Synchronous brain metastasis and impact of primary tumor side in colorectal cancers.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 712-712
Author(s):  
Mahvish Muzaffar ◽  
Abdul Rafeh Naqash
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Brain Metastasis ◽  
Regression Model ◽  
Primary Tumor ◽  
Tumor Grade ◽  
Hepatic Flexure ◽  
Female Ratio ◽  
Cancer Tumor ◽  
The Impact

712 Background: 25% of patients with colorectal cancer(CRC) present with synchronous metastatic disease. The incidence of brain metastasis (BM) in CRC is very low (1.2–3.2%) and tend to occur later in the disease course. Synchronous BM(SBM) in CRC is very rare. We sought to explore the impact of primary tumor characteristics on SBM. Methods: Surveillance Epidemiology End Results Program (SEER) 18 registries research data on primary colorectal cancer cases diagnosed during 2010-2015 with brain metastasis at diagnosis were identified. Patients with unlabeled primary site and autopsy alone cases were excluded. Demographic and colorectal cancer characteristics including age, gender, race, tumor grade and primary tumor side were analyzed. Logistic regression model was used to test the association between survival and side of cancer. Results: A total of 475 cases met the inclusion criteria. The mean age was 64.04 yrs. (range 28-95). Majority of the patients (80%) were white, 12% black and others (8%), Male: Female ratio was 1:1.58% patients had primary tumor on left side (splenic flexure, sigmoid, rectosigmoid and rectal) and 42% had right sided (ascending colon, hepatic flexure, cecum, transverse colon) primary tumor. The median overall survival was 5 months with 1-year survival of 26% in the whole cohort. The 1-year overall survival was 21% for patients with right sided primary tumor versus 30% for patients with SBM and left sided primary tumor(p = 0.03). The median disease specific survival was 5 months for right side and 7 months for Left sided tumor with SBM. The regression model showed that higher grade (RR 14, p = 0.003)) and right sided primary tumor (RR 4.2, p = 0.04) were associated with worse outcome among patients with SBM in colorectal cancer. Conclusions: Synchronous brain metastasis is very rare in colorectal cancer. Tumor side seems to be prognostic even in this aggressive disease subset. This differential outcome further indicates that sidedness should be considered in goals of care and treatment discussion.

Impact of M1a and M1b staging in patients (pts) with metastatic colorectal cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 3590-3590 ◽  
Author(s):  
Hagen F. Kennecke ◽  
Jason Yu ◽  
Sharlene Gill ◽  
Winson Y. Cheung ◽  
Charles Davic Blanke ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Primary Tumor ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Cox Proportional Hazards ◽  
Prognostic Impact ◽  
Primary Tumors ◽  
7Th Edition ◽  
The Impact

3590 Background: In 2009, pts with M1 colorectal cancer were divided into two subsets for the American Joint Committee on Cancer (AJCC) 7th edition. Pts with metastases (mets) confined to one organ or site at initial diagnosis became stage M1a while multiple sites or peritoneal mets became M1b. The objectives of the study are to evaluate the impact of site of mets and M1a/b staging among pts with M1 colorectal cancer. Methods: All pts referred to the BC Cancer Agency from 1999-2007 with newly diagnosed M1 colon or rectal cancer were included. Demographic, treatment, and outcome data were prospectively collected. The prognostic impact of individual sites of mets was assessed by hazard ratio estimates from univariate Cox models. Multivariable Cox proportional-hazards models were used to determine variables associated with overall survival in the entire cohort and in those undergoing resection of their primary tumor. Results: 2,049 pts with M1 disease were included. Median age was 66 years; 71% had colonic origin; 70% had their primary tumor resected; and 69% received chemotherapy. In univariate analysis, solitary mets were associated with improved survival. In multivariable analysis, M1a/b status still had significant prognostic effect. The effect remained significant in the subgroup analysis of pts with resected primary tumors when histology, T and N stage were included. Conclusions: Pts with solitary mets, including peritoneum, have superior overall survival as compared to those with multiple sites of mets. AJCC 7th edition staging that includes M1a/b provides significant prognostic information and should be considered in clinical practice and trials of pts with M1 disease who otherwise have few prognostic factors. [Table: see text]

scholarly journals Clinical Outcomes of Metastatic Colorectal Cancer Following Surgical Resection of the Primary tumor at Hiwa Cancer Hospital, Sulaimani, Iraq

