.com,1999:blog-19929098.post-11419243208446405772014-11-25T04:26:49.722-08:002014-11-25T04:26:49.722-08:00You sir, are one thousand percent correct with thi...You sir, are one thousand percent correct with this firstname.lastname@example.com:blogger.com,1999:blog-19929098.post-46655009955080494142014-11-23T19:04:09.980-08:002014-11-23T19:04:09.980-08:00I dont know whos hands he will nail but he and the...I dont know whos hands he will nail but he and the other progressive center lefts would like to abolish the Senate.

They want a Uniacameral legislative body so California will rule the email@example.com:blogger.com,1999:blog-19929098.post-17190621453353880542014-11-22T08:36:49.093-08:002014-11-22T08:36:49.093-08:00They are not taught in the sense of classroom inst...They are not taught in the sense of classroom instruction. It's more like monkey see, monkey do.

It's about win at all cost, not seek justice. Crimefilehttp://email@example.com:blogger.com,1999:blog-19929098.post-68476002188539955152014-11-22T08:15:49.295-08:002014-11-22T08:15:49.295-08:00Police officers are taught subterfuge in the same ...Police officers are taught subterfuge in the same way that medical doctors are not taught nutrition.
If Americans really cared about justice, they'd be signing up for common law grand juries in droves. vonuhttp://email@example.com:blogger.com,1999:blog-19929098.post-6306651024354887572014-11-22T02:10:24.673-08:002014-11-22T02:10:24.673-08:00I pity you my brother; you apparently have lost al...I pity you my brother; you apparently have lost all faith in your Creator – I'm sorry.

However, let's address your notions about eugenics. The Nazis certainly tried to cleanse the German population of their social failures and yet today dysfunctional Germans still continue to be born and why? Because the genetic link to social failure is tenuous at best.

Take the notion of homosexuality as a genetic trait. It is of course impossible because the first expression of it would not have bred and therefore he or she would not have had any offspring to pass it on to. Even if it first expressed in a woman and she was impregnated by force her children would still have the same problem. If we are to give Darwin any consideration at all we'd be forced to conclude that the inherent weakness in that mutation would have condemned it to failure.

No my friend, I firmly believe it is nurture not nature that breeds the anti-social.

We humans do not live in a natural world and therefore is illogical to blame nature for the failure of some to conform.E Langhttp://firstname.lastname@example.com:blogger.com,1999:blog-19929098.post-7474466826232893862014-11-20T23:15:45.804-08:002014-11-20T23:15:45.804-08:00It wasn't the tyranny of Caesar that ended the Rom...It wasn't the tyranny of Caesar that ended the Roman Republic. It was the retribution for this death. The day Mark Antony nailed Cicero's hands to the doors of the Senate was the last day of the republic. Whose hands do you suppose Obama will nail to doors of our Senate?E Langhttp://firstname.lastname@example.com:blogger.com,1999:blog-19929098.post-1395456642845113652014-11-20T20:12:29.880-08:002014-11-20T20:12:29.880-08:00Today, yesterday, not just Obama but others with o...Today, yesterday, not just Obama but others with one or another criminal act...

"What message does it send to our children...?" ...when our government is the biggest terrorist and the biggest lawbreaker on the planet?

Worse, this is dumbo happy on the strings he's been issued by the real powers that be.

A little animation you might enjoy: http://reasonaction.blogspot.com/2013/04/ah-yes-updated-obama-jefferson.html Obama resurrects Jefferson from the grave to brag. How ya s'pose Jefferson reacts?Indy Reasonerhttp://email@example.com:blogger.com,1999:blog-19929098.post-83553169426420020762014-11-14T19:52:43.183-08:002014-11-14T19:52:43.183-08:00I knew Tony and I know Bob they are both movies th...I knew Tony and I know Bob they are both movies that should be made. Bobs book nearly made it...Crimefilehttp://email@example.com:blogger.com,1999:blog-19929098.post-79026394894137665702014-11-14T19:21:45.127-08:002014-11-14T19:21:45.127-08:00Jackpine Bob Someone could make a very good movie...Jackpine Bob

Someone could make a very good movie about Tony Corsentino. There are some great stories about him. I witnessed at least two. Once with him a plainclothes Officer and later as a law student playing vigilante Ninja in Lincoln Park in the early AM along with another ex-p.o. law student , future infamous Mafia lawyer who brought down the corruption in Operation firstname.lastname@example.com:blogger.com,1999:blog-19929098.post-77053307406823363432014-11-14T14:50:14.101-08:002014-11-14T14:50:14.101-08:00The Western world celebrated the anniversary, exce... The Western world celebrated the anniversary, except in most parts of South America where there are neo-communist governments in power, such as in Chile where I now live. The President, Michelle Bachelet, expresed "nostalgia" for the Berlin Wall, and felt that "When the Wall fell the ideals for a utopia also fell" She lived in East Germany for several years and was good friends with Erich Honecker, the dictator who built the Wall. What a disgrace for Chile! You should remember that Chile was the first country in the world to overthrow a communist gov't. But the military heroes who overthrew Salvador Allende in 1973 were subsequently railroaded to prison for life by kangaroo courts based on the Spanish Inquisition in which the judge is also the prosecutor and the accused are presumed guilty and not given a chance to prove their innocence. Alan firstname.lastname@example.com:blogger.com,1999:blog-19929098.post-31506018574673632142014-11-14T01:43:10.889-08:002014-11-14T01:43:10.889-08:00Private enterprise? Bad. Ever increasing size of ...Private enterprise? Bad.
Ever increasing size of government? Good!

Government % of gross domestic product 25%, 35%, 45%, let's keep it going higher 55%, 65%...

Isn't Cuba 90%? Wouldn't it be a lot simpler if we all just moved there?

We all love government rules, regulation and email@example.com:blogger.com,1999:blog-19929098.post-90657920793633325312014-11-13T09:12:53.571-08:002014-11-13T09:12:53.571-08:00Since police departments are merely standing civil...Since police departments are merely standing civilian armies, abolish them and leave it up to citizens to provide their own security as their own expense and liability. If this were the case, victimless crimes would remain unprosecuted and people who break into private homes would wind up in morgues.vonuhttp://email@example.com:blogger.com,1999:blog-19929098.post-65833222275481674742014-11-13T06:59:47.775-08:002014-11-13T06:59:47.775-08:00Greetings You wrote: "We all have made ourse...Greetings

You wrote:
"We all have made ourselves believe that cops and prosecutors wear the white hats. After all they are the good guys who can always be trusted never to mislead you, right? "

That is a flat-out lie. I don't believe that these skanks wear white hats. Nor do you, right?

So why, in an essay about lying, do you lie?Doc Ellishttp://firstname.lastname@example.com:blogger.com,1999:blog-19929098.post-68302480108104457502014-11-13T02:56:33.629-08:002014-11-13T02:56:33.629-08:00What amazes me out west in LA: the extent of evide...What amazes me out west in LA: the extent of evidence amplification and the suborning of jailhouse informant perjury. They pull some mutt out of county lockup and tell him what to say; then they turn one ounce into a pound--- and get away with it easily. Add to that the threat to take children away from parents, and you have institutionalized email@example.com:blogger.com,1999:blog-19929098.post-72737751595148730742014-11-13T02:55:40.048-08:002014-11-13T02:55:40.048-08:00What amazes me out west in LA: the extent of evide...What amazes me out west in LA: the extent of evidence amplification and the suborning of jailhouse informant perjury. They pull some mutt out of county lockup and tell him what to say; then they turn one ounce into a pound--- and get away with it easily. Add to that the threat to take children away from parents, and you have institutionalized email@example.com:blogger.com,1999:blog-19929098.post-31698396650753542392014-11-12T06:43:54.929-08:002014-11-12T06:43:54.929-08:00What a great post, Paul! I'm sure the Ministr...What a great post, Paul!

