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Population-based SEER analysis of survival in colorectal cancer patients with or without resection of lung and liver metastases

BACKGROUND: Approximately one third of all patients with CRC present with, or subsequently develop, colorectal liver metastases (CRLM). The objective of this population-based analysis was to assess the impact of resection of liver only, lung only and liver and lung metastases on survival in patients...

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Autores principales: Siebenhüner, Alexander R., Güller, Ulrich, Warschkow, Rene
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7092492/
https://www.ncbi.nlm.nih.gov/pubmed/32293337
http://dx.doi.org/10.1186/s12885-020-6710-1
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author Siebenhüner, Alexander R.
Güller, Ulrich
Warschkow, Rene
author_facet Siebenhüner, Alexander R.
Güller, Ulrich
Warschkow, Rene
author_sort Siebenhüner, Alexander R.
collection PubMed
description BACKGROUND: Approximately one third of all patients with CRC present with, or subsequently develop, colorectal liver metastases (CRLM). The objective of this population-based analysis was to assess the impact of resection of liver only, lung only and liver and lung metastases on survival in patients with metastatic colorectal cancer (mCRC) and resected primary tumor. METHODS: Ten thousand three hundred twenty-five patients diagnosed with mCRC between 2010 and 2015 with resected primary were identified in the Surveillance, Epidemiology and End Results (SEER) database. Overall, (OS) and cancer-specific survival (CSS) were analyzed by Cox regression with multivariable, inverse propensity weight, near far matching and propensity score adjustment. RESULTS: The majority (79.4%) of patients had only liver metastases, 7.8% only lung metastases and 12.8% metastases of lung and liver. 3-year OS was 44.5 and 27.5% for patients with and without metastasectomy (HR = 0.62, 95% CI: 0.58–0.65, P < 0.001). Metastasectomy uniformly improved CSS in patients with liver metastases (HR = 0.72, 95% CI: 0.67–0.77, P < 0.001) but not in patients with lung metastases (HR = 0.84, 95% CI: 0.62–1.12, P = 0.232) and combined liver and lung metastases (HR = 0.89, 95% CI: 0.75–1.06, P = 0.196) in multivariable analysis. Adjustment by inverse propensity weight, near far matching and propensity score and analysis of OS yielded similar results. CONCLUSIONS: This is the first SEER analysis assessing the impact of metastasectomy in mCRC patients with removed primary tumor on survival. The analysis provides compelling evidence of a statistically significant and clinically relevant increase in OS and CSS for liver resection but not for metastasectomy of lung or both sites.
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spelling pubmed-70924922020-03-24 Population-based SEER analysis of survival in colorectal cancer patients with or without resection of lung and liver metastases Siebenhüner, Alexander R. Güller, Ulrich Warschkow, Rene BMC Cancer Research Article BACKGROUND: Approximately one third of all patients with CRC present with, or subsequently develop, colorectal liver metastases (CRLM). The objective of this population-based analysis was to assess the impact of resection of liver only, lung only and liver and lung metastases on survival in patients with metastatic colorectal cancer (mCRC) and resected primary tumor. METHODS: Ten thousand three hundred twenty-five patients diagnosed with mCRC between 2010 and 2015 with resected primary were identified in the Surveillance, Epidemiology and End Results (SEER) database. Overall, (OS) and cancer-specific survival (CSS) were analyzed by Cox regression with multivariable, inverse propensity weight, near far matching and propensity score adjustment. RESULTS: The majority (79.4%) of patients had only liver metastases, 7.8% only lung metastases and 12.8% metastases of lung and liver. 3-year OS was 44.5 and 27.5% for patients with and without metastasectomy (HR = 0.62, 95% CI: 0.58–0.65, P < 0.001). Metastasectomy uniformly improved CSS in patients with liver metastases (HR = 0.72, 95% CI: 0.67–0.77, P < 0.001) but not in patients with lung metastases (HR = 0.84, 95% CI: 0.62–1.12, P = 0.232) and combined liver and lung metastases (HR = 0.89, 95% CI: 0.75–1.06, P = 0.196) in multivariable analysis. Adjustment by inverse propensity weight, near far matching and propensity score and analysis of OS yielded similar results. CONCLUSIONS: This is the first SEER analysis assessing the impact of metastasectomy in mCRC patients with removed primary tumor on survival. The analysis provides compelling evidence of a statistically significant and clinically relevant increase in OS and CSS for liver resection but not for metastasectomy of lung or both sites. BioMed Central 2020-03-23 /pmc/articles/PMC7092492/ /pubmed/32293337 http://dx.doi.org/10.1186/s12885-020-6710-1 Text en © The Author(s). 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Siebenhüner, Alexander R.
Güller, Ulrich
Warschkow, Rene
Population-based SEER analysis of survival in colorectal cancer patients with or without resection of lung and liver metastases
title Population-based SEER analysis of survival in colorectal cancer patients with or without resection of lung and liver metastases
title_full Population-based SEER analysis of survival in colorectal cancer patients with or without resection of lung and liver metastases
title_fullStr Population-based SEER analysis of survival in colorectal cancer patients with or without resection of lung and liver metastases
title_full_unstemmed Population-based SEER analysis of survival in colorectal cancer patients with or without resection of lung and liver metastases
title_short Population-based SEER analysis of survival in colorectal cancer patients with or without resection of lung and liver metastases
title_sort population-based seer analysis of survival in colorectal cancer patients with or without resection of lung and liver metastases
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7092492/
https://www.ncbi.nlm.nih.gov/pubmed/32293337
http://dx.doi.org/10.1186/s12885-020-6710-1
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