Simultaneous resection of colorectal cancer with synchronous liver metastases: A survey-based analysis.
Bibliographic record
Abstract
e15073 Background: Patients with colorectal cancer and synchronous liver metastases may undergo simultaneous or staged resection. Methods: We electronically surveyed members of the Society of Surgical Oncology, Canadian Hepato-Pancreato-Biliary Association and the College of Physicians and Surgeons of Ontario with a pilot-tested questionnaire. Four clinical scenarios were presented. Perceived outcomes of and barriers to simultaneous resection were assessed on a Likert scale using Mann-Whitney U and Chi-square tests for ordinal and categorical variables, respectively. We compared results between general and hepatobiliary surgeons. We sought to determine surgeons’ attitudes and perceived barriers to simultaneous resection and compare them between general and hepatobiliary surgeons. Results: The response rate of 20% (234/1166) included 50 general and 134 hepatobiliary surgeons. A high likelihood score (Likert ≥5-7) for support of simultaneous resection among general and hepatobiliary surgeons, respectively, included the following: for minor liver and low complexity colon, 83% and 98% (p < 0.001); for minor liver and rectal resection, 57% and 73% (p = 0.042); for complex liver and low complexity colon resection, 26% and 24% (p = 0.858); and, for complex liver and rectal resection, 11% and 7.0% (p = 0.436). Among hepatobiliary surgeons, the most common barriers for simultaneous resections were patient comorbidities and extrahepatic disease, whereas general surgeons additionally identified transferring care to another facility. Lack of information regarding non-responders is relevant given our relatively low response rate. Our respondents mostly worked in academic settings, which may not be representative of the majority of surgeons who manage colorectal cancer. Conclusions: Surgeon support for simultaneous resection increased with less complex surgery and was similar among hepatobiliary and general surgeons. Surgeons’ perceived practice patterns and barriers to simultaneous resection should inform clinical trials and disease care pathways.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".