I'm sure the Ministry of Truth will be in touch... They don't like lies like "2+2=4" and "blue is blue" and what you said. They prefer, "black is white; day is night."

There are a lot of folks that live in Lala Land, trusting the justice system (sic) to be ... well ... just. Once in a while, it is. This mostly happens when you keep yourself far, far away from it. ...makes you want to dig a hole and crawl in, or be a character in a true-life The Moon Is A Harsh Mistress... or something.

Lately, we see multitudes of terrible cases of abuse, overreach and falsification by cops, but also by all elements of the system…

We see criminal conspiracy among even judges. See Attorney Richard Fine's story (L.A. County, CA, 2010) of illegal solitary coercive confinement here: http://www.fulldisclosure.net/2010/12/richard-fine-wins-his-freedom-exclusive-full-disclosure-interview/#14157986447281&38440 The judge that did that should be on trial for capital obstruction of justice—"capital" because he's a violent, felonious judge, not just some "unknowing" violent felon.

It doesn't take much of a scratch to scratch and sniff U.S. "administration of justice" and be overwhelmed by the stench of the injustice. But most people, like abused children too fearful to admit that their parents are monsters—it's terrifying (resultant of "official" terrorism?—THAT is where the "War on Terror" should be directed. But … by whom?) to live in a country where the wheels of justice (sic) grind the bones of the innocent.

People have to be willing to see what is right in front of them, quit denying, recognize the monstrosity, and by sheer will of noncompliance, break it. It won't go quietly into the night, but when it strikes in that Stalin-level murderousness that is completely predictable, that way everyone knows who's the aggressor.Indy Reasonerhttp://email@example.com:blogger.com,1999:blog-19929098.post-25282385836397454442014-11-12T05:07:48.465-08:002014-11-12T05:07:48.465-08:00Did anyone investigate whether DeSouza and /or Mic...Did anyone investigate whether DeSouza and /or Michelle Blaine knew Lana Clarkson? DeSouzxa's first call was not to 911 but to Michelle Blaine, supposedly because he had to ask her for the address to Spector's house(as if he didn't know it, even thouigh he worked for Phil and driven to and from his houise many times). That was total BS, and it indicates that he and Ms. Blaine may be the key to unlocking this whole puzzle.Alan firstname.lastname@example.com:blogger.com,1999:blog-19929098.post-47897491817226487172014-11-12T03:22:47.177-08:002014-11-12T03:22:47.177-08:00Kim Wilde, I lived with the deception of lying for...Kim Wilde, I lived with the deception of lying for over 40 years and you are so correct about how often people lie ! We lie about anything and everything ! I accepted JESUS as my personal Savior and through HIS Grace no longer have to lie about anything. It is so refreshing to be able to tell the truth about everything always! Ask JESUS to forgive you of your sins and to cleanse your heart and HE will not only forgive you, but HE will set you free !email@example.com:blogger.com,1999:blog-19929098.post-57237057663004706282014-11-11T17:57:35.320-08:002014-11-11T17:57:35.320-08:00Soon a cop brings a suspect to the witness in a po...Soon a cop brings a suspect to the witness in a police car. The witness assumes that the cop somehow found the right person and they want to help the cops.

A prime example of this is the case in Florida, "Murder on a Sunday Morning". If you never heard of it, look it up. Brenton Butler. Thank goodness he was email@example.com:blogger.com,1999:blog-19929098.post-77944941455728952412014-11-11T17:54:40.884-08:002014-11-11T17:54:40.884-08:00Soon a cop brings a suspect to the witness in a po...Soon a cop brings a suspect to the witness in a police car. The witness assumes that the cop somehow found the right person and they want to help the cops.

A prime example of this is the case in Florida, "Murder on a Sunday Morning". If you never heard of it, look it up. Brenton Butler. Thank goodness he was firstname.lastname@example.com:blogger.com,1999:blog-19929098.post-80962290983675458702014-11-11T16:14:09.010-08:002014-11-11T16:14:09.010-08:00What a turn of events for the defense. If this is ...What a turn of events for the defense. If this is indeed factual, I hope that whole department that was part of prosecution team including "Mr. Prosecutor" himself, are held accountable. Hopefully Ms. Arias will be released. She has more than paid her debt back to society. Great article Mr. Huebl!Lynne Richards 101http://email@example.com:blogger.com,1999:blog-19929098.post-34304839164359945052014-11-10T23:58:56.206-08:002014-11-10T23:58:56.206-08:00Paul you are an honor to the chicago police dept! ...Paul you are an honor to the chicago police dept! And ..............neener neener I told you so...

19 paul and put a lunch ticket behind THIS one Brother! firstname.lastname@example.com:blogger.com,1999:blog-19929098.post-76675714587399863022014-11-10T22:09:33.554-08:002014-11-10T22:09:33.554-08:00let's set Julianne Darius free I am really sic...let's set Julianne Darius free I am really sick of this trial

let's set Jodi arias free I am very sick of this trial she's been locked up for 6 yearsset her free now

don owenshttp://email@example.com

subset: commoncrawl


text:
Tech at Night: Here they go again with the Census. Do not do a comprehensive Communications Act.
Here we go again. The last couple of times, they wanted to use "statistical sampling" to replace the Constitutionally-mandated direct enumeration in the Census. Now they want to use onlineRead More »
Tags: aaron swartz, Aereo, Bitcoin, census, Communications Act, Consumer Watchdog, copyright, EU, FCC, fred upton, Google, Greg Walden, Molon Labe, NSA, Tech at Night


text: Leonardo DiCaprio as J. Edgar Hoover: First Look Previous Next « Back to Story Replay 1/7 Leonardo DiCaprio with dark hair and sharing a smoke on the set of 'J. Edgar'. Leonardo is playing a young J. Edgar Hoover, filming in Los Angeles, CA. « Back to Story Share Tweet


text:
Welcome to julianna's Member Page
See my Clippings See my Journal See my trade list Send me an email
Been on GW since 1998! Sad it reset my membership date :(
I live in: United States
My zone is: 7bAR
My Birthday is January 29 .
My favorite forum 1 is Balcony Gardening.
My favorite forum 2 is House Plants.
First registered on August 01, 2001 .


