Integrating Routine Clinical Factors to Stratify Colorectal Cancer Patients with Liver and Lung Metastases for Immune Therapy

Abstract Aim To identify the most relevant clinical factors in the National Bowel Cancer Audit (NBOCA) that contribute to the variation in the quality of care provided in different hospitals for colorectal cancer patients undergoing surgery. Method Data from 36,116 patients with colorectal cancer who had undergone surgery were retrospectively collected from the NBOCA and analysed from 145 and 146 hospitals over two years. A validated multiple linear regression was performed to compare the identified clinical factors with various quality outcomes. The quality outcomes defined in this study were the length of hospitalisation, 2-year mortality, readmission rate, 90-day mortality, and 18-month stoma rate. Results Four clinical factors (laparoscopy rate, abdominal-perineal-resection-of-rectum (APER), pre-operative radiotherapy and patients with distant metastases) were shown to have a significant (p < 0.05) impact on the length of hospitalisation and 18-month stoma rate. 18-month stoma rate was also significantly associated with 2-year mortality. External validation of the regression model demonstrated the Root-Mean-Square-Error of 0.811 and 4.62 for 18-month stoma rate and 2-year mortality respectively. Conclusions Hospitals should monitor the four clinical factors for patients with colorectal cancer during perioperative care. Clinicians should consider these factors along with the individual patients’ history when formulating a management plan for patients with colorectal cancer.

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Alterations in the Oral and Gut Microbiome of Colorectal Cancer Patients and Association with Host Clinical Factors

International Journal of Cancer ◽

10.1002/ijc.33596 ◽

2021 ◽

Author(s):

Yao Wang ◽

Yao Zhang ◽

Yun Qian ◽

Yuan‐Hong Xie ◽

Shan‐Shan Jiang ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Patients ◽

Gut Microbiome ◽

Clinical Factors ◽

Colorectal Cancer Patients

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Genomic Classifier ColoPrint Predicts Recurrence in Stage II Colorectal Cancer Patients More Accurately Than Clinical Factors

The Oncologist ◽

10.1634/theoncologist.2014-0325 ◽

2015 ◽

Vol 20 (2) ◽

pp. 127-133 ◽

Cited By ~ 53

Author(s):

Scott Kopetz ◽

Josep Tabernero ◽

Robert Rosenberg ◽

Zhi‐Qin Jiang ◽

Víctor Moreno ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Patients ◽

Stage Ii ◽

Clinical Factors ◽

Stage Ii Colorectal Cancer ◽

Colorectal Cancer Patients

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298. Cytoreductive surgery in colorectal cancer patients with synchronous lung metastases

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2014.08.289 ◽

2014 ◽

Vol 40 (11) ◽

pp. S117

Author(s):

V. Aliev ◽

A. Rasulov ◽

Y.U. Barsukov ◽

A. Allakhverdiev ◽

D. Kuzmichev ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Patients ◽

Cytoreductive Surgery ◽

Lung Metastases ◽

Colorectal Cancer Patients

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Prognostic clinical factors in pretreated colorectal cancer patients receiving regorafenib: Implications for clinical management.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.591 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 591-591

Author(s):

Michela Del Prete ◽

Riccardo Giampieri ◽

Fotios Loupakis ◽

Tiziana Prochilo ◽

Lisa Salvatore ◽

...

Keyword(s):

