Prognostic value of primary tumour resection in synchronous metastatic colorectal cancer: Individual patient data analysis of first-line randomised trials from the ARCAD database

2018 ◽  
Vol 91 ◽  
pp. 99-106 ◽  
Author(s):  
K.L. van Rooijen ◽  
Q. Shi ◽  
K.K.H. Goey ◽  
J. Meyers ◽  
V. Heinemann ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Data Analysis ◽  
Metastatic Colorectal Cancer ◽  
Prognostic Value ◽  
Individual Patient Data ◽  
Primary Tumour ◽  
Tumour Resection ◽  
Randomised Trials ◽  
First Line ◽  
Primary Tumour Resection

scholarly journals An Analysis of Relationship Between RAS Mutations and Prognosis of Primary Tumour Resection for Metastatic Colorectal Cancer Patients

2018 ◽  
Vol 50 (2) ◽  
pp. 768-782
Author(s):  
Li Liang ◽  
Jiawen Tian ◽  
Yiyi Yu ◽  
Zhiming Wang ◽  
Ke Peng ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Metastatic Colorectal Cancer ◽  
Survival Time ◽  
Primary Tumour ◽  
Gene Mutations ◽  
Tumour Resection ◽  
Ras Gene ◽  
The Impact ◽  
Primary Tumour Resection

Background/Aims: Non-radical primary tumour resection (PTR) of asymptomatic metastatic colorectal cancer (mCRC) can prolong survival time of some patients. Patients with mutated RAS gene have worse survival outcome. This study aimed to investigate the impact of RAS gene mutations on the prognosis of asymptomatic unresectable mCRC patients who underwent PTR. Methods: A retrospective observational cohort study was deduced among mCRC patients who experienced PTR or had intact primary tumour (IPT). All of them had the primary tumour tissue genotyping tested for RAS (KRAS and NRAS) gene mutations. The tumour-related overall survival (OS) time and progression-free survival (PFS) time was estimated. From January 2011 to June 2014, 421 mCRC patients with asymptomatic, unresectable, metastatic disease were enrolled in this study. Among them, 282 patients underwent PTR and 139 patients had IPT. Results: The mutation rate of RAS was 53.8% (221/411). With a median followed-up time of 46.5 months, the overall survival time of mCRC patients harboring wtRAS or mtRAS was 28.0 versus 22.0 months (p = 0.043) in PTR group and was 21.6 versus 17.8 months (p=0.071) in IPT groups. A Multivariate regression analysis suggested that RAS gene (p=0.039, HR=1.288,95%CI [1.072∼2.911]), metastatic organ number (p=0.033, HR=3.091,95%CI [1.090∼5.755]) and systemic therapy response (p=0.019, HR=0.622,95%CI [0.525∼0.811]) were independent prognostic factors in PTR population. Conclusion: We found that wild-type RAS gene was a favorable factor for the asymptomatic unresectable mCRC patients experiencing PTR.

Primary tumour resection and survival in the palliative management of metastatic colorectal cancer

2009 ◽  
Vol 35 (2) ◽  
pp. 164-167 ◽  
Author(s):  
A. Bajwa ◽  
N. Blunt ◽  
S. Vyas ◽  
I. Suliman ◽  
J. Bridgewater ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Primary Tumour ◽  
Tumour Resection ◽  
Primary Tumour Resection

The impact of primary tumour resection and sidedness in patients with synchronous metastatic colorectal cancer (mCRC): Findings from the South Australian Metastatic Colorectal Cancer Registry (SAMCRC).

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 739-739
Author(s):  
Myron Klevansky ◽  
Sina Vatandoust ◽  
Lukah Dykes ◽  
Rob Padbury ◽  
Timothy Jay Price ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Primary Tumour ◽  
Large Population ◽  
Population Based ◽  
Tumour Resection ◽  
Colorectal Tumour ◽  
Population Based Registry ◽  
The Impact ◽  
Primary Tumour Resection

739 Background: The benefit of primary tumour resection (PTR) in patients with synchronous mCRC is not clear. The influence of tumour location on PTR benefit is also uncertain. Methods: SAMCRC is a population based registry collating data from all patients in South Australia diagnosed with mCRC from February 2006. We examined outcomes according to whether the primary colorectal tumour was excised within 3 months of diagnosis or remained in situ; we also examined whether outcomes were affected by tumour side (right v left). Registry data was included for patients with synchronous metastic adenocarcinoma from colon or rectum. Exclusion criteria included metastasectomy, tumour resection within 7 days or death within 3 months of mCRC diagnosis. Kaplan Meier analysis was used for Survival. Tumour sidedness and PTR were analysed with a multivariate Cox proportional hazards model. Survival was measured from the landmark date (3 months from date of diagnosis). Results: 2575 patients with synchronous mCRC have entered the database, of which 1869 patients were eligible for the PTR analysis. 50.2% (n = 938) underwent PTR. 481 patients (51.3%) of the PTR analysis group had left-sided primary tumours whilst 436 had right sided tumours (46.5%) which was significant (p < 0.001). 63% of the PTR cohort were male (n = 1006). Site and age metastases were included in the multivariate analysis. PTR was associated with improved survival from landmark compared to no resection (15.0 mo vs 11.2 mo, 95% CI 15.0 – 16.3 vs 11.2 – 12.3, p = 0.031). In the entire synchronous mCRC group, left-sided tumours (62.1%) had a longer median survival (17.8 mo vs 10.4 mo, 95% CI 15.7 – 19.5 vs 10.4 – 11.7 p = < 0.001). An interaction test was performed for sidedness and was not significant. Conclusions: PTR was associated was associated with improvement in survival in this large population based registry. This finding did not differ signifcantly between right and left sided tumours. Survival was superior for patients with left sided tumours, in keeping with established data. Criteria for selection of patients with mCRC who benefit from PTR need to be defined.

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