text:
Welcome to the Chippewa Flowage
The Fall Season on the Chippewa Flowage and area is where you want to be for fishing, fall color tour, a break from a busy schedule at home and work, a time with girlfriend/spouse/fishing buddy/a son/a daughter or just go "up north" for a long week end.
Fall is the wonder of color change in our forests and the migration of birds is a sight to enjoy. These are moments that must be experienced - - - join us on the Chippewa Flowage.
As the daylight time becomes shorter, we begin to sense a shift in wind and the approaching fronts from the West----the Loons, local Canadian Geese, our Whitetail deer Black Bear, summer birds, Red Squirrels, Chipmunks, and many other home creatures are already in a sense of urgency-prepare for the inevitable change in weather and cold conditions that will decade upon the Flowage and area in the months ahead.
Musky fishing has shifted to a pattern for lake water turn-over, very cold water, strong northwest winds, dropping weeds, a increasing lake level and unpredictable dice weather - - - anglers know how to deal with the elements and dream about the potential for a fish of a lifetime.
Crappies are on the wood structure, schooled up, around planted fish cribs, and are feeding----the "slab crappie" is yours for the taking. Walleye fishing has been terrific all summer on the Chippewa Flowage----anglers followed a pattern of weed development, near deep water drop offs, and a search and find/catch mode. The fall pattern will be similar except; go deeper, locate fish on the bottom structure, use larger live bait, fish mid lake deep water humps, and be patient on the set before the hook set.
Be somewhere this Fall Season----come join us on the Chippewa Flowage and area!!
Associate Members
Outdoor Reports
|Making Ice!
|Outdoors Report from Johnson's Resort 10-10-2014
|Outdoors Report from Johnson's Resort 10-03-2014
|Outdoors Report from Johnson's Resort 09-26-2014
Don't forget to enjoy the awesome fall colors while you are bringing in fish
|Outdoors Report from Johnson's Resort 09-19-2014
Read previous news here
Fishing Report
Date: 2014-11-26
Well....ice fishing season is finally here. There are not many people heading out yet, but there is some fishable ice out on the Flowage and Round. The ice depth varies from 2 inches in some spots and 5 inches in others. Make sure you if you go out you definitely dress warm as it has been a bit colder up here for this time of year, and be careful on the ice. When in doubt, err on the side of caution because there are some areas where it is not thick enough to fish through yet.


text:
Welcome to SEOhaus, we are a team of search engine marketing professionals that help websites rank on the first page of Google and other major search engines through strategic search engine optimization (SEO) services. If you are looking for a way to increase your website's search engine visibility and to generate more targeted traffic to your website, you've come to the right place.
With locations across the globe, we are one of the net's leading web marketing & SEO firms. We understand that getting you to page 1 is our job, but that you need expert advice from experienced Marketeers who will help maximize your conversions. As your SEO agency, we will not only get you to page 1, but help you make the most of your traffic. The internet is by far the most tapped into source of information and in 2014 is the first place your customers will look for you.
If you are looking for a professional SEO firm that gets results, contact us today.
Recent Blog Posts
Leverage your product: How to make sure it's worth growing
Product demand Sit down and ask yourself. Are you answering the needs of the consumer? Will they miss you if you were not in the market place. If your answer is is less then 40% you should revise until you … Continue reading →
Single vs. Multiple Word Queries
As Google has evolved to better understand who its users are and what they want, SEO companies are continually pushed to reevaluate their onsite optimization strategies. With the search giant zeroing in on perfecting the "answer engine," keyword strategy is … Continue reading →
Tracking Time: Eye-Opening Insights Into Productivity
Here at the haus, we are always looking for ways to improve our systems internally and better improve the services that we provide to our clients. In an effort to streamline many of our internal processes and procedures, we recently … Continue reading →
Our Company
| Results
| Services
| Specialties
| Case Studies
| SEO Blog
| Careers
Our Philosophy
| News
| Resources
| Tools
| Partner
| Free Quote
| Privacy Policy
| Sitemap
| Contact
| Terms
©2014 SEOhaus - a San Diego SEO Firm & Internet Marketing Company - Search Engine Optimization
1047 University Ave. San Diego, CA 92103 | 59 Crosby St. #1 New York, New York 10012
Web Design by CreativeHaus


text:
Added Jan 21, 2014
by sewwrong
Boston, Massachu...
This cardi is massive: it's basically a giant circle with two holes in the center where the sleeves are inserted. That's it! The pattern envelope claims there's many different ways you can wear this – I didn't find that to be the case, but if you're feeling silly, you can wear it as a hoodie.
Sew Wrong: http://www.sew-wrong.com/2014/01/pattern-review-circle-top-papercut.html
Merino wool knit crepe from Metro Textiles, Circle Top pattern from Papercut Patterns
Jan 22, 2014, 02.47 PMby bjr99
Fantastic sweater!!!
Add to Favorites 2 people added it
Editors' Picks
We have marked down 50 sewing pattern to $2.99 only until Monday, so hurry!
Backstage Report
Our fabulous BurdaStylers of course! Today, save 30% Site-Wide With Code ThankYou14!
Editors' Pick
Satin takes the stage in this new collection of dresses, skirts, and fluttery tops.
Find out more about our three fabulous courses starting this week!
Backstage Report
Choose from one of 5 popular dresses.
You must allow our "request for permission" request to login to Burdastyle with Facebook.


text:
Find records of Mabel Bennett
Find birth, death, marriage, military, and other records of Mabel E Bennett at Ancestry.com.Search for records
Biography & Family History Add details
Mabel E Bennett (1908 - 1997) was born on December 25, 1908. She was born into the Bennett family.
There are no known marriages or children on file for Mabel. Mabel died on November 17, 1997 at age 88.
Mabel E Bennett's last known residence is at Comanche, Comanche County, Texas.
The data on this page comes from the official record for Mabel E Bennett in the SSDI (United States Social Security Master Death Index). According to information provided to the SSDI, this death record has been verified by a family member of the deceased. This data can be considered very accurate. What is the SSDI?
This profile of Mabel E Bennett's past is maintained by AncientFaces members Add any information you have to reach the people who knew her. Some things we would like to know about Mabel's genealogy:
- Where was Mabel born?
- Where did Mabel die?
- Who was Mabels family?
- What did Mabel look like? Add some photos of their life.
Family Tree & Genealogy Add / Edit People
You can add or remove people from this genealogy by clicking here.
History of Mabel E Bennett Add details
- Given name
- Mabel
- Surnames
- Bennett family history
- Last Known Residence
- Comanche, Comanche County, Texas
- Born
- Death
- Gender
- Female
Do you know more about Mabel E Bennett?
You can add details to this page and share Mabel's story.
Obituary Add details
No one has entered any info on the obituary records of Mabel. You can add obituary information about Mabel E Bennett by clicking "Add Details".
Discuss Mabel
Share your memories below with the rest of Mabel's family. We'll notify anyone else who is searching for Mabel of your message.
Find records of Mabel Bennett
Find birth, death, marriage, military, and other records of Mabel E Bennett at Ancestry.com.Search for records
Possible Relatives
- N K Bennett
- ·
- Marguerite Louise Bennett
- ·
- Katie Bennett
- ·
- Harry Bennett
- ·
- Naomi Bennett
- ·
- Clara Bennett
- ·
- Garlene Bennett
- ·
- Willie Ira Bennett
- ·
- Pama Bennett
- ·
- Inez C Bennett
- ·
- Ollie L Bennett
- ·
- Ruth Bennett
- ·
- Margaret Bennett
- ·
- L L Bennett
- ·
- Elouise Bennett
- ·
- Susan Bennett
- ·
- Joel Bennett
- ·
- Carol Suzanne Bennett
- ·
- Nina L Bennett
- ·
- James Bennett
- ·


text:
The Mum-Hub: An Exclusive Parental Social Club
I have never seen any dads in the hub. Not even partners. The hub is usually a child-free zone too, a place of mothers in conversation while their children fend for themselves. This day there were lots of crying and distressed pre-school children who needed the attention of scattered lone parents, before their actual parent in the hub noticed.


