Predictors of long-term survival in patients with stage IV colorectal cancer with multi-organ metastases: a single-center retrospective analysis

Yuji Miyamoto, Naoko Hayashi, Yasuo Sakamoto, Mayuko Ohuchi, Ryuma Tokunagam, Junji Kurashige, Yukiharu Hiyoshi, Yoshifumi Baba, Shiro Iwagami, Naoya Yoshida, Megumi Yoshida, Hideo Baba

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Abstract

Background: The prognosis for most patients with stage IV colorectal cancer (CRC) and multi-organ metastases is poor. However, little information is currently available on prognostic factors in these patients. The aim of this study was to identify predictors of a good prognosis in this patient group. Methods: This was a single-center retrospective study in which we examined the relationship between patient characteristics and prognosis in 161 stage IV CRC patients with indications for first-line systemic chemotherapy. Cox proportional-hazards models were used to compute hazard ratios (HR) for death, adjusted for clinical and pathological characteristics. Results: Of the 161 patients recruited to the study, 83 had single-organ and 78 had multi-organ metastases. Median survival time was significantly shorter in patients with multi-organ metastases than in those with single-organ metastases (19.2 vs. 42.0 months, respectively; log-rank, P < 0.001). There was no significant difference in survival between patients with metastases in two versus three or more organs (log-rank; P = 0.368). According to univariate analysis, primary tumor sites in the left side of the colon and in the rectum, a pretreatment carcinoembryonic antigen concentration of >50 ng/mL, a well-/moderately differentiated tumor, and R0 resection of metastatic lesions were associated with better overall survival. According to multivariate analysis, left-sided location of the primary tumor [HR 0.414, 95 % confidence interval (CI) 0.216–0.815; P = 0.011] and R0 resection of metastatic lesions (HR 0.247, 95 % CI 0.04 0–0.834; P = 0.021) were independently associated with good prognosis. Conclusions: Our results indicate that the site of the primary tumor in the left side of the colon and in the rectum and R0 resection of metastatic lesions are predictors of a good prognosis in patients with stage IV CRC and multi-organ metastases.

Original languageEnglish
Pages (from-to)1140-1146
Number of pages7
JournalInternational Journal of Clinical Oncology
Volume20
Issue number6
DOIs
Publication statusPublished - Dec 1 2015

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Colorectal Neoplasms
Neoplasm Metastasis
Survival
Confidence Intervals
Neoplasms
Proportional Hazards Models
Rectum
Colon
Multivariate Analysis
Retrospective Studies
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hematology
  • Oncology

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Predictors of long-term survival in patients with stage IV colorectal cancer with multi-organ metastases : a single-center retrospective analysis. / Miyamoto, Yuji; Hayashi, Naoko; Sakamoto, Yasuo; Ohuchi, Mayuko; Tokunagam, Ryuma; Kurashige, Junji; Hiyoshi, Yukiharu; Baba, Yoshifumi; Iwagami, Shiro; Yoshida, Naoya; Yoshida, Megumi; Baba, Hideo.

In: International Journal of Clinical Oncology, Vol. 20, No. 6, 01.12.2015, p. 1140-1146.

Research output: Contribution to journalArticle

Miyamoto, Y, Hayashi, N, Sakamoto, Y, Ohuchi, M, Tokunagam, R, Kurashige, J, Hiyoshi, Y, Baba, Y, Iwagami, S, Yoshida, N, Yoshida, M & Baba, H 2015, 'Predictors of long-term survival in patients with stage IV colorectal cancer with multi-organ metastases: a single-center retrospective analysis', International Journal of Clinical Oncology, vol. 20, no. 6, pp. 1140-1146. https://doi.org/10.1007/s10147-015-0835-2
Miyamoto, Yuji ; Hayashi, Naoko ; Sakamoto, Yasuo ; Ohuchi, Mayuko ; Tokunagam, Ryuma ; Kurashige, Junji ; Hiyoshi, Yukiharu ; Baba, Yoshifumi ; Iwagami, Shiro ; Yoshida, Naoya ; Yoshida, Megumi ; Baba, Hideo. / Predictors of long-term survival in patients with stage IV colorectal cancer with multi-organ metastases : a single-center retrospective analysis. In: International Journal of Clinical Oncology. 2015 ; Vol. 20, No. 6. pp. 1140-1146.
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abstract = "Background: The prognosis for most patients with stage IV colorectal cancer (CRC) and multi-organ metastases is poor. However, little information is currently available on prognostic factors in these patients. The aim of this study was to identify predictors of a good prognosis in this patient group. Methods: This was a single-center retrospective study in which we examined the relationship between patient characteristics and prognosis in 161 stage IV CRC patients with indications for first-line systemic chemotherapy. Cox proportional-hazards models were used to compute hazard ratios (HR) for death, adjusted for clinical and pathological characteristics. Results: Of the 161 patients recruited to the study, 83 had single-organ and 78 had multi-organ metastases. Median survival time was significantly shorter in patients with multi-organ metastases than in those with single-organ metastases (19.2 vs. 42.0 months, respectively; log-rank, P < 0.001). There was no significant difference in survival between patients with metastases in two versus three or more organs (log-rank; P = 0.368). According to univariate analysis, primary tumor sites in the left side of the colon and in the rectum, a pretreatment carcinoembryonic antigen concentration of >50 ng/mL, a well-/moderately differentiated tumor, and R0 resection of metastatic lesions were associated with better overall survival. According to multivariate analysis, left-sided location of the primary tumor [HR 0.414, 95 {\%} confidence interval (CI) 0.216–0.815; P = 0.011] and R0 resection of metastatic lesions (HR 0.247, 95 {\%} CI 0.04 0–0.834; P = 0.021) were independently associated with good prognosis. Conclusions: Our results indicate that the site of the primary tumor in the left side of the colon and in the rectum and R0 resection of metastatic lesions are predictors of a good prognosis in patients with stage IV CRC and multi-organ metastases.",
author = "Yuji Miyamoto and Naoko Hayashi and Yasuo Sakamoto and Mayuko Ohuchi and Ryuma Tokunagam and Junji Kurashige and Yukiharu Hiyoshi and Yoshifumi Baba and Shiro Iwagami and Naoya Yoshida and Megumi Yoshida and Hideo Baba",
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T1 - Predictors of long-term survival in patients with stage IV colorectal cancer with multi-organ metastases