Colorectal Cancer ◽

Multivariate Analysis ◽

Cancer Patients ◽

Lymphocyte Count ◽

Progression Free Survival ◽

Serum Levels ◽

Clinical Factors ◽

Roc Curve Analysis ◽

Related Factors ◽

Colorectal Cancer Patients

591 Background: Most of the patients receiving regorafenib do not seem to benefit from this treatment approach and are therefore exposed to unnecessary toxicity. Angiogenesis and inflammation-related factors may have a relevant role in modulating the activity of anti-angiogenetic drugs such as regorafenib. In our study, we investigated LDH serum levels, platelet, neutrophil, and lymphocyte counts, and neutrophil-to-lymphocyte ratio (NLR) in predicting clinical outcomes for colorectal cancer patients receiving regorafenib. The final aim was to individuate an easy to use and reliable selection tool for these patients in the clinical practice. Methods: We collected LDH serum levels, neutrophil, lymphocyte, and platelet counts within one month before the start of regorafenib in 208 pretreated metastatic colorectal cancer patients. Cut-off values were calculated by ROC curve analysis. Survival analysis was performed by Kaplan-Meier method, and multivariate analysis by Cox method. Results: At multivariate analysis: high platelet count (p=0.0439), low lymphocyte count (p=0.0013), and high NLR (p=0.0237) were related to worse overall survival (OS); high neutrophil count and high NLR (p=0.0058) were related to worse progression free survival (PFS). Among 52 (25%) patients who were negative for all risk factors, a significant correlation was found with improved OS and PFS if compared with the group of patients with at least one risk factor. In particular, median OS was respectively 15.9 vs. 3.1 months (HR: 3.81, 95% CI: 2.32-4.82, p<0.0001) whereas median PFS was 5.9 vs. 2.1 months (HR: 2.62, 95% CI: 2.06-3.86, p<0.0001). Conclusions: We can speculate that colorectal cancer patients showing high neutrophil, high platelet, low lymphocyte count or high NLR may not be optimal candidates for regorafenib treatment. After confirmation in further prospective series, these clinical factors could play a role in the treatment strategy process.

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Safety and efficacy of radiofrequency ablation for pulmonary metastases in metastatic colorectal cancer patients: A single center experience.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.4_suppl.141 ◽

2020 ◽

Vol 38 (4_suppl) ◽

pp. 141-141

Author(s):

Dong-Hoe Koo ◽

Hyun Pyo Hong ◽

Sukjoong Oh ◽

Yun-Gyoo Lee ◽

Kyung A. Kang ◽

...

Keyword(s):

Colorectal Cancer ◽

Radiofrequency Ablation ◽

Metastatic Colorectal Cancer ◽

Cancer Patients ◽

Pulmonary Metastases ◽

Lung Metastases ◽

Tumor Control ◽

Safety And Efficacy ◽

Extra Pulmonary ◽

Colorectal Cancer Patients

141 Background: Radiofrequency ablation (RFA) has been increasingly used for the treatment of pulmonary metastases from several types of malignancies. Methods: A retrospective analysis was performed for the safety and efficacy of percutaneous RFA in patients with metastatic colorectal cancer between October 2016 and June 2019 as well as assessing prognostic factors of local tumor control. Results: RFA was carried out for 48 lung metastases in 31 consecutive colorectal cancer patients. Male was 17 patients (55%), and the median age at RFA was 61 years (range, 42-81). The mean diameter of metastases targeted for RFA was 12 mm (range, 4-32), and 17 tumors (35%) were located in a sub-pleural or deep position. Although five cases (10%) were failed due to immediate complications, there was no procedure-related death. In terms of immediate complication, a total of 12 cases (25%) had events including nine pneumothorax (percutaneous drain in four), one pleural effusion, and two hemoptysis (ICU care in one). Delayed complications were lung abscess and diaphragm injury in each one patient, respectively. At the time of analysis, the median follow-up duration from RFA was 12.0 months (interquartile range, 6.5-23.1). Only two patients (6%) died of disease progression, and 3-year overall survival rate was 85.5% (95% CI, 75.5-95.5). RFA site progression was observed in 11 patients (23%), and 1-year and 2-year progression-free survival rates were 71.5% (95% CI, 58.7-84.3) and 56.6% (95% CI, 42.6-70.6), respectively. Multivariate analysis showed that extra-pulmonary progression (hazard ratio 17.49; p = 0.023) was only one independent prognostic factor associated with RFA site progression after adjusting for confounding factors including sex, age, performance, tumor size, location, contact with the vessel, last chemotherapy response, and duration. Conclusions: RFA is a comparatively safe and effective option for the treatment of small-sized lung metastases; however, the control of extra-pulmonary metastases should be accompanied for effective local control.

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