Treatment of metachronous colorectal cancer metastases in the Netherlands: A population-based study

Meyer, Yannick; Olthof, Pim B.; Grünhagen, Dirk J.; Hingh, Ignace de; Wilt, Johannes H. W. de; Verhoef, Cornelis; Elferink, M.A.G.

doi:10.1016/j.ejso.2021.12.004

Cited by 20 publications

(21 citation statements)

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“…The higher incidence of synchronous and metachronous metastases in men than in women was consistent with findings of previously published studies . This disparity may reflect sex differences in behavioral, biological, hormonal, and immune regulatory factors .…”

Section: Discussionmentioning

confidence: 75%

“…The higher incidence of synchronous and metachronous metastases in men than in women was consistent with findings of previously published studies. [5][6][7] This disparity may reflect sex differences in behavioral, biological, hormonal, and immune regulatory factors. 19,20 Our study found that standardized incidence had not changed significantly over the last 40 years, with the exception of a slight increase in colon cancer with synchronous liver metastases in men from 1976 to 2000.…”

Section: Jama Network Open | Oncologymentioning

confidence: 99%

“…Similarly, there have been few population-based studies describing the frequency of metachronous liver metastases after resection of the primary colorectal tumor. [4][5][6][7] These epidemiological figures can only be obtained from data covering the entire population of patients with colon cancer in a given region. Such studies are rare because they require the accurate and detailed collection of population-based data.…”

Section: Introductionmentioning

confidence: 99%

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Incidence and Survival in Synchronous and Metachronous Liver Metastases From Colorectal Cancer

et al. 2022

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ImportanceAlthough treatment and prognosis of synchronous liver metastases from colorectal cancer are relatively well known, a comparative description of the incidence, epidemiological features, and outcomes of synchronous and metachronous liver metastases is lacking. The difference in prognosis between patients with synchronous and metachronous liver metastases is controversial.ObjectiveTo investigate temporal patterns in the incidence and outcomes of synchronous vs metachronous liver metastases from colorectal cancer.Design, Setting, and ParticipantsThis population-based cohort study used information from a French regional digestive cancer registry accounting for 1 082 000 inhabitants. A total of 26 813 patients with a diagnosis of incident colorectal adenocarcinoma diagnosed between January 1, 1976, and December 31, 2018, were included. Data were analyzed from February 7 to May 20, 2022.Main Outcomes and MeasuresAge-standardized incidence was calculated. Univariate and multivariate net survival analyses were performed.ResultsOf 26 813 patients with colorectal cancer (15 032 men [56.1%]; median [IQR] age, 73 [64-81] years), 4546 (17.0%) presented with synchronous liver metastases. The incidence rate of synchronous liver metastases was 6.9 per 100 000 inhabitants in men and 3.4 per 100 000 inhabitants in women, with no significant variation since 2000. The 5-year cumulative incidence of metachronous liver metastases decreased from 18.6% (95% CI, 14.9%-22.2%) during the 1976 to 1980 period to 10.0% (95% CI, 8.8%-11.2%) during the 2006 to 2011 period. Cancer stage at diagnosis was the strongest risk factor for liver metastases; compared with patients diagnosed with stage II cancer, patients with stage III cancer had a 2-fold increase in risk (subdistribution hazard ratio, 2.42; 95% CI, 2.08-2.82) for up to 5 years. Net survival at 1 year was 41.8% for synchronous liver metastases and 49.9% for metachronous metastases, and net survival at 5 years was 6.2% for synchronous liver metastases and 13.2% for metachronous metastases. Between the first (1976-1980) and last (2011-2016) periods, the adjusted ratio of death after synchronous and metachronous metastases was divided by 2.5 for patients with synchronous status and 3.7 for patients with metachronous status.Conclusions and RelevanceIn this study, the incidence of colorectal cancer with synchronous liver metastases changed little over time, whereas there was a 2-fold decrease in the probability of developing metachronous liver metastases. Survival improved substantially for patients with metachronous liver metastases, whereas improvement was more modest for those with synchronous metastases. The differences observed in the epidemiological features of synchronous and metachronous liver metastases from colorectal cancer may be useful for the design of future clinical trials.

