Cargando…

Impact of Upfront Chemotherapy on the Effect of Primary Tumour Resection for Asymptomatic Synchronous Colorectal Cancer With Unresectable Metastases: A Propensity-Score-Matched Cohort Analysis

BACKGROUND: It is controversial whether primary tumour resection (PTR) and the sequencing of chemotherapy and PTR are associated with the survival of patients with incurable stage IV colorectal cancer. This study aimed to explore the effects of PTR and the sequencing of chemotherapy and PTR on asymp...

Descripción completa

Detalles Bibliográficos
Autores principales: Huang, Lin, Wei, Guixia, Chen, Nan, Liu, Jiewei, Wang, Ziqiang, Yu, Yongyang, Qiu, Meng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958687/
https://www.ncbi.nlm.nih.gov/pubmed/35355515
http://dx.doi.org/10.1177/11795549221085054
_version_ 1784676998274088960
author Huang, Lin
Wei, Guixia
Chen, Nan
Liu, Jiewei
Wang, Ziqiang
Yu, Yongyang
Qiu, Meng
author_facet Huang, Lin
Wei, Guixia
Chen, Nan
Liu, Jiewei
Wang, Ziqiang
Yu, Yongyang
Qiu, Meng
author_sort Huang, Lin
collection PubMed
description BACKGROUND: It is controversial whether primary tumour resection (PTR) and the sequencing of chemotherapy and PTR are associated with the survival of patients with incurable stage IV colorectal cancer. This study aimed to explore the effects of PTR and the sequencing of chemotherapy and PTR on asymptomatic colorectal cancer with synchronous unresectable metastases (asmCRC). PATIENTS AND METHODS: Patients with asmCRC were retrospectively identified from a single centre and categorised into 3 groups: PTR followed by chemotherapy (POC), upfront chemotherapy followed by PTR (UFC), and palliative chemotherapy (PC). The primary end points included median overall survival (OS) and progression-free survival (PFS). Clinical features were analysed using χ(2) test, while survival curves were generated using the Kaplan-Meier test. Propensity-score matching (PSM) was performed when comparing survival between POC and UFC groups. RESULTS: From 2008 to 2014, 255 patients were identified and included into the POC (n = 101), UFC (n = 40), and PC (n = 114) groups. The UFC and POC groups had significantly better median OS compared with the PC group (40.7 vs 16.3 months, P < .0001; 39.7 vs 16.3 months, P < .0001). Before PSM, the UFC group had better median PFS than the POC and PC groups (18.5 vs 9.7 months, P = .038; 18.5 vs 6.1 months, P < .0001). After PSM, UFC has better PFS than POC (P = .038). And the UFC group did not have higher postoperative or preoperative morbidity compared with the POC group (P = .235). CONCLUSIONS: Primary tumour resection could improve the survival of patients with asmCRC. Compared with POC or PC, UFC was associated with a better median PFS without significantly increasing preoperative or postoperative morbidity.
format Online
Article
Text
id pubmed-8958687
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-89586872022-03-29 Impact of Upfront Chemotherapy on the Effect of Primary Tumour Resection for Asymptomatic Synchronous Colorectal Cancer With Unresectable Metastases: A Propensity-Score-Matched Cohort Analysis Huang, Lin Wei, Guixia Chen, Nan Liu, Jiewei Wang, Ziqiang Yu, Yongyang Qiu, Meng Clin Med Insights Oncol Original Research Article BACKGROUND: It is controversial whether primary tumour resection (PTR) and the sequencing of chemotherapy and PTR are associated with the survival of patients with incurable stage IV colorectal cancer. This study aimed to explore the effects of PTR and the sequencing of chemotherapy and PTR on asymptomatic colorectal cancer with synchronous unresectable metastases (asmCRC). PATIENTS AND METHODS: Patients with asmCRC were retrospectively identified from a single centre and categorised into 3 groups: PTR followed by chemotherapy (POC), upfront chemotherapy followed by PTR (UFC), and palliative chemotherapy (PC). The primary end points included median overall survival (OS) and progression-free survival (PFS). Clinical features were analysed using χ(2) test, while survival curves were generated