Survival Outcomes and Prognostic Predictors in Patients With Malignant Struma Ovarii

Background: Malignant struma ovarii (MSO) is an extremely rare ovarian malignant tumor and there is limited data on the survival outcomes and prognostic predictors of MSO. The objectives of this study were to investigate the disease-free survival (DFS), overall survival (OS), and disease-specific survival (DSS) rates of patients with MSO, and also evaluate the prognostic factors in this population.Methods: A retrospective study was conducted and 194 cases of MSO were selected. DFS was assessed by the logistic regression, OS by the Kaplan–Meier method, and DSS was evaluated by the Cox regression.Results: The median age of these patients was 46.0 years; 142 cases (73.2%) were confined to the ovary and 52 cases (26.8%) had extraovarian metastasis at the initial diagnosis of MSO. During the follow-up, 75.3% of these patients showed no evidence of disease and 18.0% were alive with disease. Only 13 deaths occurred, with 10 attributed to MSO. The 5, 10, and 15-year OS rates were 91.4, 87.7, and 83.5%, respectively. The 5, 10, and 15-year DSS rates were 93.8, 90.0, and 85.7%, respectively. Logistic regression revealed that International Federation of Gynecology and Obstetrics (FIGO) stage IV was the only risk factor for DFS [p < 0.001; odds ratio (OR) 7.328; 95% CI 3.103–16.885, FIGO stage IV vs. stage I; p = 0.021; OR 4.750, 95% CI 1.264–17.856, FIGO stage IV vs. stage II-III]. The multivariate Cox regression analysis showed that poor differentiation was the only risk factor for both OS (p = 0.005, OR 6.406; 95% CI 1.730–23.717) and DSS (p = 0.001, OR 9.664; 95% CI 2.409–38.760), while age ≥45 years was the prognostic predictor for OS (p = 0.038, OR 4.959; 95% CI 1.093–22.508).Conclusion: Survival outcomes were excellent in patients with MSO, irrespective of the treatment strategy, FIGO stage IV, age ≥45 years, and poor differentiation of tumors were the independent risk factors.

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FIGO Stage IV and Age Over 55 Years as Prognostic Predicators in Patients With Metastatic Malignant Struma Ovarii

Frontiers in Oncology ◽

10.3389/fonc.2020.584917 ◽

2020 ◽

Vol 10 ◽

Author(s):

Sijian Li ◽

Tengyu Yang ◽

Xiaoyan Li ◽

Limeng Zhang ◽

Honghui Shi ◽

...

Keyword(s):

Stage Iv ◽

Figo Stage ◽

Struma Ovarii ◽

Malignant Struma Ovarii

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A Comparison of AIDS-Defining Events and Subsequent CDC Stage IV Events in IDUs and Gay Men

International Journal of STD & AIDS ◽

10.1177/095646249400500608 ◽

1994 ◽

Vol 5 (6) ◽

pp. 419-423 ◽

Cited By ~ 3

Author(s):

J D C Ross ◽

R Brettle ◽

C Zhu ◽

G Haydon ◽

R A Elton

Keyword(s):

Logistic Regression ◽

Gay Men ◽

Cox Regression ◽

Stage Iv ◽

Risk Groups ◽

Chi Square ◽

Cmv Retinitis ◽

Control Stage ◽

The Uk ◽

High Level

The two major risk groups for acquisition of HIV in the UK are gay men and IDUs. Individuals from these risk groups vary in a number of respects in their life-style, which have the potential to affect the course of their HIV disease. This study compares gay men and IDUs from the Lothian Region of Scotland with respect to their AIDS defining diagnosis and subsequent CDC (Centers for Disease Control) stage IV events. Comparisons were made between the two risk groups for their AIDS defining diagnosis by performing chi square tests, Mann-Whitney tests and logistic regression. Subsequent CDC stage IV events were analysed using ordinal logistic regression and Cox regression. 89 IDUs and 56 gay men were included in the analysis. Oesophageal Candida was a commoner AIDS-defining diagnosis in IDUs than gay men and Kaposi's sarcoma was diagnosed more frequently in gay men than IDUs. Subsequently oesophageal Candida was also commoner in IDUs and CMV retinitis was seen more frequently in gay men. The role of prophylaxis and differences in diet are discussed as possible causes of the observed differences in the incidence of oesophageal Candida. The higher incidence of CMV retinitis in gay men probably reflects the high level of sexual acquisition of CMV.

