Curative Radiotherapy using Different Radiation Techniques for Isolated Lung Metastasis from Colorectal Cancer

Aims and background Surgical resection remains the mainstay for the treatment of colorectal lung metastasis, but a group of patients who are medically inoperable or unsuitable for surgery are treated with radiotherapy. The purpose of this multi-institutional study was to evaluate the clinical outcome and investigate the prognostic factors affecting local control and survival in this subset of patients. Methods We retrospectively analyzed 30 patients with 43 lesions who underwent curative radiotherapy for isolated lung metastasis from colorectal cancer at nine institutions from 2003 and 2008. A total dose of 42–75 Gy at the peripheral planning target volume was administered in 3–35 fractions. The median biologically equivalent dose was 84 Gy (range, 58.5–180). Results Treatment response was complete in 10 (33.3%), partial in 13 (43.3%), stable in six (20.0%), and progressive in one patient (3.3%). The median follow-up period for all patients was 29.0 months (range, 5.0–93.8). Kaplan-Meier local control at 5 years was 44%. The median survival was 46.2 months, and the 5-year overall survival was 47%. Twenty-three patients (77%) experienced treatment failure, most of which were intrapulmonary failure. The intrapulmonary relapse-free survival and overall relapse-free survival at 5 years were 22% and 19%, respectively. Treatment response and pre-radiotherapy carcinoembryonic antigen level were significant prognostic factors for local control and survival. Grade 3–5 toxicity occurred in 7 patients. Three patients had grade 5 toxicity, including radiation pneumonitis, a tracheoesophageal fistula, and hemoptysis. Conclusions Curative radiotherapy for isolated lung metastasis from colorectal cancer in patients who are medially inoperable or unsuitable for surgery results in long-term survival, comparable to surgical resection. Curative radiotherapy could be an effective and noninvasive alternative if dose-limiting toxicity is carefully considered, particularly in patients with bilateral or central lesions.

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Outcome of patients with colorectal cancer undergoing lung metastases resection: a single-institution retrospective analysis

Tumori Journal ◽

10.1177/0300891620930793 ◽

2020 ◽

pp. 030089162093079

Author(s):

Marco Mammana ◽

Francesca Bergamo ◽

Letizia Procaccio ◽

Marco Schiavon ◽

Fotios Loupakis ◽

...

Keyword(s):

Colorectal Cancer ◽

Overall Survival ◽

Prognostic Factors ◽

Cox Regression ◽

Multivariable Analysis ◽

Postoperative Chemotherapy ◽

Single Institution ◽

Relapse Free Survival ◽

Free Survival ◽

Lung Metastasectomy

Introduction: This study was undertaken to review a single-institution cohort of patients with metastatic colorectal cancer undergoing lung resection after a multidisciplinary evaluation and to investigate the main prognostic factors for survival. Methods: Medical records of 129 patients undergoing lung metastasectomy for colorectal cancer with curative intent from 2001 to 2017 were reviewed. Tissue samples from the primary tumor were analyzed with a multiplex genotyping system for the detection of mutations in RAS and BRAF genes. Survival analyses were carried out by the Kaplan-Meier method. Univariate and multivariable analyses were performed using the log-rank test and the Cox regression model. Results: Postoperative morbidity and mortality were 13.2% and 0%, respectively. At a median follow-up time of 62.5 months, median overall survival was 90.5 months and median relapse-free survival was 42.8 months. Multivariable analysis for overall survival identified synchronous versus metachronous metastatic presentation as the only prognostic factor, whereas relapse-free survival was independently associated with synchronous versus metachronous metastatic presentation, number of metastases, and postoperative chemotherapy. Conclusions: This study shows particularly favorable survival outcomes for patients undergoing lung metastasectomy. The validity of some of the main prognostic factors was confirmed and a positive effect of postoperative chemotherapy on relapse-free survival was shown. Contrary to other reports, the presence of KRAS mutations was not associated with significant survival differences. Further studies are needed in order to clarify the interactions between molecular, clinical, and pathologic characteristics and treatment-related factors.