text:
Dennisport House Rental Photos and Description
3 Bathroom, 1 Bathroom, 8 Sleeps
Dennisport, MA Home Rental
Come enjoy the peace and tranquility of the Nantucket Sound this summer in our 1,000 sq foot ranch located in a quiet neighborhood. This lovely year round home features 3 bedrooms, 1 bath and sleeps 6
It is located just 1/2 mile from the very beautiful and clean Glendon Road beach.
This home has all freshly painted interior and gleaming oak hardwood floors. All new bedding/comforters and window decor. The landscape and patio area on the property was just designed by a landscaper and is exquisite. Cable, TV, WiFi.
Long term renters welcome, Non smoking only, children welcome, minimum age limit for renters, suitable for elderly, and please no 4 legged friends.
- Suitability:
- Minimum Age Limit for Renters
- children welcome
- non smoking only
- pets not allowed


text:
Colognole Rufina Villa Rental Photos and Description
Villa, 4 Bedrooms, 3 Baths, (Sleeps 8)
Only one mile from Porta Romana Square (Piazzale di Porta Romana), a historical gate into the heart of the city of Florence, this beautiful typical Florentine villa dates back to the XVth century and is ideally located on the hill of 'Poggio Imperiale' immersed into the beauty of the Tuscan countryside, surrounded by olive groves, gardens and fruit trees.
The property looks out onto the beautiful Florentine hillside as well as Villa del Poggio Imperiale - from 1737 to 1860 residence of the 'Lorena' family, the Austrian Granddukes of Tuscany - and the Arcetri observatory where Galileo Galilei continued his astronomical research after being called to Florence in 1610 by Cosimo II dei Medici.
Location details: The villa is located only about one mile away from where the historical district of the city of Florence begins (Porta Romana square). The city center is thus easily and quickly accessible either by bus, taxi or rental car. The 'heart' of the city center, such as world renowned Ponte Vecchio bridge and the Uffizi museum are only about 3 km (1.9 miles) away. The main train station (Santa Maria Novella) and Piazza Duomo only 4 km (2.4 miles) away.
The nearest bus station is within walking distance from our villa, as it is only about 0.4 mile away. At the same location of the bus stop there is also a few groceries stores, take-out places, restaurants/pizzerias, a pharmacy, etc..
The villa has been recently completely renovated and comes with two different setups available for rent:
The first setup, (for up to 6 guests), features:
3 double bedrooms (master bedroom with attached walk-in closet), 2 bathrooms (of which one with Teuco shower/tub), living room with 32' lcd tv and sky satellite tv channels, dining room, fully furnished kitchen, private garden with teak wood table and outdoors rattan chairs, small laundry room, gated parking and private swimming pool (size: 36 x 18 feet).
The second setup, (for up to 8 guests), features:
4 double bedrooms (master bedroom with attached walk-in closet), 3 bathrooms (of which one with Teuco shower/tub), living room with 32' lcd tv and sky satellite tv channels, dining room, fully furnished kitchen, private garden with teak wood table and rattan outdoors chairs, small laundry room, gated parking and private swimming pool (size: 36 x 18 feet).
Prices are all inclusive: 2 hrs. of daily housekeeping 6 times a week, 3 weekly towel changes, 1 weekly linens change, wi-fi internet connection, satellite tv, air conditioning, private swimming pool, private garden, gated parking and final cleaning.
On demand we can also have a cook available to prepare either breakfast, lunch or dinner directly at the villa for our guests.
Keywords: Villa
- Suitability:
- Long-term Renters Welcome
- children welcome


