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.

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 factors influencing survival in small bowel neuroendocrine tumors with liver metastasis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15688-e15688
Author(s):  
Nicholas Manguso ◽  
Attiya Harit ◽  
Nicholas N. Nissen ◽  
James Mirocha ◽  
Andrew Eugene Hendifar ◽  
...  
Keyword(s):  
Liver Metastasis ◽  
Small Bowel ◽  
Surgical Resection ◽  
Primary Tumor ◽  
Cox Regression ◽  
Tumor Grade ◽  
Median Number ◽  
Risk Of Death ◽  
Increased Risk ◽  
Complete Surgical Resection

e15688 Background: Management of liver metastasis in patients with small bowel neuroendocrine tumors (SBNET) remains unclear. Complete surgical resection improves long term survival however factors that influence overall prognosis are not clear. Methods: Database review identified 301 patients diagnosed with SBNET from 1990 to 2013. Only patients with known liver metastasis who underwent resection of the primary tumor were included. Outcomes among patients who underwent complete surgical resection, incomplete debulking of liver metastasis, and resection of the primary tumor alone were compared. The Kaplan-Meier method was used for survival estimates and Cox regression was used to identify predictors of death. Results: 111 patients met study criteria. Median age was 59 years (range 16-80); 49% were male. The terminal ileum (47/111, 42%) was the most common primary tumor location. The median number of liver lesions was 8.5 (range 1-31) and median lesions resected was 1 (range 0-31). In addition to resection of the primary tumor, 36 patients (32%) had no liver resection (NR), 41 (36.9%) had complete resection of liver disease (R0) and 34 (30%) had incomplete resection of liver metastasis (R1). 58 patients (36%) had one or more wedge resections, 12 (10.8%) underwent segmentectomy and 5 (4.5%) had a lobectomy. 33 (29.7%) patients underwent post-operative chemoembolization, 25 (22.5%) had radioembolization and 23 (20.7%) had radiofrequency ablation. The R1 group differed from the R0 group in median size of primary tumor (2.5 cm R1 vs 1.6 cm R0, p = 0.05) and median number of positive lymph nodes (5.0 R1 vs 3.0 R0, p = 0.05). The 5-year OS was 80.9%, 81.1% and 100% for NR, R1 and R0 groups respectively (p = 0.01). 10-year OS did not differ between groups (72.8% NR vs 81.1% R1vs 82.5% NR, p = 0.31). Cox regression showed post-operative administration of chemotherapy (HR = 3.68, p < 0.01) and higher tumor grade (HR = 18.4, p = 0.02) increased risk of death. Conclusions: In patients with SBNET with liver metastasis, higher tumor grade and post-operative chemotherapy increased risk of death. However, resection of the primary tumor along with liver metastasis improves the 5-year OS with complete cytoreduction providing the most benefit.

scholarly journals Colonic stent vs surgical resection of the primary tumor. Effect on survival from stage-IV obstructive colorectal cancer

2020 ◽  
Author(s):  
Agustín Seoane Urgorri ◽  
Esteban Saperas ◽  
Elena O'Callaghan Castella ◽  
Miguel Pera Román ◽  
Agn�s Raga Gil ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Surgical Resection ◽  
Primary Tumor ◽  
Stage Iv ◽  
Obstructive Colorectal Cancer ◽  
Colonic Stent

Impact of Site-Specific Metastases on Surgical Value and Survival among Metastatic Colorectal Cancer Patients

2020 ◽  
Vol 86 (3) ◽  
pp. 220-227
Author(s):  
Zhen Zong ◽  
Tai-Cheng Zhou ◽  
Fu-Xin Tang ◽  
Hua-Kai Tian ◽  
Anan Wang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Cancer Patients ◽  
Surgical Resection ◽  
Pulmonary Metastases ◽  
Stage Iv ◽  
Prognostic Impact ◽  
Stage Iv Colorectal Cancer ◽  
Metastatic Sites ◽  
Colorectal Cancer Patients

We aimed to explore the potential prognostic impact of the metastatic site on the management approach and prognosis of stage IV colorectal cancer patients with synchronous metastases. Synchronous metastatic colorectal cancer patients reported to the Surveillance, Epidemiology, and End Results Program database between 2010 and 2013 were included in this study. Overall survival (OS) was compared between patients with different treatment options using risk-adjusted Cox proportional hazard regression models. Overall, 17,776 patients with stage IV colorectal cancer were identified. Of these patients, 2,052 (11.5%) underwent surgical resection for tumors at both the primary and meta-static sites. Patients who underwent surgical resection of both primary and metastatic sites with liver, lung, and simultaneous liver and lung metastases had a longer median OS ( P < 0.001) than patients who underwent nonsurgical treatments. Cox regression analysis revealed that surgical resection of both primary and metastatic sites was associated with a significantly enhanced OS ( P < 0.001). Colorectal cancer patients with hepatic or pulmonary metastases, who underwent metastasectomy, even in selected patients with both hepatic and pulmonary metastases after multidisciplinary evaluation, could have a better survival benefit than patients who underwent nonsurgical treatments.

