scholarly journals The CLL comorbidity index in a population-based cohort: a tool for clinical care and research

2022 ◽  
Author(s):  
Emelie C Rotbain ◽  
Max J Gordon ◽  
Noomi Vainer ◽  
Henrik Frederiksen ◽  
Henrik Hjalgrim ◽  
...  
Keyword(s):  
Overall Survival ◽  
Rating Scale ◽  
Clinical Care ◽  
International Prognostic Index ◽  
Prognostic Significance ◽  
Population Based ◽  
Event Free Survival ◽  
Free Survival ◽  
Organ Systems ◽  
Comorbidity Index

The chronic lymphocytic leukemia comorbidity index (CLL-CI) is an efficient, CLL-specific tool derived from the Cumulative Illness Rating Scale. The CLL-CI is based on the assessment of the organ systems found to be most strongly associated with event-free survival in CLL: vascular, upper gastrointestinal, and endocrine, at the time of initiation of CLL therapy. The CLL-CI categorizes patients into low, intermediate, and high risk groups. In the present study, we have employed the CLL-CI in a population-based cohort comprising 4 975 patients with CLL. We demonstrate that CLL-CI retains prognostic significance in this large cohort and is associated with overall survival and event-free survival from time of first therapy. Furthermore, CLL-CI associates with overall survival, event-free survival, and time to first treatment from diagnosis independently of the CLL International Prognostic Index. These findings support the use of the CLL-CI both in research and in clinical practice.

scholarly journals Population-based 10-year event-free survival after radical prostatectomy for patients with prostate cancer in British Columbia

2015 ◽  
Vol 9 (11-12) ◽  
pp. 409 ◽  
Author(s):  
Michael Peacock ◽  
Jill Quirt ◽  
W James Morris ◽  
Alan So ◽  
Charmaine Kim Sing ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
British Columbia ◽  
Overall Survival ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Population Based ◽  
Gleason Grade ◽  
Event Free Survival ◽  
Free Survival ◽  
Incident Cases

<p><strong>Introduction:</strong> We determined (1) the 10-year survival outcomes after radical treatment of prostate cancer and (2) the 10-year eventfree survival following radical prostatectomy (RP) at a populationlevel in British Columbia (BC), Canada.</p><p><strong>Methods:</strong> We identified all men with a new diagnosis of prostate cancer in BC between 1999 and 2000. Those treated with RP, external beam radiotherapy (EBRT) or brachytherapy (BT) were identified. Overall survival, and prostate cancer specific survival (PCSS) were calculated from diagnosis using the Kaplan-Meier method. For those men treated with RP, we calculated the 10-year event-free survival (freedom from salvage EBRT or androgen ablation, or death from prostate cancer). Reasons for initiating androgen therapy were unknown and may include symptomatic metastatic disease or asymptomatic biochemical recurrence. An important limitation was the absence of prostate-specific antigen data for staging or follow-up.</p><p><strong>Results:</strong> Among 6028 incident cases, RP was the curative-intent treatment within 1 year in 1360 (22.6%) patients, EBRT in 1367 (22.7%), and BT in 357 (5.9%). The 10-year PCSS was 98% for RP, 95% for EBRT and 98% for BT (log rank p &lt; 0.0001). The 10-year overall survival was 87%. The 10-year event-free survival for those treated with RP was 79% and varied with Gleason grade: 87%, 74%, and 52% for Gleason 2–6, 7, and 8-10, respectively (p &lt; 0.0001).</p><p><strong>Conclusions:</strong> This population-based study provides outcomes which can inform patient decision-making and provide a benchmark to which other therapies can be compared. Event-free rates for patients treated with RP vary with Gleason score. There is room for improvement in the outcomes of patients with high Gleason score treated with RP.</p>

scholarly journals Survival outcomes of a population-based cohort of adolescent and young adult (AYA), acute lymphoblastic leukemia (ALL) patients in Ontario, Canada: The IMPACT Cohort

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Cindy Lau ◽  
Jason Pole ◽  
Rinku Sutradhar ◽  
Nancy Baxter ◽  
Paul Nathan ◽  
...  
Keyword(s):  
Overall Survival ◽  
Acute Lymphoblastic Leukemia ◽  
Young Adult ◽  
Lymphoblastic Leukemia ◽  
Population Based ◽  
Adolescent And Young Adult ◽  
Survival Outcomes ◽  
Event Free Survival ◽  
Free Survival ◽  
The Impact

