Clinical Research Papers:
Longterm effects of palliative local treatment of incurable metastatic lesions in colorectal cancer patients
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Qiong Yang1,2,3,4,*, Fangxin Liao1,3,4,*, Yuanyuan Huang1,3,4, Chang Jiang1,3,4, Shousheng Liu1,3,4, Wenzhuo He1,3,4, Pengfei Kong1,3,4, Bei Zhang1,3,4 and Liangping Xia1,3,4
1 VIP Region, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China
2 Department of Oncology, Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong, P.R. China
3 State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China
4 Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China
* These authors have contributed equally to this paper
Liangping Xia, email:
Bei Zhang, email:
Keywords: metastatic colorectal carcinoma, palliative local treatment, chemotherapy, propensity score matching, prognosis
Received: November 11, 2015 Accepted: February 24, 2016 Published: March 15, 2016
We assessed the value of palliative local treatment of incurable metastatic lesions in colorectal cancer patients. Consecutive patients with metastatic colorectal cancer treated between 2003 and 2014 were retrospectively reviewed. Propensity score matching was used to create comparable palliative local treatment and chemotherapy alone groups (n = 272 in each group). The primary endpoint was overall survival, which was calculated using Kaplan-Meier survival analyses. Factors possibly influencing survival were evaluated by univariate and subsequently by multivariate analyses. Palliative local treatment prolonged survival as compared with chemotherapy alone (38.73 vs. 19.8 months, p < 0.01). Univariate and subsequent multivariate analyses showed that primary stage IV at initial diagnosis; high CA199 level and LDH at the time of diagnosis were independent factors for a poor prognosis. Palliative local treatment improved survival better than chemotherapy alone in patients with 0, 1, 2, or 3 of the prognostic factors (p < 0.01). Patients administered treatment for pulmonary metastases survived longer than those treated for metastases elsewhere (56.77 vs. 35.43 months, p = 0.01). Surgical treatment provided marginally longer survival than non-surgical treatment (44.87 vs. 35.43 months, p = 0.05). These findings suggest palliative local treatment has survival benefit for selected patients with incurable metastatic colorectal cancer.
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