text:
Kennett Square
Sales Manager Jobs in Kennett Square, Pennsylvania
475 Kennett Square, PA Sales Manager jobs found on Monster.Jobs 1 to 20 of 475
JOB DESCRIPTION Buffett Senior Healthcare® Sales Representative About Us Sales - Sales Manager - Sales and Marketing - Healthcare Sales - Sales Representative Buffett Senior Healthcare Corp. (BSH) is a revolutionary marketing organization that is on the leading edge of the future in senior market healthcare sales. As of 8/2013, BSH is backed by the wealth of $120,000,000,000 (billion) from sev...
If you are confident in your abilities and would like the opportunity to try something new we are looking for energetic people with 5+ year's business ownership or sales experience who would like an opportunity as an Outside Sales Rep with our company. SMS is the largest full-service business development firm serving small to mid-sized businesses in the US. Through the coordinated efforts of our ...
Company Confidential West Chester, PA, 19382
Southeastern Regional Sales Manager Food Service & Hospitality Industry Company Confidential. A successful 50 year progressive manufacturer of unique food service and hospitality "disposable" products, has an exceptional opportunity for an experienced, creative and results-focused Southeastern US Regional Sales Manager. This dynamic sales professional must be able to generate and develop direct ...
A Delaware-based leader of LIMS Integration Solutions is seeking a Sales Manager to join their team. This will be a home office based position which can be located anywhere in the USA. You will be selling services that offer expertise on critical business issues involving LIMS, ELN, CDS and SDMS. Responsibilities include: Co-developing and executing their Sales and Marketing Strategy; Leading ...
Industrial Instrumentation - Technical Sales & Marketing Manager (West Chester, PA) About the Job: An Industrial Instrumentation Manufacturer is currently hiring a Technical Sales Manager to lead its US national team at their West Chester PA, Corporate Office. This is an excellent opportunity for the right sales professional looking to make that next step in a career and join an outstanding gro...
Area Sales and Service Manager Service Radio Rentals is the premier supplier of two-way radios andhas been specializing in Motorola Two-Way communications for the Petro-Chemical, Pulp & Paper and Power Industries for the past 15 years.We Inventory over 10,000 (Intrinsically Safe) radios & repeaters with over 500 frequencies across the United States. We are a national company with 8 support facili...
"Taking Your Career to New Heights!" Providing professional, exceptional, and distinctive marketing campaigns throughout the Southern New Jersey / Philadelphia Region. The Invictus Group is a sales and marketing firm contracted by Fortune 500 clients to maximize their growth and customer services. Our direct marketing methods are capable of reaching 90%-99% of our client's specific target market...
Company Confidential Glen Mills, PA, 19342
As one of the top promotional marketing and sales firm, we are seeking motivated and hard-working Entry Level Inside Sales Manager Trainees to join our growing team. The goal of the position is to prepare you for a sales management role. If you are a fresh college graduate who is seeking a company to grow with and are looking to begin an exciting and rewarding career in sales, this is the ideal op...
"Work hard, play smart and have fun!" PC Connection, a leading provider of information technology solutions to small and medium-sized businesses nationwide, has consistently been recognized for its commitment to service. We recognize that our Inside Sales Account Managers are the cornerstone to our success. If you are a motivated individual with a desire to work in an industry that constantly evo...
STC Direct is currently offering sales and marketing positions that include comprehensive training. No prior sales experience is necessary and we will train you to learn a variety of skills from sales and human resources to management and mentoring. Successful candidates will have opportunities to advance through the organization. As a fast paced company in the direct sales and marketing industry,...
Are you an experienced Customer Service representative with excellent communication skills and a drive to advance your career? Do you want a work/life balance? Take advantage of our globally-ranked training programs to help you transition into a rewarding Sales career! Our Sales Agents come from various backgrounds and we have many successful Agents that do not have sales or insurance experience,...
Are you an experienced Customer Service representative with excellent communication skills and a drive to advance your career? Do you want a work/life balance? Take advantage of our globally-ranked training programs to help you transition into a rewarding Sales career! Our Sales Agents come from various backgrounds and we have many successful Agents that do not have sales or insurance experience,...
Are you an experienced Customer Service representative with excellent communication skills and a drive to advance your career? Do you want a work/life balance? Take advantage of our globally-ranked training programs to help you transition into a rewarding Sales career! Our Sales Agents come from various backgrounds and we have many successful Agents that do not have sales or insurance experience,...
OVERVIEW The Tile Shop is now hiring Sales Professionals, Design Professionals, and Leaders for management development. Who are we? We at The Tile Shop believe a home is best judged by the feeling that it gives when you walk in, take your shoes off, and stay awhile. There is no easier way to transform the functional monotony of a house into a home that dramatically captures the personality of y...
Overview: Digital Advertising / Media Consultant - Outside Sales If you can't wait for the next new product to be launched, and networking on Facebook & LinkedIn is second nature to you, we've got a great opportunity for you! We are seeking tech-savvy, Digital Advertising - Media Consultants who are passionate about social media, SEO and driving sales. This is not your average sales opportunity...
The Invictus Group is rapidly expanding! We are an outsourced sales/ marketing/ management firm who's contracted by large corporations to help sell, market, and promote new products and services. We are high performing competitors each with an athletic background which we utilize to maximize positive results. Our management team feels as though passion, teamwork, competitive drive and camarader...
Description Overview: As a Sales Supervisor, you will support My Macy's and drive sales for a specific selling area in partnership with a Sales Manager. You will be responsible for assisting the Sales Manager by supervising all daily selling activities and leading a selling team in your selling area. Responsibilities include, assisting in the selling process; driving customer service through coa...
Company Confidential glen mills, PA, 19342
We are a leading Marketing Event / Promotions firm in the Blue Bell, PA area. We are looking for innovative, team-oriented individuals who enjoy working with others and maintaining relationships with our prestigious clientele. Our Fortune 500 Client's are quickly growing creating a larger need for our promotional marketing and sales representatives. All promotional marketing representatives receiv...
Well established and growing manufacturer has immediate need at headquarters in Newark DE Job Purpose: Supports customers, brokers, and sales managers by processing orders, invoices, sample requests, and trade promotions for specialized manufacturer in Newark DE. Duties: * Maintains customer satisfaction by establishing rapport with customers and others in a position to help meet customer need...
Sales Professional Job Label:ARI_Sales Do you love interacting with people on a daily basis? Are you someone who consistently beats your goals whether it is at work or home? We are a Farmer's Insurance Agency in Thorndale (Chester County) PA looking for a dynamic, energetic, and hungry sales professional. You will have the opportunity to work with one of America's insurance industry leaders wher...
Get new jobs by email for this search
We'll keep looking and send you new jobs that match this search.
Upload your resume and let employers find you!
It's that simple!
Related Job Titles
Sales Career Tools
Sales Manager
$41,800.00 - $165,000.00
Typical Salary for Sales Manager in Kennett Square
(33 Respondents)
Source: Monster.com Careerbenchmarking Tool
Education / Training
(18 Respondents)
Source: Monster.com Careerbenchmarking Tool
Sales Manager
Directs distribution of a product; sells products by implementing sales plans; supervises sales staff; analyzes sales statistics; forecasts future sales; manages customer relationships.
Rate of Growth
8.30 %
Size of Industry in 2006:
Source: Bureau of Labor Statistics, May 2006
Related Skills
Active listening
Building Relationships
Decision Making
Related Duties
Confer or consult with upper management to plan selling services and to secure information on equipment and customer specifications.
Establishes sales objectives by forecasting and developing annual sales quotas for regions and territories; projecting expected sales volume and profit for existing and new products.
Popular Sales Manager Articles
Sample Resume for a Sales Manager
Does your resume effectively sell your track record in sales? This resume sample for a midlevel sales manager will show you how it can.
Marketing Jobs
Jobs in marketing are wide-ranging, encompassing all forms of media and a variety of disciplines and specialties. Explore marketing careers now.
Sample Resumes by Industry
Writing a resume specific to your industry is a great way to be a star candidate. If you need help customizing your resume to your field, check out these resume examples for various careers.
The Jobs Behind the Big (Football) Game
Even though you're no professional football player, you can still be part of the action come game day. Check out this list of jobs that make each game possible.
Sample Resume for a Retail Manager
Does your resume do a good job selling your skills for retail manager jobs to potential employers? Compare it to this sample resume to find out.


text:
HAZEL HURST – Customer connections in the Lantz Corners Sewer District should be completed by October.
Dan Slagle, project engineer, gave this bright forecast Monday at a meeting of the Hamlin Township Board of Supervisors in Hazel Hurst.
HARRISBURG – Attorney General Kathleen G. Kane on Monday announced the arrest of a St. Marys man as part of ongoing efforts to target the online sharing, downloading and distribution of child pornography.
A "motive" and an "opportunity" are keys in identifying suspects in arson cases in McKean County.
Ray Learn, who as district attorney (DA) is the county's top prosecutor, said "insurance fraud" is the most common "motive" for arsonists and represents the "biggest chunk" of arson cases.
Friends' Memorial will soon be mailing Annual Fund Drive letters to area residents and local businesses and organizations.
SMETHPORT – McKean County is seeking proposals for the use of nearly $540,000 in Marcellus Shale gas well revenue.
Joe DeMott, chairman of the county Board of Commissioners, said Friday the revenue is from the state Act 13 impact fee paid by drillers of Marcellus Shale gas wells.
The county itself will use some of this Act 13 revenue balance, which has built up over a two-year period. However, the bulk of the remaining pot will go for eligible projects throughout the county, DeMott said.
SMETHPORT – It's official.Â
Andrew Johnson of Port Allegany is the new director of the McKean County 911 emergency communications center near Smethport.
The Kane Area Industrial Development Corporation (KAIDC) plans to develop the former Kane Magnetics complex at 700 Elk Ave.
The first step in utilizing the buildings for industrial development calls for a cleanup of contaminated groundwater at the 17-acre site.
JAMES CITY – A state agency is cutting off monthly pension payments to former Highland Township Supervisor Charles Vaughn.
The pension of $332.92 per month for Vaughn has been paid by the Trustees Insurance and Retirement Services-- part of the Pennsylvania State Association of Township Supervisors (PSATS).
Tickets now are on sale for the Kane High School musical-- "Bye Bye Birdie."
Mary and Scott Dinger's three children enjoy the Shrove Tuesday Pancake Dinner at the Tabor Evangelical Lutheran Church on Greeves Street in Kane. The happy diners are, left to right: Emilie, 10; Patric, 7; and Mollie, 8. The Lutheran Men hold the dinner to raise money for a Seminary Student Scholarship Fund. The Northwestern Pennsylvania Synodical Lutheran Men in Mission sponsors the fund.


text:
THE GLOBAL HEART AWAKENS!! Well friends, we passed the dark point of the year back at Winter Solstice, 2012, and we survived. Now we are moving into the light again, rounding the bend to celebrate humanity's most precious asset: LOVE. … Read more
- 11/28/2014 - 11/30/2014
7 Windows to the Soul at Semperviva Yoga Studio
Vancouver, Alberta
- 12/04/2014 - 12/07/2014
Chakra Yoga Teacher Training
Yoga Yoga Westgate
Austin, Texas
- 01/16/2015 - 01/18/2015
Intro to Chakra Therapy: East meets West at Dallas Yoga Center
Dallas, Texas
- 02/13/2015 - 02/16/2015
Activating Your Chakras:
Awaken Your Energy Body
Lenox, Massachusetts
- 02/16/2015 - 02/20/2015
Creating on Purpose: Manifesting Heaven on Earth Through the Chakras
Lenox, Massachusetts
- 03/06/2015 - 03/13/2015
Psychology of the Chakras: 7 Keys to Awakening Your Personal Journey
Ubud, Indonesia
- 03/28/2015 - 04/01/2015
Chakra Therapy Training Intensive
New York, NY, New York
Join our Mailing List to receive our monthly Newsletter and a FREE GIFT!


