Category Archives: Oncology

Simultaneous resection of primary colorectal cancer and synchronous liver metastases

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Kleive D, et al. Simultaneous Resection of Primary Colorectal Cancer and Synchronous Liver Metastases: Contemporary Practice, Evidence and Knowledge Gaps. Oncol Ther. 2021 Jun;9(1):111-120. Free full-text.

Key Summary Points

  • High-level evidence in simultaneous resection of colorectal cancer and colorectal liver metastasis remains scarce.
  • Simultaneous resections may be considered in patients with good performance status and limited liver tumour burden.
  • Simultaneous resections should be avoided when requiring major liver resection and major colorectal resection.
  • Treatment strategies should be made by a multidisciplinary team.
  • Simultaneous resections should be performed as part of a clinical trial.
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Surgical Management of Liver Metastases From Colorectal Cancer

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“Surgical resection remains one of the major curative treatment options available to patients
with colorectal liver metastases. Surgery and chemotherapy form the backbone of the
treatment in patients with colorectal liver metastases. With more effective chemotherapy
regimens being available, the optimal timing and sequencing of treatments are important. A
multidisciplinary approach with the involvement of medical oncologists and surgical
oncologists from the beginning is crucial.”

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Colorectal liver metastases

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“Colorectal cancer (CRC) represents a major worldwide health care burden, as the
second most common cancer diagnosed in women and third most common in men,
and accounting for 10% of all annually diagnosed cancers and cancer-related deaths
worldwide.
As result of improvements in detection through screening, better referral
pathways, centralisation of services, effective primary surgery, development of
systemic chemotherapy, biological agents, and understanding of tumour biology,
survival rates following diagnosis have improved.
Nevertheless, at least 25%-50% of patients with CRC develop colorectal liver
metastases (CRLM) during the course of their illness.”

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Role of Deficient DNA Mismatch Repair Status in Patients With Stage III Colon Cancer Treated With FOLFOX Adjuvant Chemotherapy

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“While most studies have found that patients with dMMR (vs proficient MMR [pMMR]) tumors have a more favorable stage-adjusted prognosis, other studies have not detected a significant difference in clinical outcome or have suggested that any favorable prognostic effect of dMMR is limited to patients with earlier-stage tumors. Furthermore, studies have shown that dMMR tumors may not benefit from fluorouracil-based adjuvant chemotherapy. However, the impact of MMR status remains controversial in the era of the standard FOLFOX adjuvant chemotherapy.
In a pooled analysis, we examined the association of MMR status with disease-free survival (DFS) in patients with stage III colon cancer treated with FOLFOX from 2 phase 3 randomized clinical trials.”

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Feasibility of preoperative chemotherapy for locally advanced, operable colon cancer: Foxtrot Study

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“Preoperative (neoadjuvant) chemotherapy and radiotherapy are substantially more effective than similar postoperative therapy in oesophageal, gastric, and rectal cancer. Earlier treatment might be more effective at eradicating micrometastatic disease than the same treatment 3 months later, the typical period between diagnosis and starting postoperative chemotherapy, particularly because surgery increases growth factor activity in the early postoperative period, promoting more rapid tumour progression.”

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Hemorrhage in Essential Thrombocythemia orPolycythemia Vera

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“Hemorrhage is a well-known complication of essential thrombocythemia (ET) and polycythemia vera (PV), but evidence-based data on its management and prevention are lacking to help inform clinicians”

“Myeloproliferative neoplasms (MPNs) are a group of hematological malignancies individualized in the 2016 World Health Organization (WHO) classification.1 They are subdivided into two groups: chronic myeloid leukemia and Philadelphia-negative MPNs, which are further divided into essential thrombocythemia (ET), polycythemia vera (PV), primitive myelofibrosis (PMF), and prefibrotic myelofibrosis.Philadelphia-negative MPNs are characterized by the chronic proliferation of myeloid cells in bone marrow and three main clonal mutations.”

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For your review: Desmoplastic melanoma

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Nicolson NG, Han D. Desmoplastic melanoma. J Surg Oncol. 2019 Jan;119(2):208-215. doi: 10.1002/jso.25317. Epub 2018 Nov 27.

Desmoplastic melanoma (DM) is a rare melanoma variant that has unique biology and pathology compared with conventional melanoma (non-DM). Importantly, DM is classified into pure and mixed histologic subtypes, which have been correlated with outcomes. Management of DM broadly mirrors that of non-DM; however, there are unique considerations for DM that influence treatment approaches. This paper will provide a contemporary overview of this disease and will review the literature regarding the management of DM.

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