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The clinical presentation of mastocytosis is heterogeneous, ranging from skin-limited to a more aggressive systemic variant [ 1].
It is also possible that surgery is a surrogate indicator of more aggressive therapy overall, including more aggressive systemic therapy, which translates into better survival.
Finally, it is also possible that local treatment is a surrogate marker of more aggressive therapy overall, including more aggressive systemic therapy, translating into better survival.
Luminal B/HER2-negative and triple-negative subtypes identify patients with a higher risk of treatment failure, which might warrant more aggressive systemic treatment.
On the basis of our results, it can be proposed that pretreatment CTC counts may identify in advance patients who have higher risk of developing widespread visceral disease and consequently might benefit from early administration of more aggressive systemic treatments.
Triple-negative and luminal-B/HER2-negative subtypes displayed the worst outcome, including a distant relapse risk which was higher than 10%% in both cases, theoretically justifying a more aggressive systemic treatment.
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The detection of uPA on disseminated tumour cells characterizes a subgroup of patients with an even worse prognosis, who should undergo more aggressive adjuvant systemic therapy.
In addition, further work needs to be done to determine if additional lives could be saved with more aggressive intervention, such as systemic or intravascular thrombolysis, or if quality of life or cost effectiveness could be improved through the use of oral agents.
Rob Spillman, the editor of Tin House, said that after the first Vida count five years ago he had vowed to take more aggressive action to tackle the "systemic issues".
2– 8 These tumors have some similarities with those known as basal-like tumors, since both affect young patients (<50 years old) and have a higher prevalence in women of African descent, besides being significantly more aggressive, with higher risk of systemic recurrence and death than other breast tumors.
They said they had hoped the department would be more aggressive in reforming a system in which the for-profit Corinthian Colleges schools could fail amid allegations of systemic fraud while maintaining full accreditation.
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