Benefit of Surgical Resection of the Primary Tumor in Patients Undergoing Chemotherapy for Stage IV Colorectal Cancer with Unresected Metastasis

2017 ◽  
Vol 22 (3) ◽  
pp. 460-466 ◽  
Author(s):  
Sean Maroney ◽  
Carlos Chavez de Paz ◽  
Mark E. Reeves ◽  
Carlos Garberoglio ◽  
Elizabeth Raskin ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Surgical Resection ◽  
Primary Tumor ◽  
Stage Iv ◽  
Stage Iv Colorectal Cancer

Impact of surgery and radiation of the primary among women with de novo stage IV breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1032-1032
Author(s):  
Shaheenah S. Dawood ◽  
Rebecca Alexandra Dent ◽  
Sudeep Gupta ◽  
Jennifer Keating Litton ◽  
Rashid Mustafa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Tumor ◽  
De Novo ◽  
Stage Iv ◽  
Primary Breast Tumor ◽  
Risk Of Death ◽  
Stage Iv Breast Cancer ◽  
Increased Risk ◽  
The Impact

1032 Background: The aim of this retrospective study was to determine the impact of surgery(S) and radiation(R) therapy to the primary tumor among patients (pts) with stage IV denovo breast cancer. Methods: The SEER registry was used to identify pts with denovo stageIV breast cancer diagnosed between 1988 and 2008. Pts were divided into 4 groups based on type of treatment to primary tumor: both S+R, S alone, R alone, or no treatment of primary (no S/R). Breast cancer specific survival (BCS) was calculated from the date of diagnosis of breast cancer to the date of death from breast cancer or last follow up. Survival outcomes were estimated by the Kaplan-Meier method, and Cox models were fit to determine the association between treatment of primary and survival after adjusting for potential confounders (e.g age, grade, hormone receptor and race). Results: 25903 pts were identified; 4640 (17.9%) S+R, 6556 (25.3%) S, 4467 (17.2%) R, and 10240 (39.5%) no S/R. 1183 (4.6%) had surgery to sites other than the primary. Median age was 63 years. Median follow-up was 14 months. Median BCS was 23 months. Median BCS among pts who underwent S+R, S, R and no S/R was 36 months, 31 months, 18 months and 15 months respectively (p<0.0001). Among pts who underwent S+R, median BCS among pts who did and did not have surgery to sites other than primary was 50 months and 41 months respectively (p=0.029). Of the pts treated with S+R 10-year BCS was 18%. In the multivariable model compared to women who were in the no S/R group those who underwent S (HR= 0.59, 95%CI 0.55- 0.62,p<0.0001) and S+R (HR=0.51, 95%CI 0.47-0.55,p<0.0001) had decreased risk of death from breast cancer and those who underwent R (HR=1.13, 95% CI 1.04-1.21, p=0.002) had an increased risk of death from breast cancer. Pts who had surgery to sites other than the primary tumor had decreased risk of death from breast cancer compared to those who did not (HR=0.80, 95%CI 0.72-0.89,p<0.0001). Conclusions: Our results indicate that S+R of the primary breast tumor among pts with denovo stage IV breast cancer maybe associated with a decreased risk of death from breast cancer. A select subgroup of pts who undergo S+R may also benefit from surgery to sites other than the primary which may afford them maximum survival advantage.

Surgical Resection of Primary Tumor in Asymptomatic or Minimally Symptomatic Patients With Stage IV Colorectal Cancer: A Canadian Province Experience

2015 ◽  
Vol 14 (4) ◽  
pp. e41-e47 ◽  
Author(s):  
Shahid Ahmed ◽  
Anthony Fields ◽  
Punam Pahwa ◽  
Selliah Chandra-Kanthan ◽  
Adnan Zaidi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Surgical Resection ◽  
Primary Tumor ◽  
Stage Iv ◽  
Canadian Province ◽  
Stage Iv Colorectal Cancer
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