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Prognostic factors for overall survival in metastatic colorectal cancer using a stop-and-go FLIRI-based treatment strategy

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

To determine overall survival and baseline prognostic variables in a cohort of patients with metastatic colorectal cancer receiving a FLIRI-based stop-and-go treatment strategy.

Methods

Clinical information was collected from patient files in consecutive patients treated with palliative combination chemotherapy using a stop-and-go strategy from September 2007 until June 2011. The primary outcome was overall survival. Cox regression analysis was used to examine the effect of prognostic variables on survival. Baseline variables were performance status, primary tumor site, status of primary tumor (resected or unresected), synchronous metastases, >1 metastatic site, liver-only metastases, alkaline phosphatase (>300 U/l), lactate dehydrogenase (>300 U/l), platelets (>400 × 109/l), and leucocytes (>10 × 109/l).

Results

We included 314 patients (median age 64.5 (57–70) years). Median overall survival was 20.9 (95 % confidence interval (CI), 19.1–223.4) months with a median follow-up of 21.3 months (interquartile range (IQR) 13–34.8). Independent prognostic markers of decreased survival were PS 1 and 2 vs. 0 hazard ratio (HR) 1.47 (95 % CI 1.14–1.91, p = 0.003) and HR 2.06 (95 % CI 1.19–3.56, p = 0.01), colon as the primary tumor site HR 1.43 (95 % CI 1.09–1.88, p = 0.009), unresected primary tumor HR 2.22 (95 % CI 1.61–3.07, p < 0.001), and elevated leucocytes (>10 × 109/l) HR 1.53 (95 % CI 1.12–2.09, p = 0.007).

Conclusions

Overall survival in metastatic colorectal cancer using a FLIRI-based stop-and-go strategy in an unselected consecutive cohort proved comparable to RCTs from the same period. Baseline prognostic markers of poorer prognosis were PS 1 or 2, colon as primary tumor site, unresected primary tumor, and leucocytes >10 × 109/l. These variables are all easy accessible in daily clinical practice.

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Acknowledgments

Roche 3-month research grant.

Conflicts of interest

Camilla Kronborg received a 3-month research grant from ROCHE, which partially founded the study.

Compliance with ethical standards

For this type of study, no formal consent is required. The study was approved by The Danish Data Protection Agency and Danish Health and Medicines Authority.

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Authors and Affiliations

  1. Department of Oncology Aarhus, Aarhus University Hospital, Nørrebrogade 44, 8000, Aarhus C, Denmark

    Camilla S. Kronborg & Anni R. Jensen

Authors
  1. Camilla S. Kronborg
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  2. Anni R. Jensen
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Corresponding author

Correspondence to Camilla S. Kronborg.

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Kronborg, C.S., Jensen, A.R. Prognostic factors for overall survival in metastatic colorectal cancer using a stop-and-go FLIRI-based treatment strategy. Int J Colorectal Dis 30, 1059–1065 (2015). https://doi.org/10.1007/s00384-015-2264-0

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  • DOI: https://doi.org/10.1007/s00384-015-2264-0

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