Comparison of Total Tumor Volume, Size and Number of Colorectal Liver Metastases in Prediction of Survival in Patients after Liver Resection

Liver is the most common location of the colorectal cancer metastases occurrence. Liver resection is the only curative method of treatment. Unfortunately it is feasible only in 25% of patients with colorectal liver metastases, often because of the extensiveness of the disease. The aim of the study was to evaluate the predictive value of total tumor volume, size and number of colorectal liver metastases in patients treated with right hemihepatectomy. Material and methods. A retrospective analysis was performed in a group of 135 patients with colorectal liver metastases, who were treated with right hemihepatectomy. Total tumor volume was estimated based on the formula (4/3)πr3. Moreover, the study included an analysis of data on the number and size of tumors, radicality of the resection, time between primary tumor resection and liver resection, pre-operative blood serum concentration of carcinoembryonal antigen (CEA) and carcinoma antigen Ca19-9. The predictive value of the factors was evaluated by applying a Cox proportional hazards model and the area under the ROC curve. Results. The univariate analysis has shown the predictive value of size of the largest tumor (p=0.033; HR=1.065 per each cm) on the overall survival, however no predictive value of number of tumors (p=0.997; HR=1.000) and total tumor volume (p=0.212; HR=1.002) was observed. The multivariate analysis did not confirm the predictive value of the size of the largest tumor (p=0.141; HR=1.056). In the analysis of ROC curves, AUROC for the total tumor volume, the size of the largest tumor and the number of tumors were 0.629, 0.608, 0.520, respectively. Conclusions. Total tumor volume, size and number of liver metastases are not independent risk factors for the worse overall survival of patients with colorectal liver metastases treated with liver resection, therefore increased values of these factors should not be a contraindication for surgical treatmen

Systemic treatment of non-small cell lung cancer - recommendations based on the results of reliable clinical trials

Rak płuca jest w Polsce najczęstszym nowotworem złośliwym. W wielodyscyplinarnym leczeniu chorych na niedrobnokomórkowego raka płuca, stanowiących około 80% ogółu chorych na raka płuca, coraz większą rolę odgrywa chemioterapia, a w ostatnich latach - także stosowanie leków ukierunkowanych na swoiste cele molekularne. W roku 2005 opublikowaliśmy zalecenia dla praktyki klinicznej dotyczące systemowego leczenia niedrobnokomórkowego raka płuca i międzybłoniaka opłucnej. W związku z licznymi nowymi doniesieniami, obecnie stało się konieczne ich uaktualnienie. Przedstawione tu zalecenia stanowią wspólne stanowisko ich autorów - grupy ekspertów w dziedzinie onkologii, torakochirurgii, patomorfologii i pneumonologii.Lung cancer is in Poland the most common malignancy. Non-small cell lung cancer (NSCLC) accounts for approximately 80% of all lung tumors. In the multidisciplinary treatment of non-small cell lung cancer patients the role of chemotherapy and, most recently, molecular targeted therapy is increasing. In 2005 we published recommendations for systemic treatment of non-small cell lung cancer and mesothelioma. As many new studies have been published since, it was necessary to update this document. We present here a consensus statement on this topic, prepared by a panel of experts in oncology, thoracic surgery, pathology and pneumonology