2021 ◽  
Vol 10 (1) ◽  
pp. 7-12
Author(s):  
Kadhim Faruq Namiq ◽  
Kosar Mohammad Ali ◽  
Mohammed Ibrahim Mohialdeen Gubari
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Clinical Outcomes ◽  
Surgical Resection ◽  
Primary Tumor ◽  
Smoking Habit ◽  
Primary Tumors ◽  
Female Ratio ◽  
Cancer Hospital ◽  
One Year

Background: Colorectal cancer (CRC) is one of the main causes of cancer-related mortality. The surgical resection of primary CRC tumors is a critical line of treatment. The present study investigated the clinical outcomes of the surgical resection of the primary tumor in metastatic CRC patients. Materials and Methods: In this prospective and retrospective study, 81 metastatic CRC patients were recruited at Hiwa Cancer Hospital in Sulaimani, Iraq from January 2016 to December 2019. Forty-one patients underwent surgical resection of their primary tumor while the remaining 40 patients did not undergo resection. Data regarding patients’ clinical outcomes were obtained from the clinical portal system of the hospital and were analyzed using SPSS (version 23.0). Results: The patients’ mean (± SD) age was 53.5 (± 17.02) years and the male-to-female ratio was 1.3:1. Patients undergoing the surgical resection of their primary tumors had a significantly better one-year survival compared to those who did not undergo resection (P = 0.04). Based on the results, patients in the surgical resection group continued to have a better overall survival although it was not statistically significant (P = 0.1). Significantly more patients with colon cancer underwent surgical resection compared to rectal cancer (P = 0.03), and smoking habit negatively affected the chance to undergo surgical resection (P = 0.009). Conclusion: In general, the surgical resection of the primary tumor has a significant favorable impact on one-year survival, but possibly not on overall survival. The primary site of the tumor and smoking habits significantly influence the chance to undergo surgical resection whereas the grade of the tumor or the type of systemic therapy has no significant impact in this regard.

Survival impact of metastasis surgical resections and sidedness of primary (1º) tumor location in metastatic colorectal cancer (mCRC) without monoclonal antibodies: Retrospective review from 2003 through 2019.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16022-e16022
Author(s):  
Marcos André Marques Portella ◽  
Mariana Paula Cunha Gonçalves ◽  
Munir Murad Junior ◽  
Robson dos Santos Borges ◽  
Ana Livia Alves Preisser ◽  
...  
Keyword(s):  
Overall Survival ◽  
Monoclonal Antibodies ◽  
Primary Tumor ◽  
Cox Regression ◽  
Tumor Location ◽  
Hepatic Flexure ◽  
Entire Cohort ◽  
Independent Prognostic Marker ◽  
Mutational Status ◽  
The Impact

e16022 Background: Recent data demonstrated a median overall survival (OS) about 35 months for patients with mCRC based on the use of monoclonal antibodies (MA), anti-VEGFR and / or anti EGFR, with sidedness of primary tumor as an independent prognostic marker. However the influence of surgical resections of metastases has not yet been quantified especially after 2003 when were attributed to the inclusion of MA (Kopetz et al 2009). We hypothesized the impact of metastatectomy rate (MR) in the OS of a population without MA and their influence on primary tumor location. Methods: Data from 291 consecutive patients diagnosed with mCRC treated in a clinical center in Brazil, from 2003 to 2019, without MA. 1° location was determined by chart review: R-sided = cecum to hepatic flexure; L-sided = splenic flexure to rectum. Pts with transverse tumors were excluded. Survival from diagnosis was calculated via kaplan-Meier and compare between the right and the left side has estimated via Cox Regression. Results: 50.85%(148) of patients had a primary tumor in the left colon. Oxaliplatin was used in 1° line in 85 % and irinotecan in 75% in 2° line, most of the metastasis was metachronous, only to a single-organ (50,9% liver, 18% lung) and 40 % underwent resection at the diagnosis. The overall survival for the entire cohort was 34.1 months (95% CI, 28.9 to 45.4 months) with 39 % MR. Sidedness (R vs L) had interaction with resected and non-resected metastasis p < 0.001). See OS Table results by sidedness below. Conclusions: It was possible to infer that the metastasectomy rate still have a significant and isolated benefit in the OS of this cohort without the use of MA, regardless of the mutational status of the tumors, being influenced by the sidedness of the primary tumor in the analyzed outcomes. [Table: see text]

