European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
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After resection of colorectal liver metastases (CLM), RAS mutations are associated with modest survival benefit and second-line chemotherapy confers limited hope for cure. ⋯ Among patients undergoing resection of CLM after second-line chemotherapy, RAS mutational status is an independent predictor of survival and outweighs other factors to select patients for liver resection.
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Two-stage hepatectomy (TSH) is the present standard for multiple bilobar colorectal liver metastases (CLM), but 25-35% of patients fail to complete the scheduled procedure (drop-out). To elucidate if drop-out of TSH is a patient selection (as usually considered) or a loss of chance. ⋯ Drop-out of TSH could be a loss of chance rather than a criteria for patient selection. "Unselected" OSH patients had the same outcomes of selected patients who completed TSH. A complete resection is the main determinant of prognosis.
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Diverse fractions of patients with locally advanced resectable rectal cancer receive neoadjuvant chemoradiotherapy (NACRT). NACRT is known to decrease physical fitness, an undesirable side effect. This pilot aimed to determine the feasibility and preliminary effectiveness of a supervised outpatient physical exercise training program during NACRT in these patients. ⋯ This pilot demonstrated that a supervised outpatient physical exercise training program for individual patients with locally advanced resectable rectal cancer during NACRT is feasible for a large part of the patients, safe and seems able to prevent an often seen decline in physical fitness during NACRT. A larger study into the cost-effectiveness of this approach is warranted.
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In 2010, the seventh Tumour-Node-Metastasis (TNM) cancer staging system of the International Union for Cancer Control (UICC) and the American Joint Committee of Cancer (AJCC) introduced a subdivision of M1 in the TNM classification of colorectal carcinomas. For the eighth TNM edition which will be released in the autumn of 2016 and will become effective in January 2017 new proposals are appreciated. The aim of our study was to define a new and better proposal for M1 subclassification. ⋯ The new proposal can identify three prognostic groups in stage IV colorectal carcinomas with significant differences in survival.
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Irreversible electroporation (IRE) is a non-thermal based tumor ablation method used close to vessels and ducts and has the potential of treating locally advanced pancreatic cancer (LAPC). The aim of this study was to evaluate the efficacy and safety of IRE in patients with LAPC after chemo- and/or radio-chemotherapy. ⋯ Percutaneous IRE is reasonably safe in LAPC after chemo-/radio-chemotherapy and with promising results regarding efficacy.