Biomedical Sciences — Online GDP1

Benefits of Hepatic Resection for Noncolorectal Nonneuroendocrine Liver Metastases Based on Histology, Shannon Banks, Jason Brinkley, Timothy Fitzgerald

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4 thoughts on “Biomedical Sciences — Online GDP1

  1. bankss09

    In response to Mr. Kulas

    Thank you for the questions regarding our poster.
    You are correct. Figures 2.1 and 2.2 are the same data but on a different scale. Figure 2.2, a zoomed in version of figure 2.1 without the error bars, allows the reader to better visualize how each subtype relates to the rest of the group. A list of the exact numbers for each group and subgroup was considered for inclusion on the poster. However, if enlarged the table would have gone beyond the poster margins.

    To answer your second question, the difference in survival rates for certain cancers when compared to others in the subgroup may be attributed to several factors. These may include the number of articles highlighting that particular group, the disease free interval, whether the discovery of the primary cancer and the liver metastasis was simultaneous, and the prognosis/success rate of treating the primary cancer.

    In order to address the variance within certain subgroups, particularly those with less than 50 articles, we are actively seeking additional papers.

    If you have any additional questions, please don’t hesitate to ask.

  2. bankss09

    Thanks for your comments as they prove valuable in helping us create the best poster possible. In a paper on this work we would include a list of the original publications used in this analysis. A few of them are listed in the Reference section while the rest could not be listed due to the limited space.

    To clarify, this project sought to examine the overall survival rates of patients with various histologic types who underwent hepatic resection alone for treatment of their NCNLM. We were interested in the overall survival rates, but only in patients who had hepatic resection as opposed to hepatic resection along with other interventions(cryoablation, radiation, or chemotherapy) for their liver mets. The patients included in this analysis did in fact only undergo hepatic resection. A limited number of studies mentioned whether or not their patients underwent R0, R1, or R2 resection. They differ in the ability to resect all of the tumor with no signs of cancer in the remaining margins, resecting the tumor with microscopic remains in the margin, and resecting the tumor with macroscopic remnants in the margins.

    We chose to search using the term liver resection so that we were not excluding any possible articles that were relevant to our criteria. We felt it was better to start out broad and then narrow things down as opposed to being so specific that we prematurely discarded articles for possible inclusion.

    The 1984 inclusion date is an arbitrary number that was agreed upon by those involved in the research. It was done in an attempt to insure an adequate number of articles on each subtype would be included in this analysis. It was an attempt to prevent one subtype or one overall group from having seemingly better or worse results by making the pool somewhat even across the board.

    Once again, thank you for your feedback and please let me know if you have any further questions.

  3. kulasa

    Hello Shannon, Tim, and Jason,
    My name is Tony Kulas and I am a secondary judge for your poster. I have already read Dr. Kain’s comments and looked over your poster. Let me first just say, that this process you have all gone through looking through and identifying these articles was fantastic. The search process was clearly outlined. I have two questions related to your poster.

    1) Figures 2.1 and 2.2 really show the same data but on a smaller scale. Was this done merely to better see the differences in some of the cancers relative to the overall group means? What value does figure 2.2. have that figure 2.1 does not?

    2) Looking within each category, you might qualitatively say that each category has at least one cancer that had very different survival rates compared to the others in the group. For example, both small bowel and testicular had much higher survival rates compared to others in the respective groups, but uterine was considerably lower in its group. Is there a reasonable explanation for these BIG differences compared to the others in the respective subgroups? Small bowel and uterine also had extremely small standard error bars indicating to me that these cancers survival rates are consistently different then the mean of the overall group.

    Thank you for your time.

  4. kaind

    Hi Shannon, Jason, and Timothy–

    Thank you for submitting your poster. It is very informative. I’m not a medical professional, but I was able to understand much of the information you included in the poster. I was very interested the methods you used for identifying the studies from the literature that you used to evaluate the efficacy of hepatic resection on various types of cancer metastases. In a paper on this work, would you append a list of the publications that you used in your analysis?

    In the introduction to the abstract (and in the introduction), you discuss resection but then you indicate that, “This study aims to present the available research on the overall survival rates of various histological types of NCNLM,” so I was a bit confused about whether you were interested in survival rates overall or just for those patients who underwent resection. The methods section indicates that you searched using the term “liver resection” and you state in the discussion section (to the right of the results) that, “This study highlighted the histological subtypes of 21 different NCNLM for which hepatic resection alone was performed,” which leads me to think that all the participants in all the studies you included did have resections. Maybe a research question that specifically includes reference to the survival rates after resection would be helpful. (It’s possible I’m missing something because I’m not in the field.) Your data reduction process was fairly clear, though I have a couple of questions. I wondered about the 1984 date—why that was one of the criteria and is the reason related to the use of certain types of protocols or something else? I assume also that there was relatively little difference in treatments across the studies selected for inclusion in terms of additional therapies, though that wasn’t explicitly indicated as a criterion for exclusion. Were the treatment protocols primarily the same in all the selected studies (limited to resection)?

    Again, thank you for participating and presenting your work. This research is a huge task and I’m sure your results will be quite useful.

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