IntroductionAdolescents and young adults (AYA) are an understudied population in cancer research. The Initiative to Maximize Progress in Adolescent and Young Adult Cancer Therapy (IMPACT) cohort includes Ontario individuals aged 15-21 years, diagnosed with a malignancy during 1992-2011. This cohort contains a rich source of patient, disease, and treatment data. Objectives and ApproachThe IMPACT cohort was created using chart review and linkages to population-based health services databases. The cohort is comprised of AYA with a primary diagnosis of acute leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, sarcoma, or testicular cancer. For the current study, we focused on acute lymphoblastic leukemia (ALL) patients, and examined survival outcomes of those treated at pediatric vs adult centers, with adult vs pediatric protocols. We assessed 5-year event-free survival (first of relapse, progression, secondary malignant neoplasm, or death) and overall survival. ResultsThe IMPACT cohort contains 2,963 patients, of which 152/271 ALL patients were treated at adult centers. The 5-year event-free survival (EFS ± standard error) among those treated at a pediatric vs. adult center was 72%±4% vs. 56%±4% (p = 0.03), respectively. The 5-year overall survival (OS) was 82%±4% vs. 64%±4% (p Conclusion/ImplicationsALL patients treated with a pediatric protocol at a pediatric center experienced better, crude survival outcomes compared to those at an adult center. The IMPACT cohort offers the opportunity to study a myriad of questions on different cancer groups, with the ultimate goal of improving outcomes among the AYA population.

Rituximab Combined with Chemotherapy and Interferon in Follicular Lymphoma Patients: Final Analysis of the GELA-GOELAMS FL2000 Study with a 5-Year Follow-Up.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 792-792 ◽  
Author(s):  
Gilles Andre Salles ◽  
Nicolas Mounier ◽  
Sophie de Guibert ◽  
Franck Morschhauser ◽  
Chantal Doyen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Follicular Lymphoma ◽  
Chemotherapy Regimen ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Response To Therapy ◽  
Event Free Survival ◽  
Free Survival ◽  
Interferon Α2a

Abstract Background. The FL2000 study evaluated the combination of the anti-CD20 monoclonal antibody rituximab with chemotherapy plus interferon in the first line treatment of follicular lymphoma patients. Methods. Untreated follicular lymphoma patients (n=359) presenting with a high tumor burden were randomly assigned to receive either 12 courses of the chemotherapy regimen CHVP (cyclophosphamide, adriamycin, etoposide and prednisolone) plus interferon-α2a (CHVP+I arm) over 18 months or 6 courses of the same chemotherapy regimen combined with 6 infusions of 375 mg/m2 of rituximab and interferon for the same time period (R-CHVP+I arm). The primary endpoint of the study was event free survival and all results are shown as intent to treat. Results. Six months after treatment initiation, 156 out of 183 (85%) and 164 out of 175 (94%) patients had a response to therapy in the CHVP+I and R-CHVP+I study arm, respectively (P=.009). At the end of the 18 months treatment period, 59% and 75% of the patients were respectively in CR or CRu in the CHVP+I and R-CHVP+I arm (P<.05). After a median follow-up of five years, event-free survival (EFS) estimates were respectively 37% [95% C.I. 29 – 44] and 53% [95% C.I. 45 – 60] in the CHVP+I and R-CHVP+I arm (P=.0004). Response duration in CR/CRu or PR patients at the end of the 18 months treatment was also improved in the R-CHVP+I arm (P=.012). 5-year overall survival (OS) estimates were not statistically different in the CHVP+I (79%) [95% C.I. 72 – 84]) and R-CHVP+I (84% [95% C.I. 78 – 84]) arms. The Follicular Lymphoma International Prognostic Index (FLIPI) score allowed separation of the whole study population into 3 different risk categories with significantly different outcome for each group both for 5 year EFS and OS (P<.0001, respectively each). In a multivariate regression analysis, event free survival was significantly influenced by both the FLIPI score (HR=2.08; 95% C.I. [1.6 – 2.8]) and the treatment arm (HR=0.59; 95% C.I. [0.44 – 0.78]). In an exploratory analysis considering the 187 patients with a low/intermediate (<3) FLIPI score, the outcome according to each treatment arm was not statistically different while the benefit of the rituximab combination was highly significant in term of EFS (P=.0002) and OS (P=.025) in the 162 patients with a high (≥3) FLIPI score. Conclusions. These results extend our previous interim analyses and confirm that with a five year follow-up, the combination of rituximab with CHVP+I provides superior disease control in follicular lymphoma patients despite a shorter duration of chemotherapy. However, this combination appears to benefit essentially to high risk patients for whom overall survival is also significantly improved.