T2 - a single-center retrospective analysis

AU - Miyamoto, Yuji

AU - Hayashi, Naoko

AU - Sakamoto, Yasuo

AU - Ohuchi, Mayuko

AU - Tokunagam, Ryuma

AU - Kurashige, Junji

AU - Hiyoshi, Yukiharu

AU - Baba, Yoshifumi

AU - Iwagami, Shiro

AU - Yoshida, Naoya

AU - Yoshida, Megumi

AU - Baba, Hideo

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Background: The prognosis for most patients with stage IV colorectal cancer (CRC) and multi-organ metastases is poor. However, little information is currently available on prognostic factors in these patients. The aim of this study was to identify predictors of a good prognosis in this patient group. Methods: This was a single-center retrospective study in which we examined the relationship between patient characteristics and prognosis in 161 stage IV CRC patients with indications for first-line systemic chemotherapy. Cox proportional-hazards models were used to compute hazard ratios (HR) for death, adjusted for clinical and pathological characteristics. Results: Of the 161 patients recruited to the study, 83 had single-organ and 78 had multi-organ metastases. Median survival time was significantly shorter in patients with multi-organ metastases than in those with single-organ metastases (19.2 vs. 42.0 months, respectively; log-rank, P < 0.001). There was no significant difference in survival between patients with metastases in two versus three or more organs (log-rank; P = 0.368). According to univariate analysis, primary tumor sites in the left side of the colon and in the rectum, a pretreatment carcinoembryonic antigen concentration of >50 ng/mL, a well-/moderately differentiated tumor, and R0 resection of metastatic lesions were associated with better overall survival. According to multivariate analysis, left-sided location of the primary tumor [HR 0.414, 95 % confidence interval (CI) 0.216–0.815; P = 0.011] and R0 resection of metastatic lesions (HR 0.247, 95 % CI 0.04 0–0.834; P = 0.021) were independently associated with good prognosis. Conclusions: Our results indicate that the site of the primary tumor in the left side of the colon and in the rectum and R0 resection of metastatic lesions are predictors of a good prognosis in patients with stage IV CRC and multi-organ metastases.

AB - Background: The prognosis for most patients with stage IV colorectal cancer (CRC) and multi-organ metastases is poor. However, little information is currently available on prognostic factors in these patients. The aim of this study was to identify predictors of a good prognosis in this patient group. Methods: This was a single-center retrospective study in which we examined the relationship between patient characteristics and prognosis in 161 stage IV CRC patients with indications for first-line systemic chemotherapy. Cox proportional-hazards models were used to compute hazard ratios (HR) for death, adjusted for clinical and pathological characteristics. Results: Of the 161 patients recruited to the study, 83 had single-organ and 78 had multi-organ metastases. Median survival time was significantly shorter in patients with multi-organ metastases than in those with single-organ metastases (19.2 vs. 42.0 months, respectively; log-rank, P < 0.001). There was no significant difference in survival between patients with metastases in two versus three or more organs (log-rank; P = 0.368). According to univariate analysis, primary tumor sites in the left side of the colon and in the rectum, a pretreatment carcinoembryonic antigen concentration of >50 ng/mL, a well-/moderately differentiated tumor, and R0 resection of metastatic lesions were associated with better overall survival. According to multivariate analysis, left-sided location of the primary tumor [HR 0.414, 95 % confidence interval (CI) 0.216–0.815; P = 0.011] and R0 resection of metastatic lesions (HR 0.247, 95 % CI 0.04 0–0.834; P = 0.021) were independently associated with good prognosis. Conclusions: Our results indicate that the site of the primary tumor in the left side of the colon and in the rectum and R0 resection of metastatic lesions are predictors of a good prognosis in patients with stage IV CRC and multi-organ metastases.

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