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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14 Citations (Scopus)

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

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hematology
  • Oncology

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    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, 20(6), 1140-1146. https://doi.org/10.1007/s10147-015-0835-2