Nationwide trends in incidence, treatment and survival of colorectal cancer patients with synchronous metastases

Geest, Lydia G. M. van der; Lam-Boer, Jorine't; Koopman, Miriam; Verhoef, C.; Elferink, M.A.G.; Wilt, Johannes H. W. de

doi:10.1007/s10585-015-9719-0

Cited by 421 publications

(325 citation statements)

References 33 publications

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“…Operations for patients with metastatic colon cancer, however, have been increasing as the safety profiles of these operations have improved and evidence has emerged supporting improved survival outcomes with resection of certain metastases (23,(27)(28)(29)(30). Our study confirms a trend toward a more aggressive surgical approach, specifically in patients with SHM, which has been demonstrated in previous studies (31,32). The overall low rates of hepatic resection in our cohort are paralleled by a low rate of surgical evaluation in the months surrounding diagnosis of stage IV colon cancer.…”

Section: Discussionsupporting

confidence: 86%

Disparities in resection of hepatic metastases in colon cancer.

Neuwirth

Epstein

Karakousis

et al. 2017

JCO

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Background: Evidence suggests that resection of synchronous hepatic metastases (SHM) in stage IV colon cancer is safe and can improve survival in select patients. Little is known, however, about the use of hepatic resection in this setting on a population level. The aim of this study was to describe trends in resection rates of SHM in patients with stage IV colon cancer using a large national cohort database. Patients who were older with higher comorbidity burden were less likely to undergo hepatic resection. Additionally, the odds of hepatic resection were 30% lower for African-American patients than for white patients (OR 0.70, P=0.05). Odds of hepatic resection were 44% lower for patients from ZIP Codes with >20% poverty than for patients from areas with <5% poverty (OR 0.56, P<0.001). Interestingly, among patients who underwent no surgical treatment at all, only 25% saw a surgeon after diagnosis. This number increased over time from 21.6% in 2000 to 29.1% in 2011 (P<0.001). Similar disparities noted above were seen with surgical evaluation for hepatic resection. Conclusions: Despite evidence supporting the safety and efficacy of hepatic resection in the setting of SHM, few patients are seen by surgeons and go onto receive hepatic surgery. Additionally, access to hepatic resection is notably lower for African Americans and patients from areas with higher poverty rates.

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Section: Discussionsupporting

confidence: 86%

Disparities in resection of hepatic metastases in colon cancer.

Neuwirth

Epstein

Karakousis

et al. 2017

JCO

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“…The treatment of metastases has developed further over time with the use of metastasectomy and evolved systemic therapy regimens. However, the minority of patients with metastasized disease can be treated with curative intent by metastasectomy, and these treated patients have a 5‐year survival of ~50% 31, 32. Systemic therapy in Stage IV CRC yields a 5‐year survival of <10%,32 and of all Stages I–III CRC patients, only ~10–30% will develop metastases 33.…”

Section: Discussionmentioning

confidence: 99%

An overview of 25 years of incidence, treatment and outcome of colorectal cancer patients

Brouwer

Bos

Lemmens

et al. 2018

Intl Journal of Cancer

241

193

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Regarding the continuous changes in the diagnostic process and treatment of colorectal cancer (CRC), it is important to evaluate long‐term trends which are relevant in giving direction for further research and innovations in cancer patient care. The aim of this study was to analyze developments in incidence, treatment and survival for patients diagnosed with CRC in the Netherlands. For this population‐based retrospective cohort study, all patients diagnosed with CRC between 1989 and 2014 in the Netherlands were identified using data of the nationwide population‐based Netherlands Cancer Registry (n = 267,765), with follow‐up until January 1, 2016. Analyses were performed for trends in incidence, mortality, stage distribution, treatment and relative survival measured from the time of diagnosis. The incidence of both colon and rectal cancer has risen. The use of postoperative chemotherapy for Stage III colon cancer increased (14–60%), as well as the use of preoperative (chemo)radiotherapy for rectal cancer (2–66%). The administration of systemic therapy and metastasectomy increased for Stage IV disease patients. The 5‐year relative survival increased significantly from 53 to 62% for colon cancer and from 51 to 65% for rectal cancer. Ongoing advancements in treatment, and also improvement in other factors in the care of CRC patients—such as diagnostics, dedicated surgery and pre‐ and postoperative care—lead to a continuous improvement in the relative survival of CRC patients. The increasing incidence of CRC favors the implementation of the screening program, of which the effects should be monitored closely.

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“…Data from the national cancer registry show an incidence of colorectal carcinoma of 12,755 patients in 2010. In recent years 21-24% of patients with colorectal cancer presented with metastatic disease (M1) at the time of diagnosis, which is approximately 3,000 patients per year [32,33,34]. These synchronous metastatic lesions are limited to the liver in approximately 55% of these patients (3,000*0.55 = 1,650 patients in Dutch population annually).…”

Section: Discussionmentioning

confidence: 99%

Liver Resection for Metastatic Disease; A Population-Based Analysis of Trends

Ridder

Lemmens²,

Overbeek³

et al. 2016

Dig Surg

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Objective: The study aims to evaluate all patients who underwent liver resection for metastatic disease for demographics, characteristics of the primary tumor and metastasis, volume of liver resection specimens per pathology laboratory and to describe trends in surgical treatment. Methods: Data were prospectively collected using the Dutch nationwide pathology network. All pathology reports containing details on liver resections for metastatic disease between January 2001 and December 2010 were evaluated. Results: A total of 3,916 liver resections were performed in 3,699 patients with a median age of 63 years (range 1-91). The primary tumor was mainly colorectal (n = 3,256; 88.0%). The number of ‘high volume liver centers' increased from 2 to 12 in the study period, whereas the number of ‘low volume centers' decreased. The number of liver resections increased from 224 to 596 per year (p ≤ 0.0001). A significant increase was demonstrated in elderly patients, patients with multiple metastases, liver resections for smaller metastases and minor liver resections. Conclusion: Although the majority of patients were young and had solitary metastasis, indications for liver resection are expanding as indicated by increasing numbers of elderly and patients with multiple liver metastases. Patients with non-colorectal liver metastases were seldom candidates for resection.

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Nationwide trends in incidence, treatment and survival of colorectal cancer patients with synchronous metastases

Cited by 421 publications

References 33 publications

Disparities in resection of hepatic metastases in colon cancer.

Disparities in resection of hepatic metastases in colon cancer.

An overview of 25 years of incidence, treatment and outcome of colorectal cancer patients

Liver Resection for Metastatic Disease; A Population-Based Analysis of Trends

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