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Evaluation of the Effect of Cumulative Cisplatin Dose in Locoregionally Advanced Nasopharyngeal Carcinoma Patients Receiving Intensity-Modulated Radiotherapy

10.21203/rs.2.13959/v1 ◽

2019 ◽

Author(s):

Sheng-Chiao Lin ◽

Yu-Hsuan Lin ◽

Yaoh-Shiang Lin ◽

Bor-Hwang Kang ◽

Kuo-Ping Chang ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Cox Regression ◽

Intensity Modulated Radiotherapy ◽

Stage Iv ◽

Survival Outcomes ◽

Specific Patient ◽

Female Ratio ◽

Free Survival ◽

Patient Groups ◽

Male To Female

Abstract Background: In nasopharyngeal carcinoma (NPC), the cut-off value of cumulative cisplatin dose (CCD) associated with survival benefits remains controversial. This study aimed to determine a CCD cut-off value for favorable survival outcomes and to identify specific patient groups benefitting from higher CCDs. Methods: We retrospectively reviewed the records of 161 patients (male-to-female ratio of 2.6:1.0) with NPC receiving concurrent chemoradiotherapy ± adjuvant chemotherapy (AC) from February 2006 through September 2015 at our referral center. The CCD was calculated for each patient, and 3-year locoregional-free survival (LRFS), distant-metastasis free survival (DMFS), disease-specific survival (DSS), and overall survival (OS) were analyzed using a multivariable Cox regression model. Results: Stage N3 patients and stage IV patients had lower DMFS, DSS, and OS. A CCD ≥ 200 mg/m 2 or AC was not associated with survival benefits. After adjusting for other factors, N3 status remained robustly correlated with DMFS ( p < 0.001) and DSS ( p = 0.001). In subgroup analyses, stage N3 patients treated with CCD ≥ 200 mg/m 2 exhibited evident trends toward higher OS (one-sided p = 0.062), DSS (one-sided p = 0.100), DMFS (one-sided p = 0.059), and LRFS (one-sided p = 0.059) than patients treated with CCD < 200 mg/m 2 . Conclusions: A CCD ≥ 200 mg/m 2 might result in better survival outcomes in stage N3 patients. Larger CCDs may be exclusively used in cases of regionally advanced disease to avoid rigorous toxicity.

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Comparison of adenocarcinoma and adenosquamous carcinoma prognoses in Chinese patients with FIGO stage IB-IIA cervical cancer following radical surgery

10.21203/rs.3.rs-20226/v2 ◽

2020 ◽

Author(s):

Xiaojing Zhang ◽

Zunfu Lv ◽

Xiaoxian Xu ◽

Zhuomin Yin ◽

hanmei Lou

Keyword(s):

Cervical Cancer ◽

Cox Regression ◽

Adenosquamous Carcinoma ◽

Risk Groups ◽

Figo Stage ◽

Chinese Patients ◽

Survival Outcomes ◽

Intermediate Risk ◽

Stage Ib ◽

Risk Patients

Abstract Background: To compare adenocarcinoma (AC) and adenosquamous carcinoma (ASC) prognoses in patients with FIGO stage IB–IIA cervical cancer who underwent radical hysterectomy. Methods. We performed a retrospective analysis of 240 patients with AC and 130 patients with ASC. Kaplan–Meier curves, Cox regression models, and log-rank tests were used for statistical analysis. Results: Patients with ASC had higher frequencies of lymphovascular space invasion (LVSI) and serum squamous cell carcinoma antigen (SCC-Ag) > 5 ng/ml (p=0.049 and p=0.013, respectively); moreover, they were much older (P=0.029) than patients with AC. There were no clinically significant differences in overall survival (OS) between the groups. When stratified into three risk groups based on clinicopathological features, survival outcomes did not differ between patients with AC and those with ASC in any risk group. Multivariate analysis showed that lymph node metastasis (LNM) was an independent risk factor for recurrence-free survival (RFS) and OS in patients with AC and in patients with ASC. Carcinoembryonic antigen (CEA) > 5 ng/ml and SCC-Ag > 5 ng/ml were independent predictors of RFS and OS in patients with AC. In addition, among those stratified as intermediate-risk, patients with ASC who received concurrent chemoradiotherapy (CCRT) had significantly better RFS and OS (P=0.036 and P=0.047, respectively). Conclusions: We did not find evidence to suggest that AC and ASC subtypes of cervical cancer were associated with different survival outcomes. CCRT is beneficial for survival in intermediate-risk patients with ASC, but not in those with AC. Serum tumour markers can assist in evaluating prognosis and in providing additional information for patient-tailored therapy for cervical AC.

