FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W101889580> ?p ?o ?g. }

• W101889580 endingPage "4, 1086" @default.
• W101889580 startingPage "1078, 1083" @default.
• W101889580 abstract "We congratulate Dr. Weiser and colleagues for an excellent and concise review of the approaches available for colorectal cancer patients with a limited number of metastases, defined as “oligometastatic disease.”[1] This commentary provides us with the opportunity to revisit the concept of “oligometastatic disease” that was developed in the era predating the use of effective chemotherapy, when surgery predominantly defined patient outcomes. At that time, a small number of metastases was considered a sign of favorable biology. Today up to 25 % of patients with metastatic colorectal cancer are candidates for resection of colorectal liver metastases (CLM). Patients with CLM encompass a broad spectrum of clinical presentations, and new concepts of prognostication are emerging. To achieve optimal outcomes, patients with CLM should undergo a planned sequence of therapeutic interventions that include perioperative chemotherapy and surgery. The surgeon and the medical oncologist are pivotal in keeping the patient on a therapeutic track that will optimize the benefits derived from chemotherapy and surgery. In this commentary, we provide approaches and perspectives that represent alternatives to the important concepts discussed by Weiser et al. We have organized our remarks around five key questions raised by the authors. 1. Should the number of lesions still be included in the criteria used to select patients for surgical resection? In 2003, Altendorf-Hofmann et al demonstrated no survival differences between patients who underwent R0 resection for 1 to 3, 4, 5 to 7, or 8 to 11 metastases (Figure 1).[2] In light of these data, we think that response to modern chemotherapy may help determine the biology of the disease better than the number of lesions. In recent studies, pathologic response to chemotherapy predicted outcome and outperformed the traditional predictors of outcome, including the number of metastases.[3]These findings may explain why the resection of multiple CLM was associated with more favorable long-term outcomes in previous studies. Because the number of lesions does not necessarily correlate with the biology of the disease, we use high-quality CT scans to assess the radiologic response to chemotherapy—which correlates with pathologic response.[4] The specific radiologic criteria we use go beyond the Response Evaluation Criteria In Solid Tumors and include morphologic changes in the CLM (eg, homogeneous loss of enhancement with well-defined margins) as a size-independent predictor of outcome.[5] In addition, we have shown that RAS mutations (KRAS and NRAS) predict poorer overall and disease-free survival, as well as a pattern of early lung recurrence in patients undergoing resection for CLM.[6,7] On multivariate analysis, RAS mutational status outperformed traditional predictors of outcome, such as the number and size of CLM. Because RAS mutational status is highly concordant (> 90%) between the primary tumor and the CLM, this prognostic information can be obtained early in the evaluation of the disease via pretreatment biopsy or from the resected primary tumor. 2. Does a small number of lesions define the extent of resection and the approach? One or two lesions may call for limited liver surgery in some patients, but if unfavorably located (eg, involvement of two hepatic veins), these few lesions may necessitate extensive resection. This could have a direct impact on decisions regarding the type and sequence of surgical procedures or the use of perioperative therapy. In patients with unfavorably located lesions, preoperative portal vein embolization may be useful prior to surgery and should be integrated into the multidisciplinary" @default.
• W101889580 created "2016-06-24" @default.
• W101889580 creator A5003399621 @default.
• W101889580 creator A5063972129 @default.
• W101889580 creator A5085656655 @default.
• W101889580 date "2013-11-01" @default.
• W101889580 modified "2023-09-23" @default.
• W101889580 title "In patients with colorectal liver metastases, can we still rely on number to define treatment and outcome?" @default.
• W101889580 cites W1586939666 @default.
• W101889580 cites W1972571009 @default.
• W101889580 cites W1974494579 @default.
• W101889580 cites W1994513558 @default.
• W101889580 cites W2052009655 @default.
• W101889580 cites W2056742269 @default.
• W101889580 cites W2063985381 @default.
• W101889580 cites W2089564445 @default.
• W101889580 cites W2110915643 @default.
• W101889580 cites W2125452425 @default.
• W101889580 cites W2131266547 @default.
• W101889580 cites W2148133880 @default.
• W101889580 cites W2149529787 @default.
• W101889580 cites W2151062573 @default.
• W101889580 cites W2155710441 @default.
• W101889580 cites W2246516118 @default.
• W101889580 cites W2413236505 @default.
• W101889580 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/24575535" @default.
• W101889580 hasPublicationYear "2013" @default.
• W101889580 type Work @default.
• W101889580 sameAs 101889580 @default.
• W101889580 citedByCount "4" @default.
• W101889580 countsByYear W1018895802015 @default.
• W101889580 countsByYear W1018895802017 @default.
• W101889580 countsByYear W1018895802020 @default.
• W101889580 crossrefType "journal-article" @default.
• W101889580 hasAuthorship W101889580A5003399621 @default.
• W101889580 hasAuthorship W101889580A5063972129 @default.
• W101889580 hasAuthorship W101889580A5085656655 @default.
• W101889580 hasConcept C118552586 @default.
• W101889580 hasConcept C121608353 @default.
• W101889580 hasConcept C126322002 @default.
• W101889580 hasConcept C141071460 @default.
• W101889580 hasConcept C143998085 @default.
• W101889580 hasConcept C27415008 @default.
• W101889580 hasConcept C2776694085 @default.
• W101889580 hasConcept C2779013556 @default.
• W101889580 hasConcept C2779134260 @default.
• W101889580 hasConcept C31174226 @default.
• W101889580 hasConcept C526805850 @default.
• W101889580 hasConcept C61434518 @default.
• W101889580 hasConcept C71924100 @default.
• W101889580 hasConceptScore W101889580C118552586 @default.
• W101889580 hasConceptScore W101889580C121608353 @default.
• W101889580 hasConceptScore W101889580C126322002 @default.
• W101889580 hasConceptScore W101889580C141071460 @default.
• W101889580 hasConceptScore W101889580C143998085 @default.
• W101889580 hasConceptScore W101889580C27415008 @default.
• W101889580 hasConceptScore W101889580C2776694085 @default.
• W101889580 hasConceptScore W101889580C2779013556 @default.
• W101889580 hasConceptScore W101889580C2779134260 @default.
• W101889580 hasConceptScore W101889580C31174226 @default.
• W101889580 hasConceptScore W101889580C526805850 @default.
• W101889580 hasConceptScore W101889580C61434518 @default.
• W101889580 hasConceptScore W101889580C71924100 @default.
• W101889580 hasIssue "11" @default.
• W101889580 hasLocation W1018895801 @default.
• W101889580 hasOpenAccess W101889580 @default.
• W101889580 hasPrimaryLocation W1018895801 @default.
• W101889580 hasRelatedWork W2364051953 @default.
• W101889580 hasRelatedWork W2378448584 @default.
• W101889580 hasRelatedWork W2381416288 @default.
• W101889580 hasRelatedWork W2388808113 @default.
• W101889580 hasRelatedWork W2392730113 @default.
• W101889580 hasRelatedWork W2413655619 @default.
• W101889580 hasRelatedWork W2783552007 @default.
• W101889580 hasRelatedWork W2981597760 @default.
• W101889580 hasRelatedWork W3004259476 @default.
• W101889580 hasRelatedWork W3130224122 @default.
• W101889580 hasVolume "27" @default.
• W101889580 isParatext "false" @default.
• W101889580 isRetracted "false" @default.
• W101889580 magId "101889580" @default.
• W101889580 workType "article" @default.