Age-adjusted incidence rates of synchronous liver metastases for stage IV colorectal cancer compared by sex, race, and age group

e16090 Background: Despite the decreasing colorectal cancer (CRC) mortality rate over the past decade, complications from CRC treatment remain a challenge. Prior research has shown that a majority of patients with stage III CRC in the adjuvant setting experience hospitalizations due to chemotherapy-related toxicity. Minimal research, however, has examined risk factors of these events and the prevalence of hospitalization among stage IV CRC patients. Methods: We used claims data from a geographically-diverse private health insurer—including both commercially-insured and Medicare Advantage patients—to estimate and characterize risk factors of hospitalizations among Stage III or IV CRC patients. We compared sociodemographic, clinical, as well as provider characteristics and cancer treatment regimens between patients with and without hospitalizations from the initiation of chemotherapy to 60 days after the end of chemotherapy. Results: Incidence rates for hospitalization from chemotherapy were 49% and 70% for stage III and IV CRC patients, respectively. Although the oldest stage III CRC patients (age 75+) were the most likely to experience hospitalizations, the youngest age group (age 18-49) of stage IV patients experienced the highest incidence (74%) of hospitalizations (p < 0.05). Higher values of the Elixhauser comorbidity index was associated with a higher risk for hospitalizations among patients with stage III CRC (p < 0.001). Both stage III and stage IV patients with diabetes were more likely (p < 0.05) to have hospitalizations from chemotherapy (55% and 73%, respectively). Conclusions: Hospitalization from chemotherapy is very common among stage III and IV CRC patients. These data identify subgroups at higher risk. Study findings may inform choice of cancer treatment regimen and focus on key underlying medical needs

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Surgical Treatment of Colorectal Cancer Liver Metastases

American Society of Clinical Oncology Educational Book ◽

10.14694/edbook_am.2012.32.52 ◽

2012 ◽

pp. 209-212

Author(s):

Steven A. Curley

Keyword(s):

Colorectal Cancer ◽

Liver Metastases ◽

Treatment Strategies ◽

Stage Iv ◽

Hepatic Arterial Infusion ◽

Arterial Infusion ◽

Colorectal Cancer Liver Metastases ◽

Stage Iv Colorectal Cancer ◽

Cancer Metastases ◽

Colorectal Cancer Metastases

Overview: Treatment strategies for patients with stage IV colorectal cancer have changed markedly in the last decade. Patients with colorectal cancer metastases to the liver have always been a fascinating group to consider biologically and for local-regional treatment strategies. In the late 1980s through the 1990s, resection was performed for a select subset of patients who had resectable disease. However, a high proportion of patients had bilobar unresectable disease and were treated with either 5-fluorouracil–based systemic chemotherapy or implanted hepatic arterial infusion pumps. The advent of the new millennium was associated with the availability of several new cytotoxic and biologic agents active in colorectal cancer. These agents have completely changed the approach to the treatment of patients with colorectal cancer liver metastases and thus have increased the complexity of the decision-making process for treatment of these patients.

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Hepatic resection may improve survival in patients with synchronic colorectal liver metastases operated on for obstructed stage iv colorectal cancer

HPB ◽

10.1016/j.hpb.2016.02.443 ◽

2016 ◽

Vol 18 ◽

pp. e183-e184

Author(s):

C. Quireze Junior ◽

A. Machado Santana Brasil ◽

L. Kenny Morais ◽

M. Castrillon Rassi ◽

E. Raymond Le Campion ◽

...

Keyword(s):

Colorectal Cancer ◽

Liver Metastases ◽

Hepatic Resection ◽

Colorectal Liver Metastases ◽

Stage Iv ◽

Stage Iv Colorectal Cancer

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Update and review of the multidisciplinary management of stage IV colorectal cancer with liver metastases

World Journal of Surgical Oncology ◽

10.1186/1477-7819-7-72 ◽

2009 ◽

Vol 7 (1) ◽

pp. 72 ◽

Cited By ~ 9

Author(s):

Sherif Abdel-Misih ◽

Carl R Schmidt ◽

Paul Bloomston

Keyword(s):

Colorectal Cancer ◽

Liver Metastases ◽

Stage Iv ◽

Multidisciplinary Management ◽

Stage Iv Colorectal Cancer

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Stage IV colorectal cancer: An NCDB analysis of the surgical treatment of peritoneal carcinomatosis versus liver metastases.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e15067 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e15067-e15067

Author(s):

Samer A Naffouje ◽

George I. Salti

Keyword(s):

Colorectal Cancer ◽

Liver Metastases ◽

Peritoneal Carcinomatosis ◽

Surgical Intervention ◽

Stage Iv ◽

Current Treatment ◽

Surgical Approaches ◽

Curative Intent ◽

Stage Iv Colorectal Cancer ◽

Significant Difference

e15067 Background: Traditionally, peritoneal carcinomatosis (PC) secondary to colorectal cancer (CRC) was perceived as a terminal disease, for which the only palliation was offered. With the emergence of new surgical approaches such as cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), surgical intervention in select patients with ‘curative’ intent was made possible. In this study, we compared the outcomes of the surgical intervention on stage IV CRC patients with isolated liver metastases (LM) to those with PC only. Methods: The National Cancer Database (NCDB) for CRC was analyzed excluding patients with PMP. Patients with isolated LM or with PC were identified, then divided into 2 treatment groups per the current treatment of each scenario: LM patients treated with surgery±chemotherapy (LM group), and PC patients treated with surgery+chemo±HIPEC (PC group). Results: 21,829 patients were identified; 18,932 fell in the LM group, and 2,897 in the PC group. Mean age in the LM and PC groups was 62.94±13.54 vs. 59.59±13.73. No significant difference was noted in the 30-day readmission rates (6.0% vs. 6.6%; p = 0.103). LM group had higher rates of 30- and 90-day mortality (4.3% vs. 0.3% and 8.6% vs. 1.8%, respectively; p < 0.0001), but a slightly shorter hospitalization (7.70±8.64 vs. 7.92±7.07; p = 0.024) Median overall survival was not different between the groups (27.3 vs. 25.36 months; p = 0.214). Conclusions: Surgery with systemic and IP chemotherapy can be a viable treatment option in stage IV CRC patients with PC with comparable short-term and survival outcomes to the widely accepted liver resection in patients with isolated LM.

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