Due to advances in chemotherapy, biologic therapy, and the development of liver-oriented treatment options, the survival of patients with metastatic cancer has more than doubled, and increasing numbers of patients have been cured, even among those with advanced disease.
This article will review the current practice of hepatic resection for colorectal liver metastases, including the possibility of combined resection of hepatic metastases at the time of resection of the primary cancer.
Clinical trial results to date show that men with visceral CRPC metastases do not benefit from ipilimumab, while their counterparts with bone- or node-only metastases do. This suggests that visceral metastases should be a stratification factor for future immunotherapy clinical trials.
Although the mechanism(s) underlying the relatively poor prognosis of prostate cancer patients with visceral disease have yet to be fully elucidated, these new findings suggest that the microenvironment of bone lesions may be immunologically distinct from those at other sites.
The incorporation of molecular subtypes into the locoregional management of breast cancer has lagged behind its use in systemic therapy. Omission or dose-intensification of RT based on subtypes should be investigated in future trials.
The development of CT lung cancer screening, the publication of results from the NLST in 2011, and the grade-B recommendation for CT lung cancer screening in high-risk smokers by the USPSTF raise a number of interesting national health policy issues.
The NLST is a landmark trial demonstrating that implementation of low-dose CT screening lowers lung cancer–related mortality. We must put the study results and cost-effectiveness analyses in the context of the staggering statistics: up to 65% of lung cancer patients present with advanced-stage disease where treatments are often costly, toxic, and only palliative in nature.
NLST data clearly demonstrate that lung cancer screening is effective and safe and reduces lung cancer-specific mortality by at least 20%. There is no possible reason for CMS to further delay or restrict lung cancer screening for those at high risk.