CIRSE 2014 Day 2

CIRSE continued full speed today. The fundamentals course on HCC covered basics of clinical, surgical, and interventional management of early and intermediate stage tumors with state-of-the-art talks. All that was lacking was a multi-disciplinary tumor board discussion to highlight the real-life integration of all these options. Philipe Pereira gave a sobering Gruentzig Lecture on the status of IO therapies vis-a-vis various oncologic practice guidelines. We stand quite poorly relative to the volume of evidence available, in part because the level of evidence in the IO literature is low. It was remarkable how often surgery and radiation therapies were prioritized despite much smaller volumes of evidence. Dr. Pereira highlighted that the authorship of these guidelines is infiltrated by these other specialists, who often publish on IO therapies without a single interventional oncologist among the expert panel. Dr. Pereira also faulted the unfortunate tendency in our specialty to quickly publish single-institution experiences, rather than joining in multi-center prospective studies with much higher evidentiary weight. This behavior is enabled by our own journals, where the majority of IO papers are retrospective single-center series that would not even be reviewed by an oncology journal.   The WCIO Board of Directors meeting took up the rest of the afternoon, so I missed the concurrent abstract sessions on combined therapies, vascular IO, and biliary intervention. After hours of planning the global progress of IO as a clinical discipline, I was ready for more than a wee dram. Fortunately we found a great little bistro with excellent food and a focused international wine list, followed by an open-mike pub hosting a series of fine singer-guitarists.  

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