Tissue Microarray in DLBCL Patients receiving R-CHOP Chemo-Immunotherapy Shows Survival Benefit for Coexpression of LMO2/BCL6

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1585-1585 ◽  
Author(s):  
Colm Keane ◽  
Linda Shen ◽  
Erica Han ◽  
Jamie P Nourse ◽  
Rod Lea ◽  
...  
Keyword(s):  
Overall Survival ◽  
Univariate Analysis ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Germinal Centre ◽  
Cell Of Origin ◽  
Event Free Survival ◽  
Free Survival ◽  
Dual Positivity ◽  
Improved Outcome

Abstract Abstract 1585 Background: Diffuse Large B-cell Lymphoma (DLBCL) is a heterogeneous disease with variable outcome within international prognostic index (IPI) categories. Previous studies indicate expression of germinal centre B-cell (GCB) markers predict good outcome and that non-GCB sub-types may benefit from alternate therapies. A variety of immunohistochemical combinations have been proposed. However results are inconsistent and there is limited data comparing strategies. The need for a robust, practical method to distinguish GCB-DLBCL remains. We evaluated co-expression of the GCB proteins LMO2 and BCL6 with the Choi, Hans and Tally algorithms in patients treated with R-CHOP chemo-immunotherapy. Patients and Methods: Seventy-five DLBCL patients, chosen solely on availability of material for tissue microarray, were studied using immunohistochemistry for FOXP1, MUM1, CD10, BCL6, LMO2 and GCET1 on original biopsies. Clinical data was obtained from a prospectively maintained database. Results were correlated with event free (EFS) and overall survival (OS). Results: The cohort was typical for DLBCL described in the literature with 63% of patients aged over 60. The International Prognostic Index (IPI) predicted overall survival (p<0.001) with 36% of patients with a low IPI score (0,1), 41% with intermediate score (2,3) and 23% with a high IPI score (4,5). The three year event free and overall survival (EFS and OS) were 68% and 73% respectively with a median follow up of 37 months. None of the cell of origin algorithm predicted for EFS or OS. The Hans (49%) and Choi algorithms (43%) typed similar number of patients as GCB but the Tally method (26%) typed patients less frequently as GCB. This difference was statistically different (p=0.014). No single marker predicted for outcome, however there was a trend for patients who were BCL6 positive to have improved outcome (p=0.06). 53% of patients were positive for BCL6. BCL6 was a significant predictor of improved event free survival on univariate analysis (p=0.016). Interestingly, patients who were positive for both LMO2 and BCL6 (26% of total) had a significantly improved outcome on univariate analysis for both event free (p=0.01) and overall survival (p=0.0036). LM02/BCL6 dual positivity retained significance for event free survival independent of IPI on multivariate analysis (p=0.017). It was not possible to demonstrate independence from IPI for overall survival using Cox regression as none of the nineteen dual positive patients have died. There was no significant differences between patients who were LMO2/BCL6 positive and the rest of the cohort with respect to any of the IPI factors. Of note, LMO2 on its own was independent of IPI with regards to overall survival despite not reaching significance at the univariate level (p=0.049). In the subgroup of patients who were positive for BCL6 approximately half were also positive for LMO2. There was a significant difference in overall survival between these BCL6 single positive and BCL6/LMO2 dual positive tumours (p=0.003) with improved outcome seen in the dual positive patients. Similarly those LMO2 positive patients who were BCL6 negative had very poor outcome compared to LMO2/BCL6 dual positive tumours (p=0.0002). Dual positivity for BCL6/LMO2 was strongly associated with germinal centre phenotype with eighty per cent of these patients typing for this cell of origin (p=0.0004). Germinal centre DLBCL as typed by the Choi algorithm could be separated into two significantly different groups with different overall survival based on LMO2/BCL6 dual positivity (p=0.01) Conclusion: LMO2/BCL6 dual positivity is a prognostic marker in DLBCL treated with R-CHOP that is independent of IPI, and predicts outcome in GCB typed tumours. Should these findings be prospectively validated, the strategy would be easily transferable to the diagnostic laboratory. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Cause of Death in Follicular Lymphoma in the First Decade of the Rituximab Era: A Pooled Analysis of French and US Cohorts

