Prognostic factors in patients with non resectable metastatic colorectal cancer in the era of targeted biotherapies: Relevance of Köhne's risk classification

Desot, Elise; Mestier, Louis de; Volet, Julien; Delmas, Christelle; Garcia, Bruno; Geoffroy, Patrick; Abdelli, Naceur; Baule, Marielle; Dubroeucq, Olivier; Marquis, Eric; Bouché, Olivier

doi:10.1016/j.dld.2012.10.016

Cited by 12 publications

(21 citation statements)

References 27 publications

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“…Although two previous analyses form French working groups were able to confirm WHO performance status as an independent prognostic factor, WBC count could not be evaluated by the GERCOR group because of missing data and LDH vice versa in the study performed by Desot et al (Chibaudel et al , 2011; Desot et al , 2013). In contrast, KPS was not found to be a prognostic factor in our analysis of 215 LLD patients, with the limitation that patients with KPS <60% were not included in the trial and the comparison between KPS, ECOG and WHO-PS constitute a difficult issue (Sorbye et al , 2007).…”

Section: Discussionmentioning

confidence: 93%

“…In 2011, the GERCOR group proposed a simplified prognostic model consisting of lactate dehydrogenase (LDH) and WHO-PS that was investigated and validated within three randomised irinotecan- and oxaliplatin-based trials (Chibaudel et al , 2011). Recently, Desot et al (2013) assessed Koehne's prognostic factors in patients treated with chemotherapy and targeted biotherapies and questioned its relevance because of a non-significant distribution of intermediate and good prognostic groups. Accordingly, WHO-PS and WBC count were proposed as potential prognostic factors for OS (Desot et al , 2013).…”

mentioning

confidence: 99%

“…Recently, Desot et al (2013) assessed Koehne's prognostic factors in patients treated with chemotherapy and targeted biotherapies and questioned its relevance because of a non-significant distribution of intermediate and good prognostic groups. Accordingly, WHO-PS and WBC count were proposed as potential prognostic factors for OS (Desot et al , 2013). …”

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confidence: 99%

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Evaluation of prognostic factors in liver-limited metastatic colorectal cancer: a preplanned analysis of the FIRE-1 trial

Gießen¹,

Weikersthal

Laubender

et al. 2013

Br J Cancer

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Background:Liver-limited disease (LLD) denotes a specific subgroup of metastatic colorectal cancer (mCRC) patients.Patients and Methods:A total of 479 patients with unresectable mCRC from an irinotecan-based randomised phase III trial were evaluated. Patients with LLD and non-LLD and hepatic resection were differentiated. Based on baseline patient characteristic, prognostic factors for hepatic resection were evaluated. Furthermore, prognostic factors for median overall survival (OS) were estimated via Cox regression in LLD patients.Results:Secondary liver resection was performed in 38 out of 479 patients (resection rate: 7.9%). Prognostic factors for hepatic resection were LLD, lactate dehydrogenase (LDH), node-negative primary, alkaline phosphatase (AP) and Karnofsky performance status (PS). Median OS was significantly increased after hepatic resection (48 months), whereas OS in LLD (17 months) and non-LLD (19 months) was comparable in non-resected patients. With the inapplicability of Koehne's risk classification in LLD patients, a new score based on only the independent prognostic factors LDH and white blood cell (WBC) provided markedly improved information on the outcome.Conclusion:Patients undergoing hepatic resection showed favourable long-term survival, whereas non-resected LLD patients and non-LLD patients did not differ with regard to progression-free survival and OS. The LDH levels and WBC count were confirmed as prognostic factors and provide a useful and simple score for OS-related risk stratification also in LLD.

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Section: Discussionmentioning

confidence: 93%

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confidence: 99%

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Evaluation of prognostic factors in liver-limited metastatic colorectal cancer: a preplanned analysis of the FIRE-1 trial

Gießen¹,

Weikersthal

Laubender

et al. 2013

Br J Cancer

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“…Figure describes the search results. The scientific literature review and web‐based search identified 53 tools predicting survival in colon or rectal cancer, reported across 63 articles . Two articles reported on the development of two tools each .…”

Section: Resultsmentioning

confidence: 99%

Personalizing prognosis in colorectal cancer: A systematic review of the quality and nature of clinical prognostic tools for survival outcomes

Mahar

Compton

Halabi

et al. 2017

Journal of Surgical Oncology

116

104

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Integrating diverse types of prognostic information into accurate, individualized estimates of outcome in colorectal cancer is challenging. Significant heterogeneity in colorectal cancer prognostication tool quality exists. Methodology is incompletely or inadequately reported. Evaluations of the internal or external validity of the prognostic model are rarely performed. Prognostication tools are important devices for patient management, but tool reliability is compromised by poor quality. Guidance for future development of prognostication tools in colorectal cancer is needed.

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“…Median survival is now of the order of 20-22 months in patients who receive biological agents and multiple sequential chemotherapy regimes [65]. Nevertheless, 5-year survival is close to 0 % unless patients can undergo and benefit from surgery.…”

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confidence: 99%

Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, the interventional oncology sans frontières meeting 2013

et al. 2015

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Objectives Previous attempts at meta-analysis and systematic review have not provided clear recommendations for the clinical application of thermal ablation in metastatic colorectal cancer. Many authors believe that the probability of gathering randomised controlled trial (RCT) data is low. Our aim is to provide a consensus document making recommendations on the appropriate application of thermal ablation in patients with colorectal liver metastases. Methods This consensus paper was discussed by an expert panel at The Interventional Oncology Sans Frontières 2013. A literature review was presented. Tumour characteristics, ablation technique and different clinical applications were considered and the level of consensus was documented.Eur Radiol (2015) Results Specific recommendations are made with regard to metastasis size, number, and location and ablation technique. Mean 31 % 5-year survival post-ablation in selected patients has resulted in acceptance of this therapy for those with technically inoperable but limited liver disease and those with limited liver reserve or co-morbidities that render them inoperable.Conclusions In the absence of RCT data, it is our aim that this consensus document will facilitate judicious selection of the patients most likely to benefit from thermal ablation and provide a unified interventional oncological perspective for the use of this technology. Key Points• Best results require due consideration of tumour size, number, volume and location.• Ablation technology, imaging guidance and intraprocedural imaging assessment must be optimised.• Accepted applications include inoperable disease due to tumour distribution or inadequate liver reserve.• Other current indications include concurrent co-morbidity, patient choice and the test-of-time approach.• Future applications may include resectable disease, e.g. for small solitary tumours.

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Prognostic factors in patients with non resectable metastatic colorectal cancer in the era of targeted biotherapies: Relevance of Köhne's risk classification

Cited by 12 publications

References 27 publications

Evaluation of prognostic factors in liver-limited metastatic colorectal cancer: a preplanned analysis of the FIRE-1 trial

Evaluation of prognostic factors in liver-limited metastatic colorectal cancer: a preplanned analysis of the FIRE-1 trial

Personalizing prognosis in colorectal cancer: A systematic review of the quality and nature of clinical prognostic tools for survival outcomes

Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, the interventional oncology sans frontières meeting 2013

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