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Section: Discussionmentioning

confidence: 75%

Section: Jama Network Open | Oncologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incidence and Survival in Synchronous and Metachronous Liver Metastases From Colorectal Cancer

et al. 2022

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“…In a population-based study, CRC patients with metachronous liver-only or lung-only metastases could achieve 3-year OS rates of 50.2% and 61.5%, respectively. 33 In fact, in this cohort, more than 80% of the metastases occurred in the lung or liver only. 34 Moreover, although the state of MRI-detected extramural vascular invasion (mrEMVI) has been reported in previous studies to be clearly related to DM, 35 there is almost a fourfold risk of developing metastases after surgery.…”

Section: Discussionmentioning

confidence: 70%

“…Although this does not seem very plausible based on the difference in MFS, it could be attributed to the early detection of metastasis in prospective trials, favorable outcome in treatment for metachronous metastases of CRC and relatively short follow‐up time. In a population‐based study, CRC patients with metachronous liver‐only or lung‐only metastases could achieve 3‐year OS rates of 50.2% and 61.5%, respectively 33 . In fact, in this cohort, more than 80% of the metastases occurred in the lung or liver only 34 …”

Section: Discussionmentioning

confidence: 90%

Metastasis risk stratification and response prediction through dynamic viable circulating tumor cell counts for rectal cancer in a neoadjuvant setting

et al. 2023

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Purpose Distant metastasis (DM) and neoadjuvant treatment response prediction remain critical challenges in the management of locally advanced rectal cancer (LARC). The aim of this study was to investigate the clinical relevance of viable circulating tumor cells (CTCs) for DM or response in patients with LARC in a neoadjuvant setting. Methods The detection of viable CTCs at different stages of treatment was planned for consecutive patients from a prospective trial. The Kaplan–Meier method, Cox proportional hazards model, and logistic regression model were utilized to analyze factors associated with DM or pathological complete response (pCR) and clinical complete response (cCR). Results Between December 2016 and July 2018, peripheral blood samples from 83 patients were collected before any treatment (median follow‐up time, 49.3 months). CTCs were present in 76 of 83 patients (91.6%) at baseline, and more than three CTCs detected in the blood sample was considered high risk. Only the CTC risk group was significantly associated with 3‐year metastasis‐free survival (MFS) (high risk vs. low risk, 57.1% (95% CI, 41.6–72.6) vs. 78.3% (95% CI, 65.8–90.8), p = 0.018, log‐rank test). When all the important variables were entered into the Cox model, the CTC risk group remained the only significant independent factor for DM (hazard ratio (HR), 2.74; 95% CI, 1.17–6.45, p = 0.021). The pCR and continuous cCR rates were higher in patients with a decreased number of CTCs of more than one after radiotherapy (HR, 4.00; 95% CI, 1.09–14.71, P = 0.037). Conclusions The dynamic detection of viable CTCs may strengthen pretreatment risk assessment and postradiotherapy decision making for LARC. This observation requires further validation in a prospective study.

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A systematic review of population‐based studies on metachronous metastases of colorectal cancer

Nyström,

Olsson

2024

World j. surg.

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BackgroundThe occurrence of metachronous metastases (MM) of colorectal (CRC), colon (CC), and rectal (RC) cancer of population‐based studies has not been compiled in a systematic review previously.MethodsMEDLINE, Embase, and Cochrane Library were searched for primary studies of any design from inception until January 2021 and updated in August 2023 (CRD42021261648). The PRISMA guidelines were adopted, and the Newcastle‐Ottawa Quality Assessment Scale used for risk of bias assessment. Outcomes on overall and organ‐specific MM were extracted. A narrative analysis followed.ResultsOut of 2143 unique hits, 162 publications were read in full‐text and 37 population‐based cohort studies published in 1981–2022 were included. Ten studies adopted time‐dependent analyses; eight were registry‐based and seven had a low risk of bias. Three studies reported 5‐year recurrence rate of MM overall of stages I–III; for CRC, it was 20.5%, for CC, it was 18% and 25.6%, and for RC, it was 23%. Four studies reported 5‐year recurrence rate of organ‐specific MM of stages I–III—for CRC, it was 2.2% and 5.5% for peritoneal metastases and 5.8% for lung metastases and for CC 4.5% for peritoneal metastases. Twenty‐seven studies reported proportions of patients diagnosed with MM, but data on the length of follow‐up was incomplete and varied widely. Proportions of patients with CRC stages I–III that developed MM overall was 14.4%–26.1% in 10 studies. In relation to the enrollment period, a downward trend may be discernible.ConclusionStudies adopting a more appropriate analysis were highly heterogeneous, whereas uncertain data of partly inadequate studies may indicate that MM are overall declining.

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Treatment of metachronous colorectal cancer metastases in the Netherlands: A population-based study

Cited by 20 publications

References 36 publications

Incidence and Survival in Synchronous and Metachronous Liver Metastases From Colorectal Cancer

Incidence and Survival in Synchronous and Metachronous Liver Metastases From Colorectal Cancer

Metastasis risk stratification and response prediction through dynamic viable circulating tumor cell counts for rectal cancer in a neoadjuvant setting

A systematic review of population‐based studies on metachronous metastases of colorectal cancer

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