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Metastatic and Locally Advanced Pancreatic Endocrine Carcinomas: Analysis of Factors Associated With Disease Progression

Journal of Clinical Oncology ◽

10.1200/jco.2010.33.0688 ◽

2011 ◽

Vol 29 (17) ◽

pp. 2372-2377 ◽

Cited By ~ 169

Author(s):

Francesco Panzuto ◽

Letizia Boninsegna ◽

Nicola Fazio ◽

Davide Campana ◽

Maria Pia Brizzi ◽

...

Keyword(s):

Risk Factor ◽

Disease Progression ◽

Cox Regression ◽

Locally Advanced ◽

Stage Iv ◽

Progression Free Survival ◽

Major Risk Factor ◽

Proliferation Index ◽

Risk Of Progression ◽

Endocrine Carcinomas

Purpose Knowledge of clinical course of pancreatic endocrine carcinomas (PECs) is poor. This study aimed to determine the time to progression of advanced PECs, and to identify predictors capable of selecting subgroups with higher risk of progression. Patients and Methods In this multicenter retrospective analysis, patients with advanced PECs were enrolled. Staging was according to European Neuroendocrine Tumors Society guidelines. Grading was based on proliferation index using Ki67 immunohistochemistry. The primary end point was progression-free survival (PFS), which was assessed using the Kaplan-Meier method. The Cox regression proportional hazard model was used to identify predictors for tumor progression. Results Two hundred two patients with PECs were enrolled, including 172 with well-differentiated and 30 with poorly differentiated endocrine carcinomas. There were 34 patients with stage III and 168 with stage IV tumors. G1 tumors were present in 19.7% of patients, whereas 60.1% of patients had G2 tumors, and the remaining 20.2% had G3 tumors. Disease progression occurred in 166 patients (82.2%), at a median interval of 10 months (interquartile range, 5 to 22) from diagnosis. Median PFS was 14 months. Different PFS were observed depending on G grade (P < .001) and tumor differentiation (P < .001) and in patients who did not receive any antitumor treatment (P = .002). The major risk factor for progression was the proliferation index Ki67 (hazard ratio, 1.02 for each increasing unit; P < .001). Overall 5-year survival was 44.1%. Conclusion The vast majority of patients with advanced PECs undergo disease progression. The major risk factor for progression is Ki67 index, which should lead physicians dealing with PECs to plan appropriate follow-up programs and therapeutic strategies.

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Evaluation of the Effect of Cumulative Cisplatin Dose in Locoregionally Advanced Nasopharyngeal Carcinoma Patients Receiving Intensity-Modulated Radiotherapy

10.21203/rs.3.rs-21436/v1 ◽

2020 ◽

Author(s):

Sheng-Chiao Lin ◽

Yu-Hsuan Lin ◽

Yaoh-Shiang Lin ◽

Bor-Hwang Kang ◽

Kuo-Ping Chang ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Cox Regression ◽

