First, a systematic and substantial overestimation of residual tumour on MRI within 48 h of resection, indicating that late MRI months after surgery is more suitable to determine the extent of resection than an early MRI days after resection.
The prognosis is better for localized disease, with a 5-year survival of 25.8%. 1 Patients with early-stage disease respond well to surgical interventions; however, only 15 20% of patients are suitable for resection due to the lack of sensitive serum biomarkers for early diagnosis.
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For the patient suitable for resection the surgeon needs to know that the disease is confined to the pancreas and that a standard resection will encompass the tumour.
After ascertaining that PRs were suitable for resection, the next step was to ensure that the selected patients were fit to undergo the operation.
In another study, Leung et al (1999) used cisplatin, doxorubicin, and IFN- α and reported that this treatment converted nine patients of 36 patients with inoperable HCC to become suitable for tumour resection, and none developed postoperative recurrence.
Localized RCC is generally considered to be suitable for surgical resection, but almost 30% of the patients with limited disease at the time of surgery develop metastasis within the next 3 years [ 2].
We designed a clinical trial to include patients with newly diagnosed localised or metastatic osteosarcoma (see supplementary Material, available at Annals of Oncology online) of the extremity or axial skeleton deemed to be suitable for complete resection of all disease sites.
RFA was recommended as the best treatment option for patients with early stage HCC who are not suitable for resection or transplantation in addition to PEI in the 2005 practice guidelines issued by the American Association for the Study of Liver Diseases [ 9].
These include the use of neo-adjuvant chemotherapy to down stage hepatic disease (Fig. 3), pre-operative portal vein embolisation to hypertrophy remaining liver segments prior to resection of diseased segments, two stage resections to ensure sufficient liver parenchyma remains after all the metastases are removed and radiofrequency ablation of tumours not suitable for resection 36 40.
