scholarly journals Potential Prognostic Impact of Baseline CEA Level and Surgery of Primary Tumor Among Patients with Synchronous Stage IV Colorectal Cancer: A Large Population Based Study

2015 ◽  
Vol 6 (3) ◽  
pp. 198-206 ◽  
Author(s):  
Shaheenah Dawood ◽  
Bhawna Sirohi ◽  
Shailesh V. Shrikhande ◽  
Han-Chong Toh ◽  
Cathy Eng
Keyword(s):  
Colorectal Cancer ◽  
Primary Tumor ◽  
Large Population ◽  
Stage Iv ◽  
Population Based ◽  
Prognostic Impact ◽  
Population Based Study ◽  
Stage Iv Colorectal Cancer

Survival impact of surgical resection of primary tumor in patients with stage IV colorectal cancer: Results from a large population-based cohort study

Cancer ◽  
2013 ◽  
Vol 120 (5) ◽  
pp. 683-691 ◽  
Author(s):  
Shahid Ahmed ◽  
Anne Leis ◽  
Anthony Fields ◽  
Selliah Chandra-Kanthan ◽  
Kamal Haider ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cohort Study ◽  
Surgical Resection ◽  
Primary Tumor ◽  
Large Population ◽  
Stage Iv ◽  
Population Based ◽  
Stage Iv Colorectal Cancer

Prognostic impact of baseline CEA level and surgery of primary tumor among patients with stage IV denovo colon cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 503-503
Author(s):  
S. S. Dawood ◽  
A. M. Gonzalez-Angulo ◽  
C. Eng
Keyword(s):  
Colorectal Cancer ◽  
Surgical Resection ◽  
Primary Tumor ◽  
Large Population ◽  
Stage Iv ◽  
Low Grade ◽  
Prognostic Impact ◽  
Tumor Surgery ◽  
Risk Of Death ◽  
Increased Risk

503 Background: Surgical resection of primary tumor among pts with stageIV denovo colorectal cancer is controversial. Prognostic role of baseline CEA level in the same cohort has yet to be defined. The objective of this study was to determine the prognostic value of CEA and surgical resection of primary tumor among pts with stage IV denovo colorectal cancer in the era of biologic therapy and to determine subgroups with improved survival outcome. Methods: The Surveillance, Epidemiology and End Results Registry was searched to identify patients with stage IV denovo colorectal cancer diagnosed between 2004-2007. Colorectal cancer specific survival (CCS) was estimated using the Kaplan-Meier product limit method. Cox models were fitted to assess the multivariable relationship of various pt and tumor characteristics and CCS. Results: 19,437 pts were identified with stage IV denovo colorectal cancer. Median CCS was 15M. Median CCS among pts with primary tumor removed was 20M vs 8M (primary intact; p<0.001). Median CCS among pts who had elevated vs. non elevated CEA was 14M vs 23M (p<0.0001). Among pts who had primary tumor surgery median CCS among pts who had elevated vs. non elevated CEA was 19M vs 29M (p<0.0001). Among pts who had primary tumor and distant disease surgically removed, the median CCS among pts who had elevated vs. non elevated CEA was 24M vs 35M (p<0.0001). By multivariable analysis, pts with elevated CEA had a 51% increased risk of death from colorectal cancer compared to those with a non elevated CEA level (HR=1.51, 95%CI 1.40-1.65, p<0.0001). Pts who underwent primary tumor surgery had a 33% decreased risk of death from colorectal cancer compared to those who did not (HR=0.67, 95%CI 0.58-0.78, p<0.0001). Other factors significantly associated with a decreased risk of death from colorectal cancer included low grade disease, non visceral metastases, surgical resection of metastases, younger age and white race. Conclusions: In this large population study, elevated baseline CEA level and surgical resection of the primary tumor had a significant impact on survival outcomes. The best prognostic group were those pts with normal baseline CEA level who proceeded to surgical resection for their primary tumor. No significant financial relationships to disclose.

Use of Surgery Among Elderly Patients With Stage IV Colorectal Cancer

2004 ◽  
Vol 22 (17) ◽  
pp. 3475-3484 ◽  
Author(s):  
Larissa K.F. Temple ◽  
Lillian Hsieh ◽  
W. Douglas Wong ◽  
Leonard Saltz ◽  
Deborah Schrag
Keyword(s):  
Colorectal Cancer ◽  
Primary Tumor ◽  
Postoperative Mortality ◽  
Stage Iv ◽  
Population Based ◽  
Treatment Modalities ◽  
Medicare Beneficiaries ◽  
Stage Iv Colorectal Cancer ◽  
Lower Socioeconomic

Purpose The role of surgery to remove the primary tumor among patients with stage IV colorectal cancer (CRC) is controversial. The purpose of this study was to evaluate surgical practice patterns for patients ≥ 65 years of age with stage IV CRC in a US population-based cohort. Patients and Methods We used the Surveillance, Epidemiology, and End Results-Medicare–linked database to evaluate the patterns of cancer treatment for 9,011 Medicare beneficiaries presenting with stage IV CRC from 1991 to 1999. Patients were categorized according to whether they had primary–cancer-directed surgery (CDS) or no CDS within 4 months of diagnosis. The use of other treatment modalities, including metastasectomy, chemotherapy, and radiation, was evaluated in relationship to whether patients belonged to the CDS or no CDS group. Results Seventy-two percent (6,469 of 9,011) of patients received CDS, and their 30-day postoperative mortality was 10%. Patients with left-sided or rectal lesions, patients older than age 75 years, blacks, and those of lower socioeconomic status were less likely to undergo CDS; but even among those older than age 75, the CDS rate was 69% (3,378 of 4,909). In contrast, chemotherapy use was less common (47% for patients who had CDS and 31% for those who did not). Metastasectomy was rare; only 3.9% of patients underwent these operations at any point from diagnosis to death. Conclusion Palliative resection of the primary tumor is often performed for elderly US patients with stage IV colorectal cancer. This practice pattern merits re-evaluation, given the improvement in the efficacy of systemic chemotherapy.

Laparoscopic surgery for palliative resection of the primary tumor in incurable stage IV colorectal cancer

2012 ◽  
Vol 26 (11) ◽  
pp. 3201-3206 ◽  
Author(s):  
Hideaki Nishigori ◽  
Masaaki Ito ◽  
Yuji Nishizawa ◽  
Atsushi Kohyama ◽  
Takamaru Koda ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Primary Tumor ◽  
Stage Iv ◽  
Palliative Resection ◽  
Stage Iv Colorectal Cancer

A Novel Derivation Predicting Survival After Primary Tumor Resection in Stage IV Colorectal Cancer

2017 ◽  
Vol 60 (9) ◽  
pp. 895-904 ◽  
Author(s):  
Winson Jianhong Tan ◽  
Sreemanee Raaj Dorajoo ◽  
Madeline Yen Min Chee ◽  
Wah Siew Tan ◽  
Fung Joon Foo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Tumor ◽  
Tumor Resection ◽  
Stage Iv ◽  
Primary Tumor Resection ◽  
Stage Iv Colorectal Cancer
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