TY - JOUR

T1 - Metastasis directed therapy for liver and lung metastases from colorectal cancer - A population based study

AU - Boysen, Anders Kindberg

AU - Spindler, Karen-Lise Garm

AU - Høyer, Morten

AU - Mortensen, Frank Viborg

AU - Christensen, Thomas Decker

AU - Kormendine Farkas, Dora

AU - Ording, Anne Gulbech

PY - 2018/12/15

Y1 - 2018/12/15

N2 - About 10-20% of patients with metastatic colorectal cancer (mCRC) are candidates for metastasis directed therapies such as surgical resection, ablation and stereotactic radiotherapy. We examined the temporal changes in use of metastasis directed therapies and established prognostic factors for survival in a nationwide cohort study. The Danish nationwide medical registries were used to retrieve data on treatment for liver and/or lung metastasis in patients with metastatic colorectal cancer in the period 2000-2013. Overall survival through 2014 was calculated from the time of treatment of metastases by Kaplan-Meier method and mortality between groups was assessed using Cox regression. We report 2912 patients undergoing a total of 3602 procedures with an increased use of all modalities during 14 calendar years. Median survival was 3.7 years (interquartile range (IQR) 2.0-9.7 years). In the multivariate analysis the nodal stage of the primary tumor had the most pronounced association with survival with a hazard ratio for mortality of 1.56 (95% CI: 1.33-1.83) for N2 stage with reference to N0. Furthermore, female gender, age, comorbidity, surgical treatment, administration of chemotherapy and left sided primary tumors were associated with improved prognosis in the multivariate analysis. This article is protected by copyright. All rights reserved.

AB - About 10-20% of patients with metastatic colorectal cancer (mCRC) are candidates for metastasis directed therapies such as surgical resection, ablation and stereotactic radiotherapy. We examined the temporal changes in use of metastasis directed therapies and established prognostic factors for survival in a nationwide cohort study. The Danish nationwide medical registries were used to retrieve data on treatment for liver and/or lung metastasis in patients with metastatic colorectal cancer in the period 2000-2013. Overall survival through 2014 was calculated from the time of treatment of metastases by Kaplan-Meier method and mortality between groups was assessed using Cox regression. We report 2912 patients undergoing a total of 3602 procedures with an increased use of all modalities during 14 calendar years. Median survival was 3.7 years (interquartile range (IQR) 2.0-9.7 years). In the multivariate analysis the nodal stage of the primary tumor had the most pronounced association with survival with a hazard ratio for mortality of 1.56 (95% CI: 1.33-1.83) for N2 stage with reference to N0. Furthermore, female gender, age, comorbidity, surgical treatment, administration of chemotherapy and left sided primary tumors were associated with improved prognosis in the multivariate analysis. This article is protected by copyright. All rights reserved.

KW - colorectal cancer

KW - metastasis directed treatment

KW - population-based study

KW - Colorectal Neoplasms/epidemiology

KW - Lung Neoplasms/epidemiology

KW - Humans

KW - Liver Neoplasms/epidemiology

KW - Middle Aged

KW - Kaplan-Meier Estimate

KW - Proportional Hazards Models

KW - Radiosurgery

KW - Male

KW - Denmark/epidemiology

KW - Radiofrequency Ablation

KW - Female

KW - Registries

KW - Aged

KW - Chemotherapy, Adjuvant

KW - Population Surveillance

U2 - 10.1002/ijc.31626

DO - 10.1002/ijc.31626

M3 - Journal article

C2 - 29923284

VL - 143

SP - 3218

EP - 3226

JO - International Journal of Cancer

JF - International Journal of Cancer

SN - 0020-7136

IS - 12

ER -