Surgical resectability of multisite metastatic colorectal cancer: Pushing the limits while appropriately selecting patients

Bliss, Lindsay A.; Strong, Erin A.; Gamblin, T. Clark

doi:10.1002/jso.25419

Cited by 5 publications

(4 citation statements)

References 27 publications

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“…This indicates a selection for either strategy, a selection that most likely occurred in this study as well, partially explaining the higher completeness of curative treatment among those undergoing simultaneous resection as compared to liver-first strategy. A proper selection of candidates for simultaneous resections presupposes close collaboration between the liver surgeon, the colorectal cancer team, thoracic surgeon and medical oncologists and therefore, all decisions should ideally be discussed in the setting of an MDT [18,19].…”

Section: Discussionmentioning

confidence: 99%

Treatment intention and outcome in patients with simultaneously diagnosed liver and lung metastases from colorectal cancer

Engstrand¹,

Sterner²,

Hasselgren³

et al. 2022

European Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 99%

Treatment intention and outcome in patients with simultaneously diagnosed liver and lung metastases from colorectal cancer

Engstrand¹,

Sterner²,

Hasselgren³

et al. 2022

European Journal of Surgical Oncology

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“…Previously distant metastasis used to be absolute contradictions to surgical resections. Now surgical options on CRC with distant metastasis have been more radical than ever (26). Yet, not all evidence supports that surgical treatment promotes prognosis of advanced CRC patients in all.…”

Section: Discussionmentioning

confidence: 99%

A Novel Risk Classification Model Predicts Overall Survival and Locoregional Surgery Benefit in Colorectal Patients with Distant Metastasis at the Initial Diagnosis

Chen¹,

Li²,

Du³

et al. 2020

Preprint

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Background and aims: In this research, we aimed to construct a risk classification model to predict overall survival (OS) and locoregional surgery benefit in colorectal cancer (CRC) patients with distant metastasis.Methods: We selected a cohort consisting of 12741 CRC patients diagnosed with distant metastasis between 2010 and 2014, from the Surveillance, Epidemiology and End Results (SEER) database. Patients were randomly assigned into training group and validation group at the ratio of 2:1. Univariable and multivariable Cox regression models were applied to screen independent prognostic factors. A nomogram was constructed and assessed by the Harrell’s concordance index (C-index) and calibration plots. A novel risk classification model was further established based on the nomogram.Results: Ultimately 12 independent risk factors including race, age, marriage, tumor site, tumor size, grade, T stage, N stage, bone metastasis, brain metastasis, lung metastasis and liver metastasis were identified and adopted in the nomogram. The C-indexes of training and validation groups were 0.77 (95% confidence interval [CI] 0.73-0.81) and 0.75 (95% CI 0.72-0.78), respectively. The risk classification model stratified patients into three risk groups (low-, intermediate- and high-risk) with divergent median OS (low-risk: 36.0 months, 95% CI 34.1-37.9; intermediate-risk: 18.0 months, 95% CI 17.4-18.6; high-risk: 6.0 months, 95% CI 5.3-6.7). Locoregional therapies including surgery and radiotherapy could prognostically benefit patients in the low-risk group (surgery: hazard ratio [HR] 0.59, 95% CI 0.50-0.71; radiotherapy: HR 0.84, 95% CI 0.72-0.98) and intermediate risk group (surgery: HR 0.61, 95% CI 0.54-0.68; radiotherapy: HR 0.86, 95% CI 0.77-0.95), but not in the high-risk group (surgery: HR 1.03, 95% CI 0.82-1.29; radiotherapy: HR 1.03, 95% CI 0.81-1.31). And all risk groups could benefit from systemic therapy (low-risk: HR 0.68, 95% CI 0.58-0.80; intermediate-risk: HR 0.50, 95% CI 0.47-0.54; high-risk: HR 0.46, 95% CI 0.40-0.53).Conclusion: A novel risk classification model predicting prognosis and locoregional surgery benefit of CRC patients with distant metastasis was established and validated. This predictive model could be further utilized by physicians and be of great significance for medical practice.

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“…Where is the fine line between being appropriately aggressive for multiple site disease (CLM +/− lung metastases +/− extra‐regional nodal diseases)? We attempt to tackle this surgical selection question as well . Lung metastases is a common issue that abdominal surgical oncologists deal with when considering clearance of abdominal metastatic disease.…”

mentioning

confidence: 99%

“…We attempt to tackle this surgical selection question as well. 9 Lung metastases is a common issue that abdominal surgical oncologists deal with when considering clearance of abdominal metastatic disease. One article helps to review the indications of resection and nonoperative treatment of lung metastases.…”

mentioning

confidence: 99%

Metastatic colorectal cancer: The reality of the present and the optimism of the future

Melstrom

Tzeng

2019

Journal of Surgical Oncology

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Surgical resectability of multisite metastatic colorectal cancer: Pushing the limits while appropriately selecting patients

Cited by 5 publications

References 27 publications

Treatment intention and outcome in patients with simultaneously diagnosed liver and lung metastases from colorectal cancer

Treatment intention and outcome in patients with simultaneously diagnosed liver and lung metastases from colorectal cancer

A Novel Risk Classification Model Predicts Overall Survival and Locoregional Surgery Benefit in Colorectal Patients with Distant Metastasis at the Initial Diagnosis

Metastatic colorectal cancer: The reality of the present and the optimism of the future

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