TY - JOUR
T1 - Predictors of long-term survival in patients with stage IV colorectal cancer with multi-organ metastases
T2 - a single-center retrospective analysis
AU - Miyamoto, Yuji
AU - Hayashi, Naoko
AU - Sakamoto, Yasuo
AU - Ohuchi, Mayuko
AU - Tokunagam, Ryuma
AU - Kurashige, Junji
AU - Hiyoshi, Yukiharu
AU - Baba, Yoshifumi
AU - Iwagami, Shiro
AU - Yoshida, Naoya
AU - Yoshida, Megumi
AU - Baba, Hideo
N1 - Publisher Copyright:
© 2015, Japan Society of Clinical Oncology.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background: The prognosis for most patients with stage IV colorectal cancer (CRC) and multi-organ metastases is poor. However, little information is currently available on prognostic factors in these patients. The aim of this study was to identify predictors of a good prognosis in this patient group. Methods: This was a single-center retrospective study in which we examined the relationship between patient characteristics and prognosis in 161 stage IV CRC patients with indications for first-line systemic chemotherapy. Cox proportional-hazards models were used to compute hazard ratios (HR) for death, adjusted for clinical and pathological characteristics. Results: Of the 161 patients recruited to the study, 83 had single-organ and 78 had multi-organ metastases. Median survival time was significantly shorter in patients with multi-organ metastases than in those with single-organ metastases (19.2 vs. 42.0 months, respectively; log-rank, P < 0.001). There was no significant difference in survival between patients with metastases in two versus three or more organs (log-rank; P = 0.368). According to univariate analysis, primary tumor sites in the left side of the colon and in the rectum, a pretreatment carcinoembryonic antigen concentration of >50 ng/mL, a well-/moderately differentiated tumor, and R0 resection of metastatic lesions were associated with better overall survival. According to multivariate analysis, left-sided location of the primary tumor [HR 0.414, 95 % confidence interval (CI) 0.216–0.815; P = 0.011] and R0 resection of metastatic lesions (HR 0.247, 95 % CI 0.04 0–0.834; P = 0.021) were independently associated with good prognosis. Conclusions: Our results indicate that the site of the primary tumor in the left side of the colon and in the rectum and R0 resection of metastatic lesions are predictors of a good prognosis in patients with stage IV CRC and multi-organ metastases.
AB - Background: The prognosis for most patients with stage IV colorectal cancer (CRC) and multi-organ metastases is poor. However, little information is currently available on prognostic factors in these patients. The aim of this study was to identify predictors of a good prognosis in this patient group. Methods: This was a single-center retrospective study in which we examined the relationship between patient characteristics and prognosis in 161 stage IV CRC patients with indications for first-line systemic chemotherapy. Cox proportional-hazards models were used to compute hazard ratios (HR) for death, adjusted for clinical and pathological characteristics. Results: Of the 161 patients recruited to the study, 83 had single-organ and 78 had multi-organ metastases. Median survival time was significantly shorter in patients with multi-organ metastases than in those with single-organ metastases (19.2 vs. 42.0 months, respectively; log-rank, P < 0.001). There was no significant difference in survival between patients with metastases in two versus three or more organs (log-rank; P = 0.368). According to univariate analysis, primary tumor sites in the left side of the colon and in the rectum, a pretreatment carcinoembryonic antigen concentration of >50 ng/mL, a well-/moderately differentiated tumor, and R0 resection of metastatic lesions were associated with better overall survival. According to multivariate analysis, left-sided location of the primary tumor [HR 0.414, 95 % confidence interval (CI) 0.216–0.815; P = 0.011] and R0 resection of metastatic lesions (HR 0.247, 95 % CI 0.04 0–0.834; P = 0.021) were independently associated with good prognosis. Conclusions: Our results indicate that the site of the primary tumor in the left side of the colon and in the rectum and R0 resection of metastatic lesions are predictors of a good prognosis in patients with stage IV CRC and multi-organ metastases.
UR - http://www.scopus.com/inward/record.url?scp=84948714683&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84948714683&partnerID=8YFLogxK
U2 - 10.1007/s10147-015-0835-2
DO - 10.1007/s10147-015-0835-2
M3 - Article
C2 - 25947545
AN - SCOPUS:84948714683
SN - 1341-9625
VL - 20
SP - 1140
EP - 1146
JO - International Journal of Clinical Oncology
JF - International Journal of Clinical Oncology
IS - 6
ER -