text:
Photos and Description of this 5 bedroom holiday villa in La-Tranche-sur-Mer - Le Pavot
Short walk to fantastic Beach through fabulous pine forest trails
La Tranche, Vendee, West Coast of France. New build property, traditional French style five bedroom, two bathroom beach villa on the edge of La Tranche sur Mer in small exclusive estate of Quichenottes. The villa is just a 10-15 minute walk through the pine woods along a cycle track to the superb long soft sandy beaches the Vendee is famous for, and walking distance to the delightful French seaside town of La Tranche sur Mer, one of the loveliest and most unspoilt holiday destinations in France. With large private heated (all year round system) pool, garden, wireless broadband, and all mod cons. Ideal property for self catering French gite rental holidays. France at it's best, with superb beach and heated pool. Villa has large 36 m sq open plan lounge/dining area with Satellite TV and DVD library. Large modern kitchen with French breakfast bar and all mod cons. Includes dishwasher, microwave, fan oven, electric hob.
- Suitability:
- Long-term Renters Welcome
- Low Allergen Environment
- children welcome
- non smoking only
- pets not allowed
- suitable for elderly or infirm


text:
Choose your preferred language. We speak English and 41 other languages.
Most often used by people in the United States
All languages
Saved to list
Save to a list
Bohemia, United States of America
1630 Lakeland Avenue, Bohemia, NY 11716, United States of America – Show map
Low rates
No booking fees • Save money! Best price guarantee — enter dates to see these prices!
2 properties in Bohemia
Including hotels, apartments, villas and more.
64 verified reviews
We verify all reviews from guests who have stayed at Lakeland Inn - Bohemia. Find out more.
They speak your language!
Lakeland Inn - Bohemia's staff speaks: English
Booking is safe
When you book with us your details are protected by a secure connection.
WiFi is available in all areas and is free of charge.
Free public parking is available on site (reservation is not needed).
Vending Machine (drinks), Vending Machine (snacks), 24-Hour Front Desk
Non-smoking Rooms, Heating, Air Conditioning
From 1:00 PM
Until 11:00 AM
Cancellation and prepayment policies vary according to room type. Please enter the dates of your stay and check what conditions apply to your preferred room.
Children and Extra Beds
All children are welcome.
All children under 18 years stay free of charge when using existing beds.
Cribs are not available.
Extra beds are not available.
There is no capacity for extra beds in the room.
Pets are not allowed.
Cards accepted at this property
Hover over the cards for more info.
Ideal Alternatives for You
Guests are required to show a photo ID and credit card upon check-in. Please note that all Special Requests are subject to availability and additional charges may apply.
Based on 64 reviews
Value for money
Show reviews from:
Sort by:
La Quinta Inn & Suites Islip MacArthur AirportFeaturing a free airport shuttle, this Long Island hotel is just half a mile from the Long Island MacArthur Airport. Facilities include free Wi-Fi access.
Score from 85 reviews Very good
Clarion Hotel and Conference CenterThe Clarion Hotel in Ronkonkoma, NY features easy access to shopping at the Islandia Shopping Center, Sunvet Mall and Smith Haven Mall.
Score from 29 reviews Review score
SpringHill Suites Long Island BrookhavenFeaturing an indoor pool and fitness center, this hotel is located less than a mile from Route 27. Guest rooms at SpringHill Brookhaven come with a mini-refrigerator and microwave.
Score from 52 reviews Very good
This Comfort Inn is located off the Long Island Expressway, a 15 minutes' drive from the Long Island MacArthur Airport. The Medford hotel offers a gym and spacious rooms.
Score from 58 reviews Very good
the lady at the front office tried to charge me a $1.00 for a cup o coffee in the morning and 25 cents for a paper clip. I asked for a microwave and she said it would be $5.00 more to change me rooms so I agreed and then she proceeded to tell me that there was no room clean with a microwave and the housekeeper was about to go home and she wasn't going to ask him to clean the room. hardly any channels on the tv.
Very clean. Friendly people working the front desk.
The bed was hard as concrete, very uncomfortable:-(
Hardly anything. Just the location. It was terrible.
Staff. The bathroom shower and tub were broken. Heating unit literally fell apart when I pressed a button. Cigar marks on blankets. Dirty walls. The worse was the staff- the women who cleaned my room one day moved all of my stuff around and I'm still looking for stuff.
I would never stay at there again w had booked our room for 2 nights. Our room was not very nice there was burn marks on the rug and the bed spread My husband said he did not fell safe . I contacted Booking.com and the helped me cancel the second night and we moved to a differnet hotel
I got a king size bedroom for 88 dollars and it was worth every penny. The room was very clean, really good space, and it has a flat screen TV which in the pictures only showed the old TVs which it was a relief. I highly recommend this place.
I liked the cleanliness.
I didn't like the staff. I didn't like the bad wifi connection. I didn't like the fact that you had to pay for a cup of coffee. The vending machine took my money more than once. No shampoo or lotion. Overall it was ok. Nothing to brag about.
Clean - bathroom, towels, sheets, and most of room. Non-smoking room did not stink of smoke like other reviews stated. Based on the area, the room price was a welcomed bargain. If you can get a room for under $100 for a one night stay, and it not make you wonder what the hell did I get myself into, you've done ok. Desk staff was courteous. Bottom line - for "bargain" price paid, you got mostly clean room to sleep & shower in undisturbed for a one night stay over. Would probably stay here again if needed to be in area.
Not many amenities in the room. No clock, but could get a wake up call. The carpet was in desperate need of steam cleaning. DO NOT walk around bare foot - bring flip flops or something. The carpet felt damp all over. Feet - then socks - got dirty walking on the carpet. Limited tv service, but as stated, you aren't usually at a motel for the channel selections.
Bugs n room cigarette burns n bed linens horrible mattress looks like a haunted house. Picture when booking room looks nothing like hotel. 1st room they gave me had no bathtub. Toilet wouldn't flush.Toilet paper n n toilet. They gave me new room. Riff raft hanging out n parking lot. I slept with a softball bat. Very uncomfortable. Had to turn TV on to go asleep. To much outside noise.
People doing drugs in the room next door people fighting all night , people yelling. Never a gain will I stay there.
Price - $80 before taxes Good taste in the pictures hung on the walls. Friendly staff
I stayed two nights; there was no maid service to make the bed after the first night. WiFi very slow. No clock in room. No continental breakfast, and diner was across a six-lane highway with difficult access by car, and no crosswalk for pedestrians. Staff seemed uninformed about the town--couldn't tell me where the post office was. Cigarette burns on the tub.
it was the cheapest price I can find in the area.
The non-smoking room was not non-smoking.The room smelled like someone just smoked in the room. Had to keep fan or air conditioning on at all times.
Location, staff, discretion, price
Not a five star by any means but serves its purpose
No refig or microwave or iron and ironboard
The price was good for what we needed it for. We only needed a place to sleep. We were not spending lots of time in the hotel so we were looking for something cheaper. The beds we're comfy and clean. The wifi worked really well.
The walls could have been reprinted and there was garbage bag left in the room. The tv had barely any channels that worked. The front desk staff were not friendly.
It is a good motel.
The location is not good. It is a noisy at night. because it is very close to the road
wet carpet inside door door had to be manipulated with key to turn. Bath lever didn't work to take shower, had to be late for morning appt. to get fixed.
The room stunk like pot..rugs all dirty n burn holes..thn chkd in late in thy charged 10.00 dollars extra...never again....
The Receptionists were all nice.
The room was not very clean. There was a old donut under the bed, open bag of popcorn, a water bottle, a lot of dust/dirt all under the bed. I asked for a non-smoking room, & it was stinking of cigarette smell, whenever any one in the other rooms are smoking it came in our room (217). Overall LAKELAND INN SHOULD NOT BE IN BUSINESS. THE FACILITY IS IN TOTAL NEED OF A COMPLETE RENOVATION. I WILL NEVER COME BACK THERE, & I WILL TELL OTHERS NOT TO STAY AT THAT FACILITY.
The ac unit was filthy to the point u see mold on the vents , and on top of the bed since the ac it's right next to it, also bathroom filthy hairs all over the floors if it wasn't because my wife need it to rest to take a test next day, I would off ask for a refund on my card n immediately n leave the place but I was late and we need it some rest,, very poor service and or cleaning staff,,, would NEVER stay there ever again!!!!
The place was not friendly and it was not that clean I found a few things that was really poor about the out side the that was scary so I would not tell anyone else to stay here.
Everything about the places.
I would not recommend this hotel unless you are not bothered by stained carpets, unclean bed sheets and a bed with a woodenframe rather than a boxspring.
Location close to airport.
The room smells like cigarette
Right now I'm trying to get my money back because they had bugs
We've negotiated with thousands of hotels to get the very best deals. We call them Secret Deals and they only last for a limited time.
You can get these deals for free by subscribing to our newsletters. You can even choose your favorite destinations to receive personalized deals.
Get started now by entering your email address. We'll instantly send you a link to our Deal Finder!
Don't worry – your email address is safe with us. We'll never share your private information and you can unsubscribe at any time.


