PURPOSE: Fluorouracil/leucovorin as the sole therapy for metastatic colorectal cancer (CRC) provides an overall survival of 8 to 12 months. With an increase in surgical resections of metastatic disease and development of new chemotherapies, indirect evidence suggests that outcomes for patients are improving in the general population, although the incremental gain has not yet been quantified. METHODS: We performed a retrospective review of patients newly diagnosed with metastatic CRC treated at two academic centers from 1990 through 2006. Landmark analysis evaluated the association of diagnosis year and liver resection with overall survival. Additional survival analysis of the Surveillance Epidemiology and End Results (SEER) database evaluated a similar population from 1990 through 2005. RESULTS: Two thousand four hundred seventy patients with metastatic CRC at diagnosis received their primary treatment at the two institutions during this time period. Median overall survival for those patients diagnosed from 1990 to 1997 was 14.2 months, which increased to 18.0, 18.6, and 29.3 months for patients diagnosed in 1998 to 2000, 2001 to 2003, and 2004 to 2006, respectively. Likewise, 5-year overall survival increased from 9.1% in the earliest time period to 19.2% in 2001 to 2003. Improved outcomes from 1998 to 2004 were a result of an increase in hepatic resection, which was performed in 20% of the patients. Improvements from 2004 to 2006 were temporally associated with increased utilization of new chemotherapeutics. In the SEER registry, overall survival for the 49,459 identified patients also increased in the most recent time period. CONCLUSION: Profound improvements in outcome in metastatic CRC seem to be associated with the sequential increase in the use of hepatic resection in selected patients (1998 to 2006) and advancements in medical therapy (2004 to 2006).
PURPOSE:Fluorouracil/leucovorin as the sole therapy for metastatic colorectal cancer (CRC) provides an overall survival of 8 to 12 months. With an increase in surgical resections of metastatic disease and development of new chemotherapies, indirect evidence suggests that outcomes for patients are improving in the general population, although the incremental gain has not yet been quantified. METHODS: We performed a retrospective review of patients newly diagnosed with metastatic CRC treated at two academic centers from 1990 through 2006. Landmark analysis evaluated the association of diagnosis year and liver resection with overall survival. Additional survival analysis of the Surveillance Epidemiology and End Results (SEER) database evaluated a similar population from 1990 through 2005. RESULTS: Two thousand four hundred seventy patients with metastatic CRC at diagnosis received their primary treatment at the two institutions during this time period. Median overall survival for those patients diagnosed from 1990 to 1997 was 14.2 months, which increased to 18.0, 18.6, and 29.3 months for patients diagnosed in 1998 to 2000, 2001 to 2003, and 2004 to 2006, respectively. Likewise, 5-year overall survival increased from 9.1% in the earliest time period to 19.2% in 2001 to 2003. Improved outcomes from 1998 to 2004 were a result of an increase in hepatic resection, which was performed in 20% of the patients. Improvements from 2004 to 2006 were temporally associated with increased utilization of new chemotherapeutics. In the SEER registry, overall survival for the 49,459 identified patients also increased in the most recent time period. CONCLUSION: Profound improvements in outcome in metastatic CRC seem to be associated with the sequential increase in the use of hepatic resection in selected patients (1998 to 2006) and advancements in medical therapy (2004 to 2006).
Authors: Timothy M Pawlik; Charles R Scoggins; Daria Zorzi; Eddie K Abdalla; Axel Andres; Cathy Eng; Steven A Curley; Evelyne M Loyer; Andrea Muratore; Gilles Mentha; Lorenzo Capussotti; Jean-Nicolas Vauthey Journal: Ann Surg Date: 2005-05 Impact factor: 12.969
Authors: P Piedbois; P Rougier; M Buyse; J Pignon; L Ryan; R Hansen; B Zee; B Weinerman; J Pater; C Leichman; J Macdonald; J Benedetti; J Lokich; J Fryer; G Brufman; R Isacson; A Laplanche; E Levy Journal: J Clin Oncol Date: 1998-01 Impact factor: 44.544
Authors: O Glehen; F Kwiatkowski; P H Sugarbaker; D Elias; E A Levine; M De Simone; R Barone; Y Yonemura; F Cavaliere; F Quenet; M Gutman; A A K Tentes; G Lorimier; J L Bernard; J M Bereder; J Porcheron; A Gomez-Portilla; P Shen; M Deraco; P Rat Journal: J Clin Oncol Date: 2004-08-15 Impact factor: 44.544
Authors: James S Tomlinson; William R Jarnagin; Ronald P DeMatteo; Yuman Fong; Peter Kornprat; Mithat Gonen; Nancy Kemeny; Murray F Brennan; Leslie H Blumgart; Michael D'Angelica Journal: J Clin Oncol Date: 2007-10-10 Impact factor: 44.544
Authors: Leonard B Saltz; Stephen Clarke; Eduardo Díaz-Rubio; Werner Scheithauer; Arie Figer; Ralph Wong; Sheryl Koski; Mikhail Lichinitser; Tsai-Shen Yang; Fernando Rivera; Felix Couture; Florin Sirzén; Jim Cassidy Journal: J Clin Oncol Date: 2008-04-20 Impact factor: 44.544
Authors: T Ruers; C Punt; F Van Coevorden; J P E N Pierie; I Borel-Rinkes; J A Ledermann; G Poston; W Bechstein; M A Lentz; M Mauer; E Van Cutsem; M P Lutz; B Nordlinger Journal: Ann Oncol Date: 2012-03-19 Impact factor: 32.976
Authors: J Goldstein; B Tran; J Ensor; P Gibbs; H L Wong; S F Wong; E Vilar; J Tie; R Broaddus; S Kopetz; J Desai; M J Overman Journal: Ann Oncol Date: 2014-02-27 Impact factor: 32.976
Authors: Bruno C Odisio; Suguru Yamashita; Steven Y Huang; Scott E Kopetz; Kamran Ahrar; Takashi Mizuno; Claudius Conrad; Thomas A Aloia; Yun Shin Chun; Sanjay Gupta; Jean-Nicolas Vauthey Journal: J Vasc Interv Radiol Date: 2018-02-01 Impact factor: 3.464
Authors: Chunwan Lu; John D Klement; Dafeng Yang; Thomas Albers; Iryna O Lebedyeva; Jennifer L Waller; Kebin Liu Journal: Cancer Lett Date: 2020-02-12 Impact factor: 8.679