Abstract
Background
Colorectal cancer is a common cause of cancer-related deaths. About 1/3 of all cases present with distant metastasis, with the liver as the leading site and the lung as the most common extra-abdominal site.
Aims
It was aimed to evaluate the clinical characteristics and the outcomes of colorectal cancer patients with liver or lung metastasis who had received local treatments.
Methods
This is a retrospective, cross-sectional, and descriptive study. The study was performed with colorectal cancer patients that referred to the medical oncology clinic of a university hospital between December 2013 and August 2021.
Results
A total number of 122 patients who have received local treatments were included. Radiofrequency ablation was applied in 32 patients (26.2%), metastasis was surgically resected in 84 patients (68.9%), and stereotactic body radiotherapy was preferred in six patients (4.9%). At the first follow-up control after completion of local or multimodal treatment, no residual tumor was determined with radiological assessment in 88 patients (72.1%). The median progression-free survival (16.7 months vs 9.7 months) (p = .000) and the median overall survival (37.3 months vs 25.5 months) (p = .004) of these patients were significantly better than the patients with residual disease.
Conclusions
Local interventions that are applied to highly selected patients may improve the survival of metastatic colorectal cancer patients. A close follow-up after local therapies is important to diagnose recurrent disease because repeated local interventions may be possible to achieve better outcomes.
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Data availability
Our data is available if it is requested.
References
Bray F, Ferlay J, Soerjomataram I et al (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68(6):394–424. https://doi.org/10.3322/caac.21492
Siegel RL, Miller KD, Fedewa SA et al (2017) Colorectal cancer statistics, 2017. CA Cancer J Clin 67(3):177–193. https://doi.org/10.3322/caac.21395
Kanzaki R, Inoue M, Kimura T et al (2017) Role of pulmonary metastasectomy in colorectal cancer in the era of modern multidisciplinary therapy. Surg Today 47(9):1111–1118. https://doi.org/10.1007/s00595-017-1478-x
Treasure T (2019) CS01.01 "Hunting a ghost for 25 years – will we ever catch OMD?” - No. J Thoracic Oncol 14(10):S77. https://doi.org/10.1016/j.jtho.2019.08.184
Palma DA, Olson R, Harrow S et al (2019) Stereotactic ablative radiotherapy versus standard of care palliative treatment in patients with oligometastatic cancers (SABR-COMET): a randomised, phase 2, open-label trial. Lancet 393(10185):2051–2058. https://doi.org/10.1016/S0140-6736(18)32487-5
Embún R, Fiorentino F, Treasure T et al (2013) Pulmonary metastasectomy in colorectal cancer: a prospective study of demography and clinical characteristics of 543 patients in the Spanish colorectal metastasectomy registry (GECMP-CCR). BMJ Open 3(5). https://doi.org/10.1136/bmjopen-2013-002787
Miller G, Biernacki P, Kemeny NE et al (2007) Outcomes after resection of synchronous or metachronous hepatic and pulmonary colorectal metastases. J Am Coll Surg 205(2):231–238. https://doi.org/10.1016/j.jamcollsurg.2007.04.039
Dienstmann R, Salazar R, Tabernero J (2015) Personalizing colon cancer adjuvant therapy: selecting optimal treatments for individual patients. J Clin Oncol 33(16):1787–1796. https://doi.org/10.1200/JCO.2014.60.0213
Hong Y, Kim J, Choi YJ et al (2020) Clinical study of colorectal cancer operation: survival analysis. Korean J Clin Oncol. 16(1):3–8. https://doi.org/10.14216/kjco.20002
Hishida T, Tsuboi M, Okumura T et al (2017) Does repeated lung resection provide long-term survival for recurrent pulmonary metastases of colorectal cancer? Results of a retrospective Japanese multicenter study. Ann Thorac Surg 103(2):399–405. https://doi.org/10.1016/j.athoracsur.2016.08.084
Ruers T, Van Coevorden F, Punt CJ et al (2017) Local treatment of unresectable colorectal liver metastases: results of a randomized phase II trial. J Natl Cancer Inst 109(9). https://doi.org/10.1093/jnci/djx015
Okumura T, Boku N, Hishida T et al (2017) Surgical outcome and prognostic stratification for pulmonary metastasis from colorectal cancer. Ann Thorac Surg 104(3):979–987. https://doi.org/10.1016/j.athoracsur.2017.03.021
Fukada M, Matsuhashi N, Takahashi T et al (2020) Prognostic factors in pulmonary metastasectomy and efficacy of repeat pulmonary metastasectomy from colorectal cancer. World J Surg Oncol 18(1):314. https://doi.org/10.1186/s12957-020-02076-3