text:
Disney Junior's PIRATE AND PRINCESS: POWER OF DOING GOOD, a Pro-Social Touring Event, Begins Thursday, July 17 in Philadelphia
"Pirate and Princess: Power of Doing Good," a pro-social touring event to introduce kids age 2-7 to the value of doing good, including caring for nature and animals and helping others, will begin THURSDAY, JULY 17 in Philadelphia before carrying on to Washington D.C., New York, Chicago, Houston, San Francisco and Los Angeles. Designed for kids and families, the tour is sponsored by Disney Junior, ASPCA, Youth Service America (YSA), National Wildlife Federation and First Book.
Tickets are required - they are free to the public and available now at DisneyJunior.com/powerofdoinggood.
"Through the power of our stories and characters, we can help the youngest of children imagine a better world and reflect on what they can do to help others within their own communities," said Nancy Kanter, Executive Vice President, Original Programming and General Manager, Disney Junior Worldwide. "Our 'Pirate and Princess: Power of Doing Good' summer tour will do exactly that by engaging kids and parents in activities that not only highlight community service but also empower them to take these learnings and continue the work amongst their friends, families and neighbors."
The event will engage kids in positive actions that benefit others through the benevolent characters and stories in Disney Junior's popular series "Sofia the First" and "Jake and the Never Land Pirates." Each tour stop will include opportunities to create a storybook at "First Book's Jake and Sofia's Storytelling Maze," share acts of kindness or service at home or school in "YSA's Enchancia Castle," participate in the "ASPCA's Sofia's Animal Friends" activities, engage in interactive lessons of environmental conservation in the "National Wildlife Federation's Jake's Beach Treasures" and to pledge continued service at the "Forever Tree."
About Author
- Anna Kendrick and Jeremy Jordan-Led THE LAST FIVE YEARS Movie to Hit Theaters, VOD on Feb 13
- Photo Flash: Key Art for GIRLS Season 4 Released
- 'BREAKING BAD (Original Score From The Television Series) Volume 2' Double LP Out Today
- President Obama Praises Icons Meryl Streep, Alvin Ailey and More at Medal of Freedom Ceremony
- NBCUniversal & Millennial Trains Project Announce New Partnership
- Official: Rachel McAdams, Taylor Kitsch & Kelly Reilly Join Cast of HBO's TRUE DETECTIVE
- Showtime to Air HOMELAND, THE AFFAIR Marathons this Weekend
- David Dobkin to Direct AMC's BADLANDS Pilot
- Cast of FINDING NEVERLAND to Perform on ABC's GOOD MORNING AMERICA on Thanksgiving
- NBC to Air NATIONAL DOG SHOW PRESENTED BY PURINA, 11/27


text:
To add to the great tips
To add to the great tips that other members have posted here -
Try eliminating all grains, sugar and anti-nutrients from the diet; eliminate A1 diary; eliminate beans and legumes and even nuts (can re-introduce them later if needed). Also try to hit a low-carb, high-fat, moderate-protein composition in his diet.
A healthy gut is important for the immune system. Also try to achieve ketogenic state in the kid, so that his brain function is optimal. Ketogenic diets (think coconut oil) have long been used against epilepsy and is now also found useful against Autism, depression and many other gut-brain issues - https://en.wikipedia.org/wiki/Ketogenic_diet#Other_applications
Good luck to your son. Food is medicine and we should take full advantage of it :)
- Login to post comments


text:
Shared Departure Transfer: Rome Hotels to Fiumicino Airport
- Shared transfer from Rome hotels to Fiumicino Airport
- Stress-free way to get to the airport
- Relax in a spacious, air-conditioned vehicle
- Friendly and professional driver
- Service available 24 hours a day, seven days a week for the Rome area
Recent Photos of This Tour
What You Can Expect
When making a booking, you will need to advise your flight details and your hotel accommodation details. Your transfer will be confirmed instantaneously and you will be provided a travel voucher to present to the driver. Approximately 24 hours prior to your departure from Rome, you will be required to reconfirm exact pickup time and place (contact info will be provided on your confirmation voucher).
Price is per person, based on eight adults per car/vehicle.
Please note: This service is only available for transfers from selected Rome hotels. Click on the 'View Additional Info' button below to see the hotels that are not included.
Customer Reviews
Marsh M
November 2014
The shuttle which was actually a late model Mercedes sedan was on time and quite comfortable for the 40 minute ride to the airport. The driver was courteous, impeccably dressed and professional.
November 2014
On time for my hotel pick-up and on time for my arrival at the airport. Traffic between Rome and FCO is epic. This is the only way to beat it. Plus I love being able to prepay from home in my own currency and not have to juggle foreign funds as I'm leaving the country and heading home. (Works arriving too!)