scholarly journals Primary tumor surgery improves survival in non-metastatic primary urethral carcinoma patients: a large population-based investigation

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jie Wu ◽  
Yu-Chen Wang ◽  
Wen-Jie Luo ◽  
Bo-Dai ◽  
Ding-Wei Ye ◽  
...  
Keyword(s):  
Regression Model ◽  
Competing Risks ◽  
Primary Tumor ◽  
Cox Regression ◽  
Radical Surgery ◽  
Large Population ◽  
Local Therapy ◽  
Primary Site ◽  
Urethral Carcinoma ◽  
The Impact

Abstract Background Primary urethral carcinoma (PUC) is a rare genitourinary malignancy with a relatively poor prognosis. The aim of this study was to examine the impact of surgery on survival of patients diagnosed with PUC. Methods A total of 1544 PUC patients diagnosed between 2004 and 2016 were identified based on the SEER database. The Kaplan-Meier estimate and the Fine and Gray competing risks analysis were performed to assess overall survival (OS) and cancer-specific mortality (CSM). The multivariate Cox regression model and competing risks regression model were used to identify independent risk factors of OS and cancer-specific survival (CSS). Results The 5-yr OS was significantly better in patients who received either local therapy (39.8%) or radical surgery (44.7%) compared to patients receiving no surgery of the primary site (21.5%) (p < 0.001). Both local therapy and radical surgery were each independently associated with decreased CSM, with predicted 5-yr cumulative incidence of 45.4 and 43.3%, respectively, compared to 64.7% for patients receiving no surgery of the primary site (p < 0.001). Multivariate analyses demonstrated that primary site surgery was independently associated with better OS (local therapy, p = 0.037; radical surgery, p < 0.001) and decreased CSM (p = 0.003). Similar results were noted regardless of age, sex, T stage, N stage, and AJCC prognostic groups based on subgroup analysis. However, patients with M1 disease who underwent primary site surgery did not exhibit any survival benefit. Conclusion Surgery for the primary tumor conferred a survival advantage in non-metastatic PUC patients.

Predicting biomarkers of hepatic metastasis in Chinese colorectal cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15545-e15545
Author(s):  
Honghua Peng ◽  
Tianhao Mu ◽  
Yaping Sheng ◽  
Yingmei Li ◽  
Peiguo Cao
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Hepatic Metastasis ◽  
Primary Tumor ◽  
Potential Candidate ◽  
Poor Overall Survival ◽  
Primary Tumors ◽  
Distant Spread ◽  
Colorectal Cancer Patients

e15545 Background: Hepatic metastasis is the most common site of distant spread from colorectal cancer. About 15-25% patients with colorectal cancer harbors hepatic metastasis. The molecular mechanism and predicting biomarkers in colorectal cancer are still not fully understood. Methods: 57 Chinese colorectal cancer patients were enrolled in a cohort study. Samples of primary tumor were collected in these patients and underwent whole exome sequencing. Mutation profiles of primary tumors between the patients with metastasis and those without metastasis were analyzed and compared. Results: In the cohort, 54.4% (31/57) patients presented hepatic metastasis at the time of diagnosis, while 45.6% (26/57) did not. The patients were divided into 2 groups—with hepatic metastasis and without hepatic metastasis. The mutation landscape of primary tumor indicated that the Top 3 most frequently mutated genes of both groups were the same and presented mutated TP53, APC, and KRAS. 2. Interestingly, compared with the patients without hepatic metastasis, the patients with hepatic metastasis presented a higher frequency of mutated TCF7L2 (35.5% vs 3.85%) and TRIM77 (16.1% vs 0%). Moreover, in the patients with hepatic metastasis, the patients with TRIM77 mutation in primary tumor showed a worse overall survival (p < 0.0001). Conclusions: TCF7L2 and TRIM77 may be identified as potential candidate predicting biomarkers for hepatic metastasis in colorectal patients. In addition, mutated TRIM 77 predicted a poor overall survival in hepatic metastasis from colorectal cancer.