Intensity Modulated Radiotherapy ◽

Stage Iv ◽

Survival Outcomes ◽

Specific Patient ◽

Female Ratio ◽

Free Survival ◽

Patient Groups ◽

Male To Female

Abstract Background: In nasopharyngeal carcinoma (NPC), the cut-off value of cumulative cisplatin dose (CCD) associated with survival benefits remains controversial. This study aimed to determine a CCD cut-off value for favorable survival outcomes and to identify specific patient groups benefitting from higher CCDs. Methods: We retrospectively reviewed the records of 161 patients (male-to-female ratio of 2.6:1.0) with NPC receiving concurrent chemoradiotherapy ± adjuvant chemotherapy (AC) from February 2006 through September 2015 at our referral center. The CCD was calculated for each patient, and 3-year locoregional-free survival (LRFS), distant-metastasis free survival (DMFS), disease-specific survival (DSS), and overall survival (OS) were analyzed using a multivariable Cox regression model. Results: Stage N3 patients and stage IV patients had lower DMFS, DSS, and OS. A CCD ≥ 200 mg/m 2 or AC was not associated with survival benefits. After adjusting for other factors, N3 status remained robustly correlated with DMFS ( p < 0.001) and DSS ( p = 0.001). In subgroup analyses, stage N3 patients treated with CCD ≥ 200 mg/m 2 exhibited evident trends toward higher OS ( p = 0.119), DSS ( p = 0.119), DMFS ( p = 0.201), and LRFS ( p = 0.125) than patients treated with CCD < 200 mg/m 2 . Conclusions: A CCD ≥ 200 mg/m 2 might result in better survival outcomes in stage N3 patients. Larger CCDs may be exclusively used in cases of regionally advanced disease to avoid rigorous toxicity.

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Clinical characteristics and survival outcomes of malignant struma ovarii confined to the ovary

BMC Cancer ◽

10.1186/s12885-021-08118-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sijian Li ◽

Tengyu Yang ◽

Yang Xiang ◽

Xiaoyan Li ◽

Limeng Zhang ◽

...

Keyword(s):

Papillary Carcinoma ◽

Clinical Characteristics ◽

Cox Regression ◽

Treatment Options ◽

Treatment Strategies ◽

Survival Outcome ◽

Struma Ovarii ◽

Unique Type ◽

Malignant Struma Ovarii

Abstract Background Malignant struma ovarii (MSO) is a unique type of ovarian malignancy that data on the survival outcome is limited and management strategy remains controversial due to its extreme rarity. Methods To investigate the clinical characteristics and treatment options in patients with MSO confined to the ovary, while also evaluating the recurrent-free survival (RFS) and overall survival (OS) rate in this population, a retrospective study was conducted. One hundred twenty-five cases of MSO confined to the ovary were enrolled and their clinical characteristics, treatment strategies, and results of follow-up were analyzed. OS and RFS were assessed by Kaplan-Meier analyses and Cox regression models. Results The most common pathological subtype in this cohort was papillary carcinoma (44.8%). Other reported subtypes, in order of prevalence, were follicular variant of papillary carcinoma, follicular carcinoma, and mixed follicular-papillary carcinoma. Surgical treatment options varied in this cohort that 8.0% of the patients received ovarian cystectomy, 33.6% underwent unilateral salpingo-oophorectomy (USO), 5.6% received bilateral salpingo-oophorectomy (BSO), 21.6% received total abdominal hysterectomy with BSO (TAH/BSO), and 17.6% were treated with debulking surgery; 20.0% of them received radioiodine therapy (RAI). Twenty-seven patients experienced recurrence with a median RFS of 14.0 years (95% confidence interval [CI], 9.5–18.5). The 5-year and 10-year recurrent rate were 27.1, 35.2%, respectively. Eight patients died during follow-up, with five attributed to MSO; the 5-year, 10-year, and 20-year OS rate was 95.3, 88.7 and 88.7%, respectively. However, the univariate and multivariate Cox regression showed no potential risk factor for RFS and OS. Conclusion Patients with MSO confined to the ovary had an excellent survival outcome, despite varied treatment strategies, and the recurrent rate was relatively high. We recommend USO as the preferred surgical option in this population since more aggressive surgery does not improve outcomes and the benefits of RAI are uncertain.

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P0691LIPOPROTEIN(A) AS A POTENTIAL RISK FACTOR FOR CARDIOVASCULAR (CV) AND THROMBOTIC EVENTS IN CHRONIC KIDNEY DISEASE (CKD) AND TRANSPLANTED PATIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0691 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Simona Simone ◽

Francesca Cianciotta ◽

Fabio Sallustio ◽

Francesco Pesce ◽

Giuseppe Grandaliano ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Risk Factor ◽

