Abstract 2338
Background
The benefit of preoperative chemotherapy (pre-CT) and metastasectomy for pulmonary metastasis (PM) from colorectal cancer (CRC) (PM-CRC) are unclear due to a lack of enough studies. However, there are some patients who receive chemotherapy after PM detection and subsequently undergo metastasectomy in clinical practice. The aim of this study was to investigate the impact of response to pre-CT on the outcome of pulmonary metastasectomy for PM-CRC.
Methods
The subjects were 92 patients, who received pre-CT before metastasectomy for PM-CRC, identified from the 1237 patients whose PM-CRC were curatively resected at 46 institutions in Japan between 2004 and 2008.
Results
Twenty-six (28%) patients initially judged to have inoperable PM underwent chemotherapy leading to conversion to be resectable and subsequently received metastasectomy. The remaining 66 patients initially judged to have operable PM received pre-CT and subsequently underwent metastasectomy. Fifty-six (61%) patients received fluoropyrimidine based regimens combined with oxaliplatin or irinotecan, and most of the remaining 26 received tegafur/uracil. Pre-CT yielded partial response (PR), stable disease (SD) and progressive disease (PD) in 28 (30%), 26 (28%) and 38 (42%) patients, respectively. At metastasectomy, the proportions of patients with extrathoracic lesion, multiple PMs, and abnormal carcinoembryonic antigen level were 34, 58, and 40%, respectively. Wedge resection was the most frequent (62%) surgical procedure. The five-year disease-free (DFS) and overall survival (OS) rate of the all 92 patients were 25.1% (95% CI 16.4-34.7) and 45.4% (33.4-56.7). The five-year DFS rates of the patients with PR/SD and PD during pre-CT were 28.2% (16.5-41.1) and 20.6% (9.2-35.2), and those of OS were 58.1% (40.8-71.9) and 27.5% (12.9-44.3), respectively. By multivariate analysis, independent prognosticators were two or less PMs (HR = 0.56, 95% CI 0.33-0.94; p = 0.029) for DFS, and performance status 0 (0.44, 0.22-0.90; 0.024) and PR/SD during pre-CT (0.33, 0.18-0.61; < 0.001) for OS.
Conclusions
Response to Pre-CT had some impacts on OS after metastasectomy for PM-CRC: better in the patients with PR/SD compared to PD.
Clinical trial identification
Legal entity responsible for the study
Nonprofit Organization Tsukuba Cancer Clinical Trial Group.
Funding
Non-profit organization Tsukuba Cancer Clinical Trial Group.
Editorial Acknowledgement
Disclosure
N. Boku: Honoraria: Ono, BMS, Chugai, Merck Serono, Yakult, Eli Lilly companies. I. Hyodo: Honoraria: Taiho, Chugai, Daiichi-Sankyo, Yakult-Honshya companies. All other authors have declared no conflicts of interest.
Resources from the same session
4784 - Tranilast inhibits TGF-beta-induced EMT and invasion/metastasis via the suppression of Smad4 in lung cancer cell lines.
Presenter: Koji Takahashi
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
767 - Integrin beta-like 1 overexpression stimulates invasiveness of ovarian cancer cells in vitro
Presenter: Alexander Cortez
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
938 - MiR-449a suppresses endometrial cancer invasion and metastasis by targeting NDRG1
Presenter: Lihua Qiu
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
4866 - Cancer-associated fibroblasts-derived VEGFA mediates the migration of gastric cancer cells through VEGFR1
Presenter: xiaoxun Wang
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
4934 - Risk prediction of metastasis through study of circulating tumor cells
Presenter: Panagiotis Apostolou
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
3289 - First step to metastasis: miRNAome abnormalities impair cell-cell adhesion and facilitate detachment of breast cancer cells
Presenter: Volodymyr Halytskiy
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
4110 - Extracellular matrix of normal brain tissue is affected by temozolomide during anti-glioblastoma treatment
Presenter: Alexandra Tsidulko
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
1526 - Study of the activation of TLR receptors in neurospheres from glioblastoma cells in vitro
Presenter: David Albert Bellver
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
4862 - 5-Fluorouracil induced up-regulation of exosomal PD-L1 causing immunosuppression in gastric cancer patients
Presenter: Zhang Min
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract
635 - Thrombocytosis and leukocytosis: are they negative prognostic factors in solid tumours?
Presenter: Filip Kohutek
Session: Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology
Resources:
Abstract