Metastasis directed therapy for liver and lung metastases from colorectal cancer—A population‐based study. Issue 12 (22nd October 2018)

• Record Type: Journal Article
• Authors: Boysen, Anders Kindberg; Spindler, Karen‐Lise; Høyer, Morten; Mortensen, Frank Viborg; Christensen, Thomas Decker; Farkas, Dóra Kormendine; Ording, Anne Gulbech
• Is Part Of: International journal of cancer. Volume 143:Issue 12(2018)
• Page Start: 3218
• Page End: 3226
• Publication Date: 2018-10-22
• Subjects: metastasis directed treatment -- colorectal cancer -- population‐based study; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.31626
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract : About 10–20% of patients with metastatic colorectal cancer (mCRC) are candidates for metastasis directed therapies such as surgical resection, ablation and stereotactic radiotherapy. We examined the temporal changes in use of metastasis directed therapies and established prognostic factors for survival in a nationwide cohort study. The Danish nationwide medical registries were used to retrieve data on treatment for liver and/or lung metastasis in patients with metastatic colorectal cancer in the period 2000–2013. Overall survival through 2014 was calculated from the time of treatment of metastases by Kaplan–Meier method and mortality between groups was assessed using Cox regression. We report 2, 912 patients undergoing a total of 3, 602 procedures with an increased use of all modalities during 14 calendar years. Median survival was 3.7 years (interquartile range (IQR) 2.0–9.7 years). In the multivariate analysis, the nodal stage of the primary tumor had the most pronounced association with survival with a hazard ratio for mortality of 1.56 (95% CI: 1.33–1.83) for N2 stage with reference to N0. Furthermore, female gender, age, comorbidity, surgical treatment, administration of chemotherapy, and left‐sided primary tumors were associated with improved prognosis in the multivariate analysis. Abstract : What's new? The treatment of metastatic colorectal cancer (mCRC) centers primarily on surgical resection, ablative therapy, and stereotactic radiotherapy. Little is known, however, about recent trends in the use of these treatments for mCRC. Here, analyses of data from nationwide medical registries in Denmark reveal temporal changes in the use of metastasis‐directed therapies over the period 2000–2013. Specifically, the use of all three modalities—resection, ablation, and stereotactic radiotherapy—increased for liver and lung metastases from mCRC. Median survival was 3.7 years for patients undergoing metastasis‐directed therapy, indicating an improvement in long‐term survival for this patient subset.