2019 ◽  
Vol 37 (2) ◽  
pp. 144-152 ◽  
Author(s):  
Clémentine Sarkozy ◽  
Matthew J. Maurer ◽  
Brian K. Link ◽  
Hervé Ghesquieres ◽  
Emmanuelle Nicolas ◽  
...  
Keyword(s):  
Overall Survival ◽  
Follicular Lymphoma ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Event Free Survival ◽  
Free Survival ◽  
International Prognostic Index Score ◽  
Treatment Related Mortality ◽  
Related Mortality

Purpose Although the life expectancy of patients with follicular lymphoma (FL) has increased, little is known of their causes of death (CODs) in the rituximab era. Patients and Methods We pooled two cohorts of newly diagnosed patients with FL grade 1-3A. Patients were enrolled between 2001 and 2013 in two French referral institutions (N = 734; median follow-up 89 months) and 2002 and 2012 in the University of Iowa and Mayo Clinic Specialized Program of Research Excellence (SPORE; N = 920; median follow-up 84 months). COD was classified as being a result of lymphoma, other malignancy, treatment related, or all other causes. Results Ten-year overall survival was comparable in the French (80%) and US (77%) cohorts. We were able to classify COD in 248 (88%) of 283 decedents. In the overall cohort, lymphoma was the most common COD, with a cumulative incidence of 10.3% at 10 years, followed by treatment-related mortality (3.0%), other malignancy (2.9%), other causes (2.2%), and unknown (3.0%). The 10-year cumulative incidence of death as a result of lymphoma or treatment was higher than death as a result of all other causes for each age group (including patients ≥ 70 years of age at diagnosis [25.4% v 16.6%]) Follicular Lymphoma International Prognostic Index score 3 to 5 (27.4% v 5.2%), but not Follicular Lymphoma International Prognostic Index score 0 to 1 (4.0% v 3.7%); for patients who failed to achieve event-free survival within 24 months from diagnosis (36.1% v 7.0%), but not for patients who achieved event-free survival within 24 months of diagnosis (6.7% v 5.7%); and for patients with a history of transformed FL (45.9% v 4.7%), but not among patients without (8.1% v 6.2%). Overall, 77 of 140 deaths as a result of lymphoma occurred in patients whose FL transformed after diagnosis. Conclusion Despite the improvement in overall survival in patients with FL in the rituximab era, their leading COD remains lymphoma, especially after disease transformation. Treatment-related mortality also represents a concern, which supports the need for less-toxic therapies.

CNS Involvement in Children With Newly Diagnosed Non-Hodgkin’s Lymphoma

2000 ◽  
Vol 18 (16) ◽  
pp. 3018-3024 ◽  
Author(s):  
John T. Sandlund ◽  
Sharon B. Murphy ◽  
Victor M. Santana ◽  
Frederick Behm ◽  
Dana Jones ◽  
...  
Keyword(s):  
Overall Survival ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Large Cell ◽  
Tumor Burden ◽  
Newly Diagnosed ◽  
Event Free Survival ◽  
Cns Involvement ◽  
Free Survival ◽  
Cns Disease

