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Validation study of a prognostic classification in patients with metastatic colorectal cancer who received irinotecan-based second-line chemotherapy

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Abstract

Purpose

Five prognostic factors had been previously identified in patients with metastatic colorectal cancer (MCRC) who received irinotecan-based second-line chemotherapy. Patients were classified into three prognostic groups based on significant differences in median overall survival (OS). This study is conducted to validate this classification in an external validation cohort.

Methods

This retrospective study included 193 patients of an external validation cohort who received irinotecan-based second-line chemotherapy after first-line oxaliplatin-based chemotherapy, with or without bevacizumab at three institutions.

Results

Three of the five predefined factors (poorly differentiated adenocarcinoma, LDH ≥400 IU/L, progression-free survival of first-line therapy <6 months) remained highly significant in the validation cohort, although two (performance status 2 and peritoneal metastasis) were associated with borderline significance. The distribution of the three prognostic groups (low risk = no factors, intermediate risk = 1 factor, high risk = 2 or more factors) was low risk (n = 68; 35 %), intermediate risk (n = 80; 41 %), and high risk (n = 45; 23 %). The median OS of each group were 19.8, 11.0, and 7.9 months, respectively, with significant differences between groups, as found in the previous cohort.

Conclusion

The previous prognostic classification of patients with MCRC who received irinotecan-based second-line chemotherapy was validated in another independent cohort. Validation in prospective studies is warranted.

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Conflict of interest

The authors have no financial and/or personal relationships with other people or organizations to report.

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Authors and Affiliations

  1. Department of Gastrointestinal Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Kohei Shitara

  2. Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan

    Kohei Shitara & Kei Muro

  3. Department of Gastroenterology, Hokkaido University Hospital, Hokkaido, Japan

    Satoshi Yuki

  4. Department of Gastroenterology, Shizuoka Cancer Center, Shizuoka, Japan

    Kentaro Yamazaki & Hirofumi Yasui

  5. Department of Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan

    Yoichi Naito

  6. Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan

    Yoichi Naito & Toshimi Takano

  7. Department of Cancer Center, Hokkaido University Hospital, Hokkaido, Japan

    Hiraku Fukushima & Yoshito Komatsu

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  1. Kohei Shitara
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  2. Satoshi Yuki
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  3. Kentaro Yamazaki
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  8. Toshimi Takano
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  9. Kei Muro
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Correspondence to Kohei Shitara.

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Shitara, K., Yuki, S., Yamazaki, K. et al. Validation study of a prognostic classification in patients with metastatic colorectal cancer who received irinotecan-based second-line chemotherapy. J Cancer Res Clin Oncol 139, 595–603 (2013). https://doi.org/10.1007/s00432-012-1349-1

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  • DOI: https://doi.org/10.1007/s00432-012-1349-1

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