Comment on “RAS/TP53 co-Mutation is Associated With Worse Survival After Concurrent Resection of Colorectal Liver Metastases and Extrahepatic Disease”

Abstract

Quality of Life Questionnaire Lung Module 13 (LC13), and Functional Assessment of Cancer Therapy lung cancer specific module. Although both tools have acceptable feasibility and validity, they are not interchangeable and their variable emphasis on different aspects of QOL has affected their clinical utility in patients with lung cancer. 2 The European Organization for Research and Treatment of Cancer modules were also validated in a cohort of patients with inoperable lung cancer, their use, therefore, is limited amongst resectable lung cancer patients as in our analysis. 3,4 Our aim -to evaluate the prevalence, trajectory, and predictors of the most common cancer-associated symptoms -was best served by the Edmonton Symptom Assessment System (ESAS). The ESAS is a well-validated cancer PROM that offered meaningful population level information from over 14 million users in the province of Ontario. 5 Other practical limitations to population-wide implementation of diseasespecific PROMs include balancing the need to obtain additional information and overburdening patients with additional questionnaires at the time of their clinic visit. It is also challenging to classify patients based on disease-site in the context of a populationwide symptom screening initiative. We acknowledge that the clinic-based nature of ESAS screening does not capture symptom burden of patients who are managed outside of a regional cancer center and/or hospitalized patients. Accurate measurement also hinges on highly variable patient factors, including language and culture. The burgeoning interest in PROMs is expected to galvanize national and provincial agencies, such as the Canadian Institute for Health Information, the US National Institutes of Health and Cancer Care Ontario, to standardize and improve ways to measure patient reported outcomes remotely and across various clinical settings.Second, the classification of procedures to define our cohort is important. We utilized Canadian Classification of Health Interventions codes, which were developed and validated and now maintained by the Canadian Institute for Health Information to facilitate the capture of health care interventions. 6 These codes are based on the generic type of procedure performed and entered into the database by expert thirdparty coders. We included all patients undergoing sublobar resection (ie, any partial lobar excision), lobar resection (ie, any total lobar excision including sleeve lobectomy), and pneumonectomy. There are strict standards, which mandate coders to specify