1,721,363 research outputs found
Oligometastatic disease in esophagogastric cancer
No full textPatients with limited metastatic esophageal or gastric cancer (oligometastatic esophagogastric cancer) may benefit from local treatment of oligometastases combined with systemic therapy. This PhD thesis investigates the development of a multidisciplinary European consensus on the definition, diagnosis, and treatment of oligometastatic esophagogastric cancer (Part I) and evaluates the incidence and treatment strategies of this disease in clinical practice (Part II). Part I: The “OligoMetastatic Esophagogastric Cancer” (OMEC) project lays a detailed foundation for the approach to oligometastatic esophagogastric cancer. The OMEC project consists of 49 esophagogastric cancer expert centers across 16 different countries in Europe. The project, as described in the study protocol, includes first, a systematic review of the definitions of oligometastatic esophagogastric cancer in the literature and a meta-analysis of outcomes after local treatment of oligometastases; and second, multidisciplinary team considerations from cancer expert centers of real-life clinical cases of patients with oligometastatic esophagogastric cancer. To reach a broadly supported consensus on the best ways to define, diagnose, and treat oligometastatic esophagogastric cancer, the experts contributed to a Delphi consensus process as the third study. This has led, as a fourth step, to a series of recommendations that serve as guidelines for clinical practice. Part II: In studies on oligometastatic esophagogastric cancer in clinical practice, the prevalence and survival of patients with oligometastatic esophagogastric cancer were studied in multicenter cohort studies. These studies show that approximately one-quarter of patients with metastatic esophagogastric cancer have oligometastatic disease. The studies also suggest that the combination of local and systemic therapy can significantly improve overall survival compared to treatments that use only one of these approaches
Is chemotherapy for advanced or metastatic oesophageal squamous cell carcinoma no longer needed?
No full textPrognostic value of microRNA-21 in intra- and extrahepatic cholangiocarcinoma after radical resection: cohort study
No full textDefinitions and treatment of oligometastatic oesophagogastric cancer according to multidisciplinary tumour boards in Europe
No full textBackground: Consensus about the definition and treatment of oligometastatic oesophagogastric cancer is lacking. Objective: To assess the definition and treatment of oligometastatic oesophagogastric cancer across multidisciplinary tumour boards (MDTs) in Europe. Material and methods: European expert centers (n = 49) were requested to discuss 15 real-life cases in their MDT with at least a medical, surgical, and radiation oncologist present. The cases varied in terms of location and number of metastases, histology, timing of detection (i.e. synchronous versus metachronous), primary tumour treatment status, and response to systemic therapy. The primary outcome was the agreement in the definition of oligometastatic disease at diagnosis and after systemic therapy. The secondary outcome was the agreement in treatment strategies. Treatment strategies for oligometastatic disease were categorised into upfront local treatment (i.e. metastasectomy or stereotactic radiotherapy), systemic therapy followed by restaging to consider local treatment or systemic therapy alone. The agreement across MDTs was scored to be either absent/poor (<50%), fair (50%–75%), or consensus (≥75%). Results: A total of 47 MDTs across 16 countries fully discussed the cases (96%). Oligometastatic disease was considered in patients with 1–2 metastases in either the liver, lung, retroperitoneal lymph nodes, adrenal gland, soft tissue or bone (consensus). At follow-up, oligometastatic disease was considered after a median of 18 weeks of systemic therapy when no progression or progression in size only of the oligometastatic lesion(s) was seen (consensus). If at restaging after a median of 18 weeks of systemic therapy the number of lesions progressed, this was not considered as oligometastatic disease (fair agreement). There was no consensus on treatment strategies for oligometastatic disease. Conclusion: A broad consensus on definitions of oligometastatic oesophagogastric cancer was found among MDTs of oesophagogastric cancer expert centres in Europe. However, high practice variability in treatment strategies exists
Can we do without chemotherapy? A perspective on the combinations nivolumab-chemotherapy and nivolumab–ipilimumab in metastatic gastric and esophageal cancer
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Can we do without chemotherapy? A perspective on the combinations nivolumab-chemotherapy and nivolumab–ipilimumab in metastatic gastric and esophageal cancer
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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