Treasure T, Farewell V, Macbeth F et al (2019) Pulmonary metastasectomy versus continued active monitoring in colorectal cancer (PulMiCC): a multicentre randomised clinical trial. Trials 20(1):718. https://doi.org/10.1186/s13063-019-3837-y
Van Cutsem E, Cervantes A, Adam R et al (2016) ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol 27(8):1386–1422. https://doi.org/10.1093/annonc/mdw235
Loree JM, Kopetz S (2017) Why a one size fits all approach to RAS might not fit colorectal cancer. J Natl Compr Canc Netw 15(4):545–547. https://doi.org/10.6004/jnccn.2017.0052
Mavros MN, Hyder O, Pulitano C et al (2013) Survival of patients operated for colorectal liver metastases and concomitant extra-hepatic disease: external validation of a prognostic model. J Surg Oncol 107(5):481–485. https://doi.org/10.1002/jso.23260
Nagashima I, Takada T, Adachi M et al (2006) Proposal of criteria to select candidates with colorectal liver metastases for hepatic resection: comparison of our scoring system to the positive number of risk factors. World J Gastroenterol 12(39):6305–6309. https://doi.org/10.3748/wjg.v12.i39.6305
Konopke R, Kersting S, Distler M et al (2009) Prognostic factors and evaluation of a clinical score for predicting survival after resection of colorectal liver metastases. Liver Int 29(1):89–102. https://doi.org/10.1111/j.1478-3231.2008.01845.x
Adam R, de Haas RJ, Wicherts DA et al (2008) Is hepatic resection justified after chemotherapy in patients with colorectal liver metastases and lymph node involvement? J Clin Oncol 26(22):3672–3680. https://doi.org/10.1200/JCO.2007.15.7297
Jaeck D, Nakano H, Bachellier P et al (2002) Significance of hepatic pedicle lymph node involvement in patients with colorectal liver metastases: a prospective study. Ann Surg Oncol 9(5):430–438. https://doi.org/10.1007/BF02557264
Nordlinger B, Vaillant JC, Guiguet M et al (1994) Survival benefit of repeat liver resections for recurrent colorectal metastases: 143 cases. Association Francaise de Chirurgie. J Clin Oncol 12(7):1491–1496. https://doi.org/10.1200/JCO.1994.12.7.1491
Pawlik TM, Schulick RD, Choti MA (2008) Expanding criteria for resectability of colorectal liver metastases. Oncologist 13(1):51–64. https://doi.org/10.1634/theoncologist.2007-0142
Pulitanò C, Bodingbauer M, Aldrighetti L et al (2012) Colorectal liver metastasis in the setting of lymph node metastasis: defining the benefit of surgical resection. Ann Surg Oncol 19(2):435–442. https://doi.org/10.1245/s10434-011-1902-1
Yasuno M, Uetake H, Ishiguro M et al (2019) mFOLFOX6 plus bevacizumab to treat liver-only metastases of colorectal cancer that are unsuitable for upfront resection (TRICC0808): a multicenter phase II trial comprising the final analysis for survival. Int J Clin Oncol 24(5):516–525. https://doi.org/10.1007/s10147-018-01393-8
Tang W, Ren L, Liu T et al (2020) Bevacizumab plus mFOLFOX6 versus mFOLFOX6 alone as first-line treatment for RAS mutant unresectable colorectal liver-limited metastases: the BECOME randomized controlled trial. J Clin Oncol 38(27):3175–3184. https://doi.org/10.1200/JCO.20.00174
Jawed I, Wilkerson J, Prasad V et al (2015) Colorectal cancer survival gains and novel treatment regimens: a systematic review and analysis. JAMA Oncol 1(6):787–795. https://doi.org/10.1001/jamaoncol.2015.1790
Wimmer K, Schwarz C, Szabo C et al (2017) Impact of neoadjuvant chemotherapy on clinical risk scores and survival in patients with colorectal liver metastases. Ann Surg Oncol 24(1):236–243. https://doi.org/10.1245/s10434-016-5615-3
Roberts KJ, White A, Cockbain A et al (2014) Performance of prognostic scores in predicting long-term outcome following resection of colorectal liver metastases. Br J Surg 101(7):856–866. https://doi.org/10.1002/bjs.9471
Yamashita S, Brudvik KW, Kopetz SE et al (2018) Embryonic origin of primary colon cancer predicts pathologic response and survival in patients undergoing resection for colon cancer liver metastases. Ann Surg 267(3):514–520. https://doi.org/10.1097/SLA.0000000000002087
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Simsek, M., Besiroglu, M., Akcakaya, A. et al. Local interventions for colorectal cancer metastases to liver and lung. Ir J Med Sci 192, 2635–2641 (2023). https://doi.org/10.1007/s11845-023-03340-7
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DOI: https://doi.org/10.1007/s11845-023-03340-7