scholarly journals The prognostic impact of RAS on overall survival following liver resection in early versus late-onset colorectal cancer patients

2020 ◽  
Author(s):  
Alexandre A. Jácome ◽  
Timothy J. Vreeland ◽  
Benny Johnson ◽  
Yoshikuni Kawaguchi ◽  
Steven H. Wei ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Liver Resection ◽  
Age Of Onset ◽  
Negative Impact ◽  
Late Onset ◽  
Linear Regression Analysis ◽  
Multidisciplinary Treatment ◽  
Prognostic Impact ◽  
The Impact

Abstract Background The impact of molecular aberrations on survival after resection of colorectal liver metastases (CLM) in patients with early-age-onset (EOCRC) versus late-age-onset colorectal cancer (LOCRC) is unknown. Methods Patients who underwent liver resection for CLM with known RAS, BRAF and MSI status were retrospectively studied. The prognostic impact of RAS mutations by age was analysed with age as a categorical variable and a continuous variable. Results The study included 573 patients, 192 with EOCRC and 381 with LOCRC. The younger the age of onset of CRC, the greater the negative impact on overall survival of RAS mutations in the LOCRC, EOCRC, and ≤40 years (hazard ratio (HR), 1.64 (95% confidence interval (CI), 1.23–2.20), 2.03 (95% CI, 1.30–3.17), and 2.97 (95% CI, 1.44–6.14), respectively. Age-specific mortality risk and linear regression analysis also demonstrated that RAS mutations had a greater impact on survival in EOCRC than in LOCRC (slope: −4.07, 95% CI −8.10 to 0.04, P = 0.047, R2 = 0.08). Conclusion Among patients undergoing CLM resection, RAS mutations have a greater negative influence on survival in patients with EOCRC, more so in patients ≤40 years, than in patients with LOCRC and should be considered as a prognostic factor in multidisciplinary treatment planning.

scholarly journals Coadjuvant Anti-VEGF A Therapy Improves Survival in Patients with Colorectal Cancer with Liver Metastasis: A Systematic Review

2020 ◽  
Vol 2 (2) ◽  
pp. 71-85
Author(s):  
Isabel Novo ◽  
Bárbara Campos ◽  
Filipa Pinto-Ribeiro ◽  
Sandra F. Martins
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Liver Metastasis ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Vascular Endothelial ◽  
Inclusion Criteria ◽  
Effective Treatment Modality ◽  
Endothelial Growth Factor ◽  
The Impact

Background: the presence of liver metastasis in colorectal cancer (CRC) remains one of the most significant prognostic factors. Objective: systematically review the results of studies evaluating the benefit of adding bevacizumab to a normal chemotherapy regime in the survival of patients with colorectal-cancer liver metastasis (CRLM). Search methods: Pubmed and Google Scholar databases were searched for eligible articles (from inception up to the 2 April 2019). Inclusion criteria: studies including patients with CRLM receiving anti-vascular endothelial growth factor (VEGF; bevacizumab) as treatment, overall survival as an outcome; regarding language restrictions, only articles in English were accepted. Main results: Eleven studies met the inclusion criteria. In 73% of these cases, chemotherapy with bevacizumab was an effective treatment modality for treating CRLM, and its administration significantly extended both overall survival (OS) and/or progression-free survival (PFS). Nevertheless, three articles showed no influence on survival rates of bevacizumab-associated chemotherapy. Author conclusions: It is necessary to standardize methodologies that aim to evaluate the impact of bevacizumab administration on the survival of patients with CRLM. Furthermore, follow-up time and the cause of a patient’s death should be recorded, specified, and cleared in order to better calculate the survival rate and provide a comparison between the produced literature.

Sign in / Sign up

Export Citation Format

Share Document