PURPOSE: To determine the frequency of CNS involvement at diagnosis of non-Hodgkin’s lymphoma (NHL), to characterize its pattern of presentation, and to determine its prognostic significance. PATIENTS AND METHODS: We reviewed the records of 445 children (1975 through 1995) diagnosed with NHL (small noncleaved cell NHL/B-cell acute lymphoblastic leukemia [SNCC NHL/B-ALL], 201 patients; lymphoblastic, 113; large cell, 119; other, 12). Tumor burden was estimated by serum lactate dehydrogenase (LDH) measurement and reclassification of disease stage irrespective of CNS involvement (modified stage). RESULTS: Thirty-six of 445 children with newly diagnosed NHL had CNS involvement (lymphoma cells in the CSF [n = 23], cranial nerve palsy [n = 9], both features [n = 4]), representing 13%, 7%, and 1% of small noncleaved cell lymphoma, lymphoblastic lymphoma, and large-cell cases, respectively. By univariate analysis, CNS disease at diagnosis did not significantly impact event-free survival (P = .095), whereas stage and LDH did; however, children with CNS disease at diagnosis were at 2.0 times greater risk of death than those without CNS disease at diagnosis. In a multivariate analysis, CNS disease was not significantly associated with either overall or event-free survival, whereas both serum LDH and stage influenced both overall and event-free survival. Among cases of SNCC NHL/B-ALL, CNS disease was significantly associated with event-free and overall survival (univariate analysis); however, in multivariate analysis, only LDH had independent prognostic significance. Elevated serum LDH or higher modified stage were associated with a trend toward poorer overall survival among children with CNS disease. CONCLUSION: A greater tumor burden at diagnosis adversely influences the treatment outcome of children with NHL and CNS disease at diagnosis, suggesting a need for ongoing improvement in both systemic and CNS-directed therapy.

scholarly journals OP0294 SJÖGREN’S SYNDROME ASSOCIATED LYMPHOMAS: CLINICAL DESCRIPTION AND 10-YEAR SURVIVAL

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 180-181
Author(s):  
L. Chatzis ◽  
V. Pezoulas ◽  
A. Goules ◽  
I. Stergiou ◽  
C. Mavragani ◽  
...  
Keyword(s):  
Overall Survival ◽  
T Cell ◽  
Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Histologic Type ◽  
Single Center ◽  
Event Free Survival ◽  
Survival Curves ◽  
Free Survival ◽  
Kaplan Meier

Background:Sjögren’s Syndrome (SS) is a chronic systemic autoimmune disease of unknown etiology, carrying the highest lymphoma risk among autoimmune diseases, with significant impact on mortality and morbidity of patients.Objectives:To describe: i) the clinical phenotype of SS, ii) the histologic type, stage, treatment options regarding lymphomas and iii) the prognosis of patients with SS related lymphoproliferative disorders.Methods:Eight hundred and fifteen consecutive SS patients’ records from a single center fulfilling the 2016 ACR/EULAR were reviewed retrospectively for the purpose of this study. One hundred twenty-one patients with a diagnosis of non-Hodgkin Lymphoma (NHL) were identified and enrolled in the study population. Cumulative clinical, laboratory and histologic data were recorded and overall survival as well as event free survival curves were constructed using the Kaplan-Meier method. An event was defined as a disease progression, lymphoma relapse, treatment failure, histologic transformation, development of a 2nd lymphoma or death from any cause.Results:From 121 pSS patients with lymphoma the most common histologic type encountered was MALT lymphoma (92/121, 76,0%) followed by DLBCL (11/121, 9.0%) and NMZL (8/119, 6.6%). The remaining 10 patients had various lymphomas of B (follicular, lymphoplasmacytic, chronic lymphocytic leukemia} and T cell origin (peripheral T cell lymphoma not otherwise specified, primary cutaneous T cell lymphoma, angioimmunoblastic t-cell lymphoma). Permanent salivary gland enlargement (66.1%, 80/121), palpable purpura (34,7% 42/121), peripheral nervous involvement (9,9%, 12/121), interstitial lung disease (8,2%, 10/121) presence of serum cryoglobulins (38,7%, 43/111) and C4 hypocomplementemia (69,8% 81/116) present at least 1 year before the development of lymphoma were the main pSS related features. The median age at lymphoma diagnosis was 58 years old (range 29-82) while MALT lymphomas developed earlier compared to DLBCL from pSS diagnosis (8 vs 3 OR= 3.84, 95%CI: 0.29 to 10.46; p=0.0266). The commonest biopsy proven extranodal sites included the labial minor salivary (43,8% patients) and parotid glands (30,5%) while 11% of patients had more than 1 extranodal sites affected. Bone marrow involvement was evident in 24,3% of patients (29/119) while nodal involvement in 35,5% (42/118). The majority of patients (65%) had limited disease (stage I or II). A watch and wait therapeutic policy was chosen in 40 patients while the rest received rituximab with or without chemotherapy. The 10-year survival and event free rates were 79% and 45,5% for MALT lymphomas, 40,9% and 24,2% for DLBCL and 46% and 31% for NMZL respectively (Figure 1). The Mantel-Cox log-rank comparison of the overall survival curves revealed a statistically significant difference (p=0.0016) among lymphoma subtypes.Figure 1.Overall and event free survival of SS-associated lymphoma patients. A. Kaplan-Meier overall survival analysis. B. A Kaplan-Meier event free survival analysis.Conclusion:This is the largest single center series of SS- associated lymphoma patients, providing a detailed description of SS and lymphoma related features, combined with a 10-year survival and event free curves for the first time in the literature.Disclosure of Interests:None declared.