text:
Ex-Evercore dealmaker pleads guilty to insider trading
03 April 2014
Frank Perkins Hixon Jr. pleaded guilty to insider trading on Wednesday, punctuating the downfall of the former senior dealmaker at Wall Street fixture Evercore.
Take a Financial News trial today:
- Breaking industry news & commentary
- 10 year searchable archive
- FN Powerlists & Special Reports
- FN on mobile and iPad
Does your company already have an FN licence? Email us now


text:
$10,000 reward offered in University of Michigan student's murder
Updated On: Aug 30 2013 08:36:22 AM EDT
A $10,000 reward is being offered to find who killed a University of Michigan medical student.
Ann Arbor police and the University of Michigan are offering the reward.
Tips can be called or emailed to 734-794-6939 or email@example.com.
Student, Air Force lieutenant found dead:
Paul DeWolf, 25, was found dead in his apartment on July 24. He had died from a single gunshot.
DeWolf failed to arrive for a scheduled assignment at the Veteran's Affairs Hospital, so it sent a colleague to the home to check on him, police said. That person discovered DeWolf had died.
DeWolf, a 2010 graduate of Grand Valley State University, was to graduate from the medical school next spring. He is from Schoolcraft.
DeWolf also was an active duty second lieutenant in the U.S. Air Force.
Jen Hemberg, who had known DeWolf since the fall of 2010 when they both began medical school, said he got along with everyone and loved making others laugh.
"Paul was one of those people that knew everybody and knew everything about everybody, because he liked being around people," she told AnnArbor.com.
DeWolf was a cross country and track standout at Schoolcraft High School.
Coach Dave Sanders said DeWolf had a bright future ahead of him.
"I feel a real sense of loss, but not just for me personally," Sanders told MLive.com. "Even more so for the people in his life that would have benefited from him achieving his dream and the contribution he was going to make to society and those around him."
The views expressed below are not those of Click On Detroit, WDIV, or its affiliated companies. By clicking on "Post," you acknowledge that you have read the Terms of Service and your comment is in compliance with such terms. Readers, please help keep this discussion respectful and on topic by flagging comments that are offensive or inappropriate (hover over the commenter's name and you'll see the flag option appear on right side of that line). And remember, respect goes both ways: Tolerance of others' opinions is important in a free discourse. If you're easily offended by strong opinions, you might skip reading comments entirely.


text:
Sex toys and sex toy shopping can be very intimidating for some people. I get emails and facebook me messages all of the time from women and couples who have no idea where to start. And, there are just some people who will NEVER walk into a sex toy store no matter what. It is just not in their personality no matter how "female oriented" a store is designed. (Some people are even shy buying online and over the phone!)
Stress Triggers for Kids- Overwhelmed Families(EXPERT)
Stress Triggers for Kids How do you know what is stress and what is a temper tantrum? How do you figure out if the stomachache is from too many tacos last night or the math test scheduled today? Why would your six year old be stressed when you are the one who lost the job? Why would your eight year old suddenly hate Little League and begin wheezing as it nears time to go? At times all parents are confused by what are normal growing pains and what is a genuine fear or stress in their child's life.
The power behind every great husband is a smart wife
Smart wife The true meaning behind the title is really quite simple, a smart wife understands how to make her husband happy. In the idea alone this will contribute to making him a more successful man. The old saying is not quite the same because you can have a good woman behind a man so to speak, but a smart wife is really going to make him successful. What exactly is a smart wife and what does she do to make her husband successful?
Looking for love in all the web pages
Now you can cast your bait into many seas hoping that cupid will find you the perfect match with the perfect chemistry that supplies the spark for perfect harmony. Today the search for Miss or Mr. Right is no longer the never-ending maze of frustration that it used to be. Singles no longer have to endure the 'happy hour drinks and winks for phone numbers' or desperately dance their way into their destinies.
Any way you want it, that's the way you need it, fetish dating
Fancy my fetish There are many advantages at your fingertips in this new world of online dating sites. In the search for your perfect match, you are not only able to key in the height, weight, age, race, religious preference and locale of a potential partner, but now you can also key in any specific kink that you may desire. New online fetish dating sites are popping up on a daily basis.
Male sexuality, what all women need to know about their man?
As a sex counselor I help men from around the world with various sexual issues and I have learned from each of my clients something new. There is no such thing as a" know it all" in the business of human sexuality. My male clients talk about sexual fetishes, ways they get turned on or even their basic lack of knowledge concerning their own body when it comes to sex.
4 Bold Changes To Make In Your Marriage
Everyone knows that once you get married, there are certain expectations you're supposed to follow. Expectations that make men feel like they have signed their lives away, and make women think that they'll never have to worry about being betrayed or alone. Once you're married there are "rules" such as, "You can't cheat.", "You can't flirt.", "You must love and be attracted only to your partner." What most people don't realize is that following those rules goes against the grain of our human experience.
Want Celebrity Skincare?
Everyone is trying to find miracle cures for their skin ailments. Lotions, oils, peels; some even go as far as facial reconstructive surgery. Celebrities too have skin problems, regardless of what you may see in the tabloids and magazines, and go to extremes to try and fix their problems.
Reasons Why A Woman Cheats In The Marriage
The reasons a woman cheats may be different than why a man does. In this article we will look at the psychology of why women cheat and how they do it. In the past ten years the amount of women that cheat in marriage has gone up considerably, the one problem is getting a realistic pole on this more taboo subject. The cheating from a woman seems to be much more of a secretive past time, because the man she cheats with are not likely to spill the beans.
That Doesn't Work for Me
"THAT DOESN'T W0RK FOR ME." I spend most of my time working with clients to focus on the positive in their lives and relationships. We uncover limited beliefs and create new empowering ones. We discover values they didn't know they had and then we cook up a vision for their life that begins to unfold like magic. We do all of that and more. After all that wonderfully fulfilling work there comes a moment where I have to break it to them gently.


text:
Cloud Nine Original Iron - Limited Edition
was $299.00
Special Price $269.10
Dermalogica PowerBright TRx Treatment Kit
was $49.50
Special Price $41.09
Pelactiv Hydration Station Pack
was $82.00
Special Price $73.80
Alpha-H Luxe Limited Edition
was $99.00
Special Price $81.18
Thalgo Exception Ultime Coffret
was $249.00
Special Price $225.00
evo love is in the hair pack
was $89.85
Special Price $80.87
MOROCCANOIL Home & Away Original Oil Set
was $82.50
Special Price $69.95
Ecoya French Pear Large Gift Set
was $109.95
Special Price $98.96
Elemis Ultimate Gift of Pro-Collagen
was $520.00
Special Price $468.00
ASAP Summer Skin Essentials
was $215.00
Special Price $134.10
A New Breed of Beauty
Since our inception into the online world in 2007 we have made enormous leaps towards becoming...
Find your Youngblood colour
Love your loose mineral foundation but not sure which shade of liquid foundation is right for you...
Why use a serum?
Your moisturiser does the job, or does it?
The difference between a good quality...
Welcome to Alive Skin + Hair
Alive Skin + Hair is home to over 3,000 haircare, makeup, beauty and skincare products. We're proud to bring you top brands Dermalogica, Thalgo, MorocconOil, ASAP Skincare, Alpha H and more.
Trusted & loved by thousands of people across Australia & New Zealand, we consistently deliver genuine, quality products that truly make a difference.
With same day dispatch on most orders, Alive reward points and free express delivery on orders over $99 you'll love shopping with Alive Skin + Hair.
We offer a 100% authenticity guarantee on every product we sell with the confidence of a price match promise. You can trust that when you shop with us for skin care products you'll get nothing but the best.
I's not always easy to figure out which products are right for your skin, hair and body. Our experienced & friendly team can help make this process simpler by providing you with tailored advice on which skin care products may be best for you. You can trust in our team, who have all been extensively trained!
Enjoy the extensive collection of cosmetic products brought to you by Alive Skin + Hair. If you have any questions don't hesitate to call us on 1300 688 088.