using the Kaplan-Meier test. Propensity-score matching (PSM) was performed when comparing survival between POC and UFC groups. RESULTS: From 2008 to 2014, 255 patients were identified and included into the POC (n = 101), UFC (n = 40), and PC (n = 114) groups. The UFC and POC groups had significantly better median OS compared with the PC group (40.7 vs 16.3 months, P < .0001; 39.7 vs 16.3 months, P < .0001). Before PSM, the UFC group had better median PFS than the POC and PC groups (18.5 vs 9.7 months, P = .038; 18.5 vs 6.1 months, P < .0001). After PSM, UFC has better PFS than POC (P = .038). And the UFC group did not have higher postoperative or preoperative morbidity compared with the POC group (P = .235). CONCLUSIONS: Primary tumour resection could improve the survival of patients with asmCRC. Compared with POC or PC, UFC was associated with a better median PFS without significantly increasing preoperative or postoperative morbidity. SAGE Publications 2022-03-25 /pmc/articles/PMC8958687/ /pubmed/35355515 http://dx.doi.org/10.1177/11795549221085054 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research Article
Huang, Lin
Wei, Guixia
Chen, Nan
Liu, Jiewei
Wang, Ziqiang
Yu, Yongyang
Qiu, Meng
Impact of Upfront Chemotherapy on the Effect of Primary Tumour Resection for Asymptomatic Synchronous Colorectal Cancer With Unresectable Metastases: A Propensity-Score-Matched Cohort Analysis
title Impact of Upfront Chemotherapy on the Effect of Primary Tumour Resection for Asymptomatic Synchronous Colorectal Cancer With Unresectable Metastases: A Propensity-Score-Matched Cohort Analysis
title_full Impact of Upfront Chemotherapy on the Effect of Primary Tumour Resection for Asymptomatic Synchronous Colorectal Cancer With Unresectable Metastases: A Propensity-Score-Matched Cohort Analysis
title_fullStr Impact of Upfront Chemotherapy on the Effect of Primary Tumour Resection for Asymptomatic Synchronous Colorectal Cancer With Unresectable Metastases: A Propensity-Score-Matched Cohort Analysis
title_full_unstemmed Impact of Upfront Chemotherapy on the Effect of Primary Tumour Resection for Asymptomatic Synchronous Colorectal Cancer With Unresectable Metastases: A Propensity-Score-Matched Cohort Analysis
title_short Impact of Upfront Chemotherapy on the Effect of Primary Tumour Resection for Asymptomatic Synchronous Colorectal Cancer With Unresectable Metastases: A Propensity-Score-Matched Cohort Analysis
title_sort impact of upfront chemotherapy on the effect of primary tumour resection for asymptomatic synchronous colorectal cancer with unresectable metastases: a propensity-score-matched cohort analysis
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958687/
https://www.ncbi.nlm.nih.gov/pubmed/35355515
http://dx.doi.org/10.1177/11795549221085054
work_keys_str_mv AT huanglin impactofupfrontchemotherapyontheeffectofprimarytumourresectionforasymptomaticsynchronouscolorectalcancerwithunresectablemetastasesapropensityscorematchedcohortanalysis
AT weiguixia impactofupfrontchemotherapyontheeffectofprimarytumourresectionforasymptomaticsynchronouscolorectalcancerwithunresectablemetastasesapropensityscorematchedcohortanalysis
AT chennan impactofupfrontchemotherapyontheeffectofprimarytumourresectionforasymptomaticsynchronouscolorectalcancerwithunresectablemetastasesapropensityscorematchedcohortanalysis
AT liujiewei impactofupfrontchemotherapyontheeffectofprimarytumourresectionforasymptomaticsynchronouscolorectalcancerwithunresectablemetastasesapropensityscorematchedcohortanalysis
AT wangziqiang impactofupfrontchemotherapyontheeffectofprimarytumourresectionforasymptomaticsynchronouscolorectalcancerwithunresectablemetastasesapropensityscorematchedcohortanalysis
AT yuyongyang impactofupfrontchemotherapyontheeffectofprimarytumourresectionforasymptomaticsynchronouscolorectalcancerwithunresectablemetastasesapropensityscorematchedcohortanalysis
AT qiumeng impactofupfrontchemotherapyontheeffectofprimarytumourresectionforasymptomaticsynchronouscolorectalcancerwithunresectablemetastasesapropensityscorematchedcohortanalysis