Published online Mar 7, 2022. doi: 10.3748/wjg.v28.i9.973
Peer-review started: October 31, 2021
First decision: December 12, 2021
Revised: January 3, 2022
Accepted: January 29, 2022
Article in press: January 29, 2022
Published online: March 7, 2022
Processing time: 122 Days and 19.2 Hours
There remains a persistent unmet need to detect the disease nonresponse (nonDR) subgroup before adjuvant therapy in synchronous liver metastasis patients with colorectal cancer. Ma’s radiomics-clinical nomogram shows potential for the early detection of nonDR subgroups, but it is not good enough owing to at least three limitaions, which we address in this letter to the editor. First, the study did not explore RAS/BRAF mutations, HER2 amplifications, etc. to complement the current nomogram. Second, the nomogram was not validated in left- and right-sided tumors separately. Third, the most critical factor for determining the success of adjuvant therapy should be resectability rather than tumor size shrinkage, which was used in the study.
Core Tip: There remains a persistent unmet need to detect the disease nonresponse subgroup before adjuvant therapy in synchronous liver metastasis patients with colorectal cancer. Ma’s radiomics-clinical nomogram is currently not good enough, as the study did not explore the statuses of certain tumor genes, did not validate the nomogram in left- and right-sided tumors separately, and used tumor size shrinkage rather than resectability to judge the success of adjuvant therapy.