Efficacy and prognostic significance of triflurodine/tipiracil beyond oxaliplatin and irinotecan based chemotherapy in patients with refractory metastatic colorectal cancer: An observational multicenter study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15586-e15586
Author(s):  
Mohamed Alghamdi ◽  
Shouki Bazarbashi ◽  
Elsamany Shereef ◽  
Mervat Mahrous ◽  
Omar Al shaer ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Saudi Arabia ◽  
Neutrophil Count ◽  
Prognostic Significance ◽  
Progression Free Survival ◽  
P Value ◽  
Second Line ◽  
First Line ◽  
Free Survival

e15586 Background: In Saudi Arabia, the incidence of colorectal cancer has been increased over the past few years. The optimal treatment beyond the second line is not fully understood. To the best of our knowledge, the efficacy and disease outcomes of triflurodine/tipiracil in Saudi patients with refractory metastatic colorectal cancer(mCRC) has not been studied yet. Our study is a real-life practice evaluation of the efficacy of triflurodine/tipiracil in patients with refractory mCRC. Moreover, the prognosis and the prognostic significance of the different clinical variables have been analyzed. Methods: A retrospective, multi-centers ( 5 centers representative of Saudi Arabia )observational study in patients with mCRC who have received triflurodine/tipiracil beyond oxaliplatin & Irinotecan-based chemotherapy between December 2018-December 2020.We aimed to assess the response to triflurodine/tipiracil, to evaluate the progression-free survival (PFS ), the overall survival (OS), and the associated factors of prognostic significance. Results:The data of 100 patients with refractory mCRC who has received triflurodine/tipiracil have been analyzed. The mean age was 55.2 +11.8 years. Forty-two patients were (42%) females and 58 (58%) were male patients. Sigmoid was the most common primary site of cancer in 35 (35%) patients, followed by rectum 29 (29%). Peritoneal metastasis was present in 17 (23.3%) patients ,liver in 51(56.6%) and lung in 39 (50.7%). Metastatic sites were ≥ 2 in 45 (45%) patients. Metastatic lesions were ≥ 5 in 65 (65%) patients. Xelox chemotherapy regimen was the most commonly used first-line chemotherapy which represents 43%, while Folfiri or Xeliri combination was the most used second line in 57 (60%). For the third line, Folfox or Xelox was used in 81 (83.5%) patients. The fourth line was given to 49 (67.1%). For first-line biological agents, Cetuximab was used most frequently 31 (46.3%).Evaluation of the response to treatment with triflurodine/tipiracil revealed one patient (1%) with a complete response,3 patients (3%) with partial response, 28 (28%) patients with stable disease, and 66 (66%) showed progressive disease. The estimated median progression-free survival was 5 months ( 3.839 - 6.161) and the median overall survival was 12 months (9.732-14.268). The log-rank analysis showed that the baseline neutrophils ≤ 75 % ( P-value= 0.0092) and low hemoglobin level (P-value= 0.0245) were strongly associated with a higher survival. By multivariate Cox regression analysis, the neutrophil count ≤ 75 % was the only independent predictor for survival. Conclusions: Trifluridine/tipiracil is effective in patients with refractory mCRC. The low neutrophil count might predict a better overall survival.

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