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Perioperative therapy in metastatic colorectal cancer: Pattern of use and survival outcomes
Author(s) -
Alese Olatunji B.,
Zakka Katerina,
Huo Xingyue,
Jiang Renjian,
Shaib Walid L.,
Akce Mehmet,
Behera Madhusmita,
Sullivan Patrick,
Wu Christina,
ElRayes Bassel F.
Publication year - 2021
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26278
Subject(s) - medicine , colorectal cancer , perioperative , proportional hazards model , hazard ratio , primary tumor , chemotherapy , univariate analysis , oncology , multivariate analysis , cancer , surgery , panitumumab , metastasis , cetuximab , confidence interval
Background Multimodality therapy of metastatic colorectal cancer (mCRC) is currently considered the standard of care. The aim of this study was to evaluate the impact of perioperative therapy on surgical resection in mCRC. Methods The National Cancer Database was analyzed for affected patients between 2004 and 2013. Univariate and multivariate analyses were done to identify factors associated with patient outcomes. Kaplan–Meier analysis and Cox proportional hazards models were used for the association between patient characteristics and survival. Results About 61,940 patients with mCRC were identified. Mean age = 63.4 years ( SD ± 14). About 69% had a colon primary and 32% had only one metastatic site. Only 49% of those who underwent surgery for both primary and metastatic sites received postoperative chemotherapy ( p < .001). Negative prognostic factors included no chemotherapy received (hazard ratio [HR], 2.32; 2.27–2.37; p < .001), more than three metastatic sites (HR, 2.28; 2.09–2.48; p < .001), year of diagnosis between 2004 and 2008 (HR, 1.71; 1.15–1.20; p < .001) and colon tumor location with right worse than left‐sided (HR, 1.21; 1.19–1.24; p < .001). Five‐year overall survival for resection of the primary and metastatic site (28.2%) was higher than for no surgical treatment (4.7%). Conclusion Perioperative therapy was associated with improved survival, following resection of metastatic sites or primary tumor.