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YY1 Silencing Induces 5-Fluorouracil-Resistance and BCL2L15 Downregulation in Colorectal Cancer Cells: Diagnostic and Prognostic Relevance

International Journal of Molecular Sciences ◽

10.3390/ijms22168481 ◽

2021 ◽

Vol 22 (16) ◽

pp. 8481

Author(s):

Silvia Vivarelli ◽

Luca Falzone ◽

Saverio Candido ◽

Benjamin Bonavida ◽

Massimo Libra

Keyword(s):

Colorectal Cancer ◽

Response To Therapy ◽

Advanced Stage ◽

Relapse Free Survival ◽

Free Survival ◽

Expression Levels ◽

Single Cell Sequencing ◽

Yin Yang 1 ◽

Anti Cancer ◽

Colorectal Cancer Cells

Colorectal cancer (CRC) is characterized by genetic heterogeneity and is often diagnosed at an advanced stage. Therefore, there is a need to identify novel predictive markers. Yin Yang 1 (YY1) is a transcription factor playing a dual role in cancer. The present study aimed to investigate whether YY1 expression levels influence CRC cell response to therapy and to identify the transcriptional targets involved. The diagnostic and prognostic values of YY1 and the identified factor(s) in CRC patients were also explored. Silencing of YY1 increased the resistance to 5-Fluorouracil-induced cytotoxicity in two out of four CRC cells with different genotypes. BCL2L15/Bfk pro-apoptotic factor was found selectively expressed in the responder CRC cells and downregulated upon YY1 knockdown. CRC dataset analyses corroborated a tumor-suppressive role for both YY1 and BCL2L15 whose expressions were inversely correlated with aggressiveness. CRC single-cell sequencing dataset analyses demonstrated higher co-expression levels of both YY1 and BCL2L15 within defined tumor cell clusters. Finally, elevated levels of YY1 and BCL2L15 in CRC patients were associated with larger relapse-free survival. Given their observed anti-cancer role, we propose YY1 and BCL2L15 as candidate diagnostic and prognostic CRC biomarkers.

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Prognostic factors of local control and disease free survival in centrally located non-small cell lung cancer treated with stereotactic body radiation therapy

Acta Oncologica ◽

10.1080/0284186x.2020.1750693 ◽

2020 ◽

Vol 59 (7) ◽

pp. 809-817

Author(s):

Marloes Duijm ◽

Noëlle C. van der Voort van Zyp ◽

Patrick V. Granton ◽

Paul van de Vaart ◽

Mirjam E. Mast ◽

...

Keyword(s):

Lung Cancer ◽

Radiation Therapy ◽

Prognostic Factors ◽

Local Control ◽

Stereotactic Body Radiation Therapy ◽

Disease Free Survival ◽

Small Cell ◽

Small Cell Lung ◽

Free Survival ◽

Disease Free

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Genome-Wide Scan for Copy Number Alteration Association with Relapse-Free Survival in Colorectal Cancer with Liver Metastasis Patients

Journal of Clinical Medicine ◽

10.3390/jcm7110446 ◽

2018 ◽

Vol 7 (11) ◽

pp. 446 ◽

Cited By ~ 1

Author(s):

Po-Sheng Yang ◽

Hsi-Hsien Hsu ◽

Tzu-Chi Hsu ◽

Ming-Jen Chen ◽

Cin-Di Wang ◽

...

Keyword(s):