Vascular Access ◽

Renal Allograft ◽

Stage Iv ◽

Serum Levels ◽

Thrombotic Risk ◽

Ckd Stage

Abstract Background and Aims Several studies suggested an independent association between elevated Lipoprotein (a) [Lp(a)] levels and the incidence of CV events in the normal population. Lp(a) levels start to rise with decreasing glomerular filtration rate. Whether high Lp(a) serum levels may contribute to the pathogenesis of atherosclerosis or thrombosis in CKD and, particularly, in transplanted (Tx) patients is largely unclear. Furthermore, it is still uncertain to which extent very high Lp(a) levels might influence CV events in this population. Aims: 1. To evaluate Lp(a) serum concentrations and lipid profile in CKD, dialysis and Tx patients. 2. To investigate the relationship between Lp(a) serum levels and atherosclerotic cardiovascular disease (ASCVD), including myocardial infarction, coronary revascularization, cerebrovascular accident, carotid endarterectomy, peripheral revascularization, gangrene, or limb amputation. 3. To assess whether Lp(a) may have a role in thrombotic events (failure of vascular access in HD or early renal allograft thrombosis after transplantation) in these patients. Method Serum Lp(a) levels and lipid profile were assessed in 295 patients (M 172, F 123; mean age 57.3, range 19-85 years): 23 with CKD stage I-III, 76 with CKD stage IV-V, 128 on dialysis (68 hemodialysis (HD), 60 peritoneal dialysis) and 68 were kidney Tx recipients (eGFR>30 ml/min). In the latter group, Lp(a) values were assayed before and after transplantation. Lp(a) levels were determined using the Macra® Lp(a) ELISA kit (Trinity Biotech, USA). Values are expressed as median and interquartile range. Logistic regression analysis was used to determine whether Lp(a) is a risk factor for CV and thrombosis disease. The cut-off value was identified according to maximum Youden index by receiver operating characteristic (ROC) curve. Results Increased mean serum levels of LDL-C (93.85 mg/d; normal values=<70 mg/dl) were observed in all groups of patients, while HDL-C and triglycerides serum levels were in the normal range. Serum Lp(a) levels (nv=14-31 mg/dl) were significantly (p<0.001) increased in advanced CKD group (stage IV-V) (45.5, 1.5-216.5 mg/dl) and, mostly, in patients on dialysis treatment (63.2, 2.0-216.6 mg/dl, p=0.001) compared to mild-moderate CKD group (stage I-III) (32, 1.3-149 mg/dl). Lp(a) serum levels correlated significantly with age (r=0.11, p<0.05) and, inversely, with eGFR only in advanced CKD group (r=-0.21 p<0.05). A significant (-56%; p<0.001) decrease of serum Lp(a) was observed after renal Tx, while staying in HD for another year resulted in an increase in serum Lp (a) levels of about 23.7% (p<0.003). No significant relationship was found between Lp(a) values and gender, inflammation (as assessed by serum C-reactive protein levels), or diabetes. By logistic regression analysis, Lp(a) values were found to be a risk factors for ASCVD in the whole population (No events 246 pts: Lp(a) 47.8 mg/dl; Yes events 49 pts: Lp(a) 53.8 mg/dl; p=0.049) and for thrombotic events in HD group (vascular access thrombosis: 4 events) and Tx patients (early acute renal vein thrombosis after Tx: 4 events) (p=0.028). The ROC curve (AUC 0.7829, 95% CI 0.5751-0.9907) allowed us to define the cut-off value for serum Lp(a) (82.45 mg/dl) (sensitivity of 87%; specificity of 73%) as a thrombotic risk factor in HD and Tx patients. Conclusion The study confirms the relevance of Lp(a) as non-traditional CV risk factor in CKD and Tx patients predicting both, the development of ASCVD and thrombosis. Serum Lp(a) levels higher than 82.45 mg/dl are potential thrombotic risk factors for vascular access failure in HD patients or early acute renal allograft thrombosis in Tx patients, suggesting more aggressive strategies to lower Lp(a) serum levels in this patient setting.

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Rare subtypes of pancreatic cancer: Clinical outcomes and implications for clinical trial enrollment.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.445 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 445-445 ◽

Cited By ~ 1

Author(s):

John David ◽

Richard Tuli ◽

Nicholas Nissen ◽

Jun Gong ◽

Alexandra Gangi ◽

...

