Survival impact of surgical resection of primary tumor (SRPT) in metastatic colorectal cancer (mCRC): A population-based cohort study.

Ahmed, Shahid; Leis, Anne; Kanthan, Selliah; Karim, Safiya; Perron, Thomas; Haider, Kamal; Reeder, Bruce; Pahwa, Punam

doi:10.1200/jco.2013.31.4_suppl.456

Cited by 3 publications

(3 citation statements)

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Section: Current Strategies For Treatmentmentioning

confidence: 99%

“…At present, there appears to be good data showing that there is improved survival and quality of life with resection of the primary before symptoms, even in the setting of metastatic disease. 16 - 20 Highlighting this, five abstracts from a recent ASCO meeting were presented related to the management of the primary tumor. In one of these, the authors performed a retrospective study looking at 517 patients with metastatic colon cancer by way of a propensity score matched analysis that included age, gender, ECOG, and palliative chemotherapy to palliative resection, and found the patients who received palliative resection had overall improved survival (hazard ratio 0.66, p value 0.0019).…”

Section: Current Strategies For Treatmentmentioning

confidence: 99%

“…They concluded that resection improves survival independent of chemotherapy, age, functional status, and comorbidities. 16 …”

Section: Current Strategies For Treatmentmentioning

confidence: 99%

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Current Approaches and Challenges for Monitoring Treatment Response in Colon and Rectal Cancer

McKeown¹,

Nelson²,

Johnson³

et al. 2014

J. Cancer

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Introduction: With the advent of multidisciplinary and multimodality approaches to the management of colorectal cancer patients, there is an increasing need to define how we monitor response to novel therapies in these patients. Several factors ranging from the type of therapy used to the intrinsic biology of the tumor play a role in tumor response. All of these can aid in determining the ideal course of treatment, and may fluctuate over time, pending down-staging or progression of disease. Therefore, monitoring how disease responds to therapy requires standardization in order to ultimately optimize patient outcomes. Unfortunately, how best to do this remains a topic of debate among oncologists, pathologists, and colorectal surgeons. There may not be one single best approach. The goal of the present article is to shed some light on current approaches and challenges to monitoring treatment response for colorectal cancer.Methods: A literature search was conducted utilizing PubMed and the OVID library. Key-word combinations included colorectal cancer metastases, neoadjuvant therapy, rectal cancer, imaging modalities, CEA, down-staging, tumor response, and biomarkers. Directed searches of the embedded references from the primary articles were also performed in selected circumstances.Results: Pathologic examination of the post-treatment surgical specimen is the gold standard for monitoring response to therapy. Endoscopy is useful for evaluating local recurrence, but not in assessing tumor response outside of the limited information gained by direct examination of intra-lumenal lesions. Imaging is used to monitor tumors throughout the body for response, with CT, PET, and MRI employed in different circumstances. Overall, each has been validated in the monitoring of patients with colorectal cancer and residual tumors.Conclusion: Although there is no imaging or serum test to precisely correlate with a tumor's response to chemo- or radiation therapy, these modalities, when used in combination, can aid in allowing clinicians to adjust medical therapy, pursue operative intervention, or (in select cases) identify complete responders. Improvements are needed, however, as advances across multiple modalities could allow appropriate selection of patients for a close surveillance regimen in the absence of operative intervention.

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Section: Current Strategies For Treatmentmentioning

confidence: 99%

Section: Current Strategies For Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Current Approaches and Challenges for Monitoring Treatment Response in Colon and Rectal Cancer

McKeown¹,

Nelson²,

Johnson³

et al. 2014

J. Cancer

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Clinical Implementation of Germ Line Cancer Pharmacogenetic Variants During the Next-Generation Sequencing Era

Gillis

Patel

Innocenti

2013

Clin Pharmacol Ther

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Over 100 FDA-approved medications include pharmacogenetic biomarkers in the drug label, many with cancer indications referencing germline DNA variations. With the advent of next-generation sequencing (NGS) and its rapidly increasing uptake into cancer research and clinical practice, an enormous amount of data to inform documented gene-drug associations will be collected, which must be exploited to optimize patient benefit. This state-of-the-art article focuses on the implementation of germline cancer pharmacogenetics into clinical practice. Specifically, it discusses the importance of germline variation in cancer and the role of NGS in pharmacogenetic discovery and implementation. In the context of a scenario where massive NGS-based genetic information will be increasingly available to health stakeholders, this review explores the ongoing debate over the threshold of evidence necessary for implementation, provides an overview of recommendations in cancer by professional organizations and regulatory bodies, discusses limitations of current guidelines and strategies to improve third-party coverage.

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Role of Surgical Approach to Synchronous Colorectal Liver Metastases: A Retrospective Analysis

Zhai¹,

Sun

Du³

et al. 2021

CMAR

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Purpose This study is a retrospective analysis of exploring the efficiency of surgical management on patients with synchronous colorectal liver metastasis (SCLM). Patients and Methods Nine hundred fifty-three consecutive patients with SCLM from Weifang People’s Hospital of Shandong Province between January 2006 and December 2015 were reviewed. The values of different factors were analyzed, such as different surgical indications of liver metastases, simultaneous or staged resection of primary colorectal cancer and liver metastases, and primary tumor resection (PTR) of asymptomatic patients with unresectable liver metastases. Results Median survival time (47.3 months) and 5-year survival rate (31%) for patients with resected liver metastases were significantly superior to that of with nonoperative treatment (17.2 months, 4%, P<0.001); enlarging the standard of liver metastases resection can improve the resection rates (31.0% vs 13.6%, P<0.001); for patients with resectable liver metastases, the in-hospital cost for simultaneous resection group was lower than that in the staged resection group (36,698 vs 45,134 RMB, P<0.001); for patients of the asymptomatic primary tumor with unresectable liver metastases, PTR was associated with improved median survival (18.0 vs 15.0 months, P=0.006). Conclusion For patients with SCLM, liver resection is considered the best treatment; expanding indications of liver resection can improve the resection rates. Simultaneous resection of the primary tumor and liver metastases were indicated in patients with resectable SCLM; PTR was recommended for asymptomatic patients with unresectable hepatic metastases.

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Survival impact of surgical resection of primary tumor (SRPT) in metastatic colorectal cancer (mCRC): A population-based cohort study.

Cited by 3 publications

References 0 publications

Current Approaches and Challenges for Monitoring Treatment Response in Colon and Rectal Cancer

Current Approaches and Challenges for Monitoring Treatment Response in Colon and Rectal Cancer

Clinical Implementation of Germ Line Cancer Pharmacogenetic Variants During the Next-Generation Sequencing Era

Role of Surgical Approach to Synchronous Colorectal Liver Metastases: A Retrospective Analysis

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