Prognostic factors in advanced colorectal carcinoma: A multifactorial analysis

Forti, L.; Miraglia, Stefania; Bertona, E.; Rossi, Virginia; Rondonotti, David; Tampellini, Marco; Porcile, Gianfranco; Alabiso, Oscar

doi:10.1200/jco.2005.23.16_suppl.3732

Cited by 2 publications

(6 citation statements)

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“…Only cases with an N2 category conferred a negative prognostic effect similar in magnitude to M1a/b. High histological grade and the presence of lymphovascular invasion were also associated with a significant detrimental effect similar in magnitude to previous studies of early category and advanced colorectal cancer [3,5,17,18].…”

Section: Discussionsupporting

confidence: 83%

“…Although previous studies have documented inferior outcomes of patients with multiple sites of metastasis, not all studies have differentiated between patients presenting with newly diagnosed stage IV colorectal cancer versus those with relapsed disease [3][4][5]. Validated prognostic factors used among patients with relapsed disease include stage at initial presentation (stage I/II versus III), receipt of adjuvant chemotherapy, and interval between initial disease and relapse [6].…”

Section: Discussionmentioning

confidence: 99%

“…The M1b category is assigned to patients with disease in multiple sites or those with peritoneal metastasis. Although the number of metastatic sites is an established prognostic marker among patients with advanced colorectal cancer [3][4][5], the prognostic impact of the newly introducedM1a and M1b categories has not yet beendescribed.…”

Section: Introductionmentioning

confidence: 99%

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Effect of M1a and M1b Category in Metastatic Colorectal Cancer

Kennecke

Gill

et al. 2014

The Oncologist

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Background. In 2009, the American Joint Committee on Cancer version 7 staging system introduced the M1 subclassifications M1a (single metastatic site) and M1b (peritoneal or multiple metastatic sites).The study objectives were to evaluate the prognostic effect of site of metastasis and M1a/ b category among patients with newly diagnosed colorectal cancer and synchronous metastasis. Patients and Methods. Patients with newly diagnosed pathologic or clinical category M1 colorectal cancer referred to the British Columbia Cancer Agency between 1999 and 2007 were included. Demographic, tumor, treatment, and outcome data were prospectively collected, and prognostic factors were identified. Univariate Cox models were used to assess the prognostic impact of individual sites of metastasis and to determine the effect of M1a/b category on overall survival (OS). Results. Among 2,049 eligible patients, 70% had M1a and 30% M1b category disease. The most common sites of common single sites of metastasis included liver (56%), lung (5.3%), and

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Effect of M1a and M1b Category in Metastatic Colorectal Cancer

Kennecke

Gill

et al. 2014

The Oncologist

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“…This survival benefit was even more pronounced in patients with liver-limited disease compared to patients with additional extended extrahepatic metastasis. Correspondingly, metastatic spread to more than one organ has been identified as a poor prognostic factor in mCRC patients [8][9][10] leading to the introduction of the subcategories M1A (single metastatic site) and M1b (peritoneal or multiple metastatic sites) within the American Joint Committee on Cancer (AJCC)…”

Section: Predictive Analyses Of Metastatic Organ Involvementmentioning

confidence: 99%

“…1,7 Metastatic spread to more than one organ has previously been described to worsen survival outcomes in mCRC patients serving as an established prognostic marker. [8][9][10] Likewise, anatomic site and spread of metastases present major drivers of treatment decisions in the management of oligometastatic disease, which is vaguely characterized by limited number of lesions and organs involved. 1 The most common site of distant metastasis in mCRC patients is the liver followed by the lung.…”

Section: Introductionmentioning

confidence: 99%

Prognostic and predictive impact of metastatic organ involvement on maintenance therapy in advanced metastatic colorectal cancer: Subgroup analysis of patients treated within the PanaMa trial (AIO KRK 0212)

Sommerhäuser,

Karthaus,

Kurreck

et al. 2023

Intl Journal of Cancer

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Despite molecular selection, patients (pts) with RAS wildtype mCRC represent a heterogeneous population including diversity in metastatic spread. We investigated metastatic patterns for their prognostic and predictive impact on maintenance therapy with 5‐fluorouracil/folinic acid ± panitumumab. The study population was stratified according to (1) number of involved metastatic sites (single vs multiple organ metastasis), liver‐limited disease vs (2) liver metastasis plus one additional site, and (3) vs liver metastasis plus ≥two additional sites. Kaplan‐Meier method and Cox regressions were used to correlate efficacy endpoints. Single organ metastasis was observed in 133 pts (53.6%) with 102 pts (41.1%) presenting with liver‐limited disease, while multiple organ metastases were reported in 114 pts (46.0). Multiple compared to single organ metastases were associated with less favorable PFS (HR 1.48, 95% CI 1.13‐1.93; P = .004) and OS (HR 1.37, 95% CI 0.98‐1.93; P = .068) of maintenance therapy. While metastatic spread involving one additional extrahepatic site was not associated with clearly impaired survival compared to liver‐limited disease, pts with liver metastasis plus ≥two additional sites demonstrated less favorable PFS (HR 1.92, 95% CI 1.30‐2.83; P < .001), and OS (HR 2.38, 95% CI 1.51‐3.76; P < .001) of maintenance therapy. Pmab‐containing maintenance therapy appeared active in both pts with multiple (HR 0.58; 95% CI, 0.39‐0.86; P = .006) as well as to a lesser numerical extent in pts with single organ metastasis (HR 0.83; 95% CI, 0.57‐1.21; P = .332; Interaction P = .183). These data may support clinical decisions when EGFR‐based maintenance therapy is considered.

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Prognostic factors in advanced colorectal carcinoma: A multifactorial analysis

Cited by 2 publications

References 0 publications

Effect of M1a and M1b Category in Metastatic Colorectal Cancer

Effect of M1a and M1b Category in Metastatic Colorectal Cancer

Prognostic and predictive impact of metastatic organ involvement on maintenance therapy in advanced metastatic colorectal cancer: Subgroup analysis of patients treated within the PanaMa trial (AIO KRK 0212)

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