Keyword(s):

Pancreatic Cancer ◽

Clinical Trial ◽

Overall Survival ◽

Clinical Trials ◽

Clinical Outcomes ◽

Cox Regression ◽

Stage Iv ◽

Survival Outcomes ◽

Median Income ◽

Cancer Subtypes

445 Background: Pancreatic cancer subtypes such as adenosquamous (AS) and squamous cell carcinoma (SCC) are rare and poorly understood. Treatment recommendations are extrapolated from pancreatic adenocarcinoma (AC) and these patients are often included in AC clinical trials. Herein, we describe clinical outcomes and inclusion of these subtypes in AC clinical trials. Methods: The National Cancer Database (NCDB) was queried to identify patients with AC, AS, and SCC between 2004 and 2014. Overall survival was evaluated using Kaplan-Meier methodology and multivariable (MVA) cox regression models were fit to identify differences in survival outcomes between subtypes adjusted by baseline demographic and clinical variables. ClinicalTrials.gov was interrogated to identify inclusion of AS and/or SCC in contemporary PA clinical trials. Results: We identified 115,061 patients with pancreatic cancer. Median age was 69 (range 18 – 90) and median follow up was 54 months (95% CI 53 – 55). Age, sex, median income, education, comorbidities, race, and stage were significantly associated with overall survival (OS). OS by subtype compared to AC: AS HR of 0.98 (p = 0.59) and SCC HR 1.29 (p < 0.001). OS by subtype and stage compared to AC: stage I/II, AS HR of 0.98 (p = 0.59), SCC HR 1.44 (p = 0.001); stage III, AS HR of 1.32 (p = 0.02) and SCC HR 1.48 (p = 0.01); stage IV, AS HR of 1.1 (p = 0.06), SCC HR 1.2 (p = 0.06). Data from 283 phase II or III interventional trials completed between 2008-2018 were exported from clinicaltrials.gov. The majority of trials listed did not specify inclusion or exclusion of AS or SCC subtypes. Conclusions: This is the largest report of clinical outcomes in rare subtypes of pancreatic cancer. SCC and to a lesser extent, AS, have worse OS compared to AC. It is unclear how rare pancreatic cancer subtypes are handled in the inclusion and analysis of clinical trial data and how this may impact enrollment and survival outcomes.[Table: see text]

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Prognosis of Laparoscopic Surgery for Colorectal Cancer in Middle-Aged Patients: A Propensity Score-Matched Analysis

10.21203/rs.3.rs-428811/v1 ◽

2021 ◽

Author(s):

Feng Bao ◽

Li-rong Wu ◽

Zhi-gang Deng ◽

Chun-hua Xiang ◽

Guo-qiang Li ◽

...

Keyword(s):

Propensity Score ◽

Cox Regression ◽

Histological Grade ◽

Stage Iv ◽

Progression Free Survival ◽

Stage Iii ◽

Survival Outcomes ◽

Middle Aged ◽

Aged Patients ◽

High Histological Grade

Abstract Background: The prognosis of middle-aged patients with CRC treated by laparoscopic resection (LR) is unclear. This study aimed to evaluate the survival outcomes of LR compared with open resection (OR) for patients with CRC and 45-65 years of age.Methods: This retrospective cohort study used the data from a database of all consecutive colorectal resections performed between January 2009 and December 2017. Propensity score matching (PSM) was done to handle the selection bias based on age, gender, body mass index (BMI), tumor location, AJCC stage, and admission year. Univariate and multivariate COX regression model was used to identify risk factors of overall survival (OS) and progression-free survival (PFS).Results: After PSM, 217 patients were included in each group. There were no differences in OS and PFS between the two groups (all P>0.05). There was less blood loss for LR (P<0.001), but the other complications were similar between the two groups. The multivariate analysis showed that high histological grade (hazard ratio [HR]=2.262, 95%CI: 1.334-3.836, P=0.002), stage III (HR=1.744, 95%CI: 2.360-25.406, P=0.001), stage IV (HR=47.905, 95%CI: 14.430-159.033, P<0.001), and adjuvant therapy (HR=0.547, 95%CI: 0.358-0.838, P=0.006) were independently associated with OS. High preoperative CEA (HR=1.585, 95%CI: 1.049-2.394, P=0.029), high histological grade (HR=2.128, 95%CI: 1.272-3.558, P=0.004), stage III (HR=5.562, 95%CI: 1.980-15.624, P=0.001), and stage IV (HR=26.338, 95%CI: 9.090-76.315, P<0.001), were independently associated with OS. LR was not associated with OS and PFS.Conclusions: In middle-aged patients with CRC, OR and LR have similar survival outcomes and complications.

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