This Week in Oncology: Colorectal Cancer Prevention and Liver Ablation

From the New England Journal of Medicine, a trial reported that clinicians must weigh uncertain long-term benefits against definite short-term harm when considering aspirin and NSAIDs for colorectal cancer prevention ^[1].

This Cochrane meta-analysis involving 124,837 participants found little to no reduction in cancer incidence or mortality during the first 15 years, while noting that these drugs increase serious bleeding risks. Meanwhile, researchers in Blood advances described high response rates for novel therapies in patients with follicular lymphoma experiencing disease progression within 24 months ^[2].

The analysis of 1242 patients treated with agents like CAR T-cell therapy and bispecific antibodies indicated strong outcomes, though the authors note significant heterogeneity in the data and caution regarding unreported safety information.

Elsewhere this week, a study in the Korean journal of radiology examined ultrasound features associated with neoplastic gallbladder polyps ^[3].

A systematic review of 8,953 patients found that features such as size ≥10 mm and vascularity were significantly associated with neoplastic polyps, with size ≥10 mm showing a sensitivity of 0.79. The authors suggest interpreting these findings cautiously, as associations from observational data do not imply causation. We also saw research in JAMA network open regarding symptom monitoring in cancer patients ^[4].

This secondary analysis evaluated patients initiating chemotherapy across six US hospitals and found that EHR-integrated symptom questionnaires were associated with a decrease in severe and moderate symptom prevalence over 180 days. However, specific symptom severities were associated with higher hazards of death, requiring cautious interpretation of the relationship between symptoms and mortality.

Finally, a separate study in the European journal of surgical oncology evaluated minimally invasive surgical thermal ablation for liver malignancies ^[5].

The meta-analysis included 3983 patients with hepatocellular carcinoma or colorectal liver metastases and indicated high technical success rates and low mortality. While durable local control remains a concern, the authors describe these findings as supportive of the procedure for specific tumor profiles, acknowledging heterogeneity in reporting standards.