Colorectal Cancer ◽

Liver Metastasis ◽

Liver Metastases ◽

Copy Number ◽

Copy Number Alteration ◽

Gene Signature ◽

Comparative Genomic ◽

Relapse Free Survival ◽

Cgh Array ◽

Free Survival

Predicting a patient’s risk of recurrence after the resection of liver metastases from colorectal cancer is critical for evaluating and selecting therapeutic approaches. Clinical and pathologic parameters have shown limited accuracy thus far. Therefore, we combined the clinical status with a genomic approach to stratify relapse-free survival in colorectal cancer liver metastases patients. To identify new molecular and genetic signatures specific to colorectal cancer with liver metastasis (CRCLM) patients, we conducted DNA copy number profiling on a cohort of 21 Taiwanese CRCLM patients using a comparative genomic hybridization (CGH) array. We identified a three-gene signature based on differential copy number alteration between patients with different statuses of (1) recurrence and (2) synchronous metastasis. In relapse hotspot regions, only three genes (S100PBP, CSMD2, and TGFBI) were significantly associated with the synchronous liver metastasis factor. A final set of three genes—S100PBP, CSMD2, TGFBI—significantly predicted relapse-free survival in our cohort (p = 0.04) and another CRCLM cohort (p = 0.02). This three-gene signature is the first genomic signature validated for relapse-free survival in post-hepatectomy CRCLM patients. Our three-gene signature was developed using a whole-genome CGH array and has a good prognostic position for the relapse-free survival of CRCLM patients after hepatectomy.

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PS1177 PROGNOSTIC FACTORS FOR MOLECULAR RELAPSE-FREE SURVIVAL AFTER DISCONTINUATION OF TYROSINE KINASE INHIBITORS IN CHRONIC MYELOID LEUKEMIA BASED ON RUSSIAN MULTICENTER PROSPECTIVE TRIAL (RU-SKI)

HemaSphere ◽

10.1097/01.hs9.0000562992.29771.be ◽

2019 ◽

Vol 3 (S1) ◽

pp. 535-536

Author(s):

O. Shukhov ◽

E. Chelysheva ◽

A. Petrova ◽

A. Bykova ◽

I. Nemchenko ◽

...

Keyword(s):

Prognostic Factors ◽

Chronic Myeloid Leukemia ◽

Tyrosine Kinase ◽

Tyrosine Kinase Inhibitors ◽

Myeloid Leukemia ◽

Kinase Inhibitors ◽

Prospective Trial ◽

Relapse Free Survival ◽

Free Survival

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Prognostic Factors on the Graft-versus-Host Disease-Free and Relapse-Free Survival after Adult Allogeneic Hematopoietic Stem Cell Transplantation

Stem Cells International ◽

10.1155/2016/5143071 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 7

Author(s):

Yao-Chung Liu ◽

Sheng-Hsuan Chien ◽

Nai-Wen Fan ◽

Ming-Hung Hu ◽

Jyh-Pyng Gau ◽

...

Keyword(s):

Stem Cell ◽

Prognostic Factors ◽

Hematopoietic Stem Cell Transplantation ◽

Stem Cell Transplantation ◽

Hematologic Malignancy ◽

Relapse Free Survival ◽

Hematopoietic Stem ◽

Free Survival ◽

Graft Versus Host ◽

Disease Free

The cure of hematologic disorders by allogeneic hematopoietic stem cell transplantation (HSCT) is often associated with major complications resulting in poor outcome, including graft-versus-host disease (GVHD), relapse, and death. A novel composite endpoint of GVHD-free/relapse-free survival (GRFS) in which events include grades 3-4 acute GVHD, chronic GVHD requiring systemic therapy, relapse, or death is censored to completely characterize the survival without mortality or ongoing morbidity. In this regard, studies attempting to identify the prognostic factors of GRFS are quite scarce. Thus, we reviewed 377 adult patients undergoing allogeneic HSCT between 2003 and 2013. The 1- and 2-year GRFS were 40.8% and 36.5%, respectively, significantly worse than overall survival and disease-free survival (log-rankp<0.001). European Group for Blood and Marrow Transplantation (EBMT) risk score > 2 (p<0.001) and hematologic malignancy (p=0.033) were poor prognostic factors for 1-year GRFS. For 2-year GRFS, EBMT risk score > 2 (p<0.001), being male (p=0.028), and hematologic malignancy (p=0.010) were significant for poor outcome. The events between 1-year GRFS and 2-year GRFS predominantly increased in relapsed patients. With prognostic factors of GRFS, we could evaluate the probability of real recovery following HSCT without ongoing morbidity.

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