• <tr id="yyy80"></tr>
  • <sup id="yyy80"></sup>
  • <tfoot id="yyy80"><noscript id="yyy80"></noscript></tfoot>
  • 99热精品在线国产_美女午夜性视频免费_国产精品国产高清国产av_av欧美777_自拍偷自拍亚洲精品老妇_亚洲熟女精品中文字幕_www日本黄色视频网_国产精品野战在线观看 ?

    Radiomics-clinical nomogram for response to chemotherapy in synchronous liver metastasis of colorectal cancer: Good, but not good enough

    2022-12-06 12:11:47HanYanTuNanYu
    World Journal of Gastroenterology 2022年9期

    Han Yan,Tu-Nan Yu

    Abstract There remains a persistent unmet need to detect the disease nonresponse (nonDR)subgroup before adjuvant therapy in synchronous liver metastasis patients with colorectal cancer. Ma’s radiomics-clinical nomogram shows potential for the early detection of nonDR subgroups, but it is not good enough owing to at least three limitaions, which we address in this letter to the editor. First, the study did not explore RAS/BRAF mutations, HER2 amplifications, etc. to complement the current nomogram. Second, the nomogram was not validated in left- and rightsided tumors separately. Third, the most critical factor for determining the success of adjuvant therapy should be resectability rather than tumor size shrinkage,which was used in the study.

    Key Words: Synchronous liver metastasis; Colorectal cancer; Radiomics

    TO THE EDITOR

    Maet al[1] recently published a novel study investigating the effect of magnetic resonance imagingradiomics in predicting chemotherapeutic response in synchronous liver metastasis (SLM) patients with colorectal cancer (CRC). They proposed a radiomics-clinical nomogram (including the radiomics score,CA19-9, and lymphatic staging) with an area under the curve of 0.809, suggesting high predictive accuracy.

    We congratulate the authors for their creative work, as in decision-making for adjuvant therapy in CRC patients with unresectable SLM, there remains a persistent unmet need to detect the disease nonresponse (nonDR) subgroup. Early detection of nonDR patients, aided by the radiomics-clinical nomogram of Ma’s study, could result in substantial changes in subsequent therapeutic plans. For instance, in nonDR cases, more aggressive regimens could be applied instead of the frequently used FOLFOX or CAPOX, such as administration of bevacizumab to inhibit vascular endothelial growth factor or pembrolizumab for immunotherapy. Local regional therapies, including radiofrequency ablation and transcatheter arterial chemoembolization,could also be considered to treat SLM.

    However, despite the aforementioned merit, there are at least three limitations to be discussed concerning this nomogram. First, although the authors explored tumor biomarkers, including CEA and CA19-9, to complement radiomics, the statuses of some critical tumor genes (e.g., RAS/BRAF mutations,HER2 amplification, and MSI/MMR status) were not examined, despite the relevant recommendation in the latest National Comprehensive Cancer Network guideline[2]. Second, it is noteworthy that the biological behaviors of CRC differed depending on the anatomical location[3]. For instance, right-sided CRC patients with SLM were unlikely to respond to cetuximab and panitumumab as first-line therapy.Therefore, the performance of Ma’s nomogram should be validated in right- and left-sided CRC separately. Last but not least, the most critical limitation was that the success of adjuvant therapy in CRC patients with SLM should be resectability, rather than tumor size shrinkage used in this study.

    In conclusion, in CRC patients with SLM, Ma’s radiomics-clinical nomogram shows potential for clinical utilization. However, it is currently not good enough.

    FOOTNOTES

    Author contributions:All authors helped to prepare this manuscript; Yan H and Yu TN contributed to manuscript writing, drafting conception and design.

    Conflict-of-interest statement:All authors declare that there are no conflicts of interest, and there was no fund

    supporting this manuscript.

    Open-Access:This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BYNC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is noncommercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

    Country/Territory of origin:China

    ORCID number:Han Yan 0000-0001-8189-6678; Tu-Nan Yu 0000-0003-0866-3178.

    S-Editor:Gong ZM

    L-Editor:A

    P-Editor:Gong ZM

    广宗县| 融水| 白朗县| 永昌县| 自贡市| 永修县| 阿城市| 霍州市| 剑川县| 江西省| 大足县| 固安县| 彩票| 巴林左旗| 越西县| 西乌| 佳木斯市| 馆陶县| 六枝特区| 江孜县| 巴林左旗| 南皮县| 满洲里市| 汕尾市| 海伦市| 蓬安县| 永康市| 白朗县| 庆安县| 上饶市| 西林县| 新田县| 武平县| 上蔡县| 枣强县| 石泉县| 遵义县| 木兰县| 新余市| 新源县| 梧州市|