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
5720 - Evaluation of stemness and proliferation of human breast cancer stem cells (ALDH+) supplemented with heat-activated TGF-beta1 in the secretomes of stem cells from human exfoliated deciduous teeth (SHED)
Presenter: Septelia Wanandi
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
4844 - Estrogen-related receptor _ as a potential molecular target for endometrial cancer therapy
Presenter: TETSUYA KOKABU
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
1200 - Good tolerability and limited target-specific tissue distribution of an anti-L1CAM antibody administered to cynomolgus monkey indicates favorable safety profile of L1CAM-targeting therapies
Presenter: Jacques Gaudreault
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
2905 - Pharmacokinetic drug-drug interaction between mitotane and etoposide in the treatment of adrenocortical carcinoma
Presenter: Anne Jouinot
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
2597 - Real-world dosing of regorafenib (REG) in metastatic colorectal cancer (mCRC): final results from the prospective, observational CORRELATE study
Presenter: Juan Manuel O'Connor
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
2663 - Safety and efficacy of trifluridine/tipiracil (FTD/TPI) in metastatic colorectal cancer (mCRC) patients according to previous treatment with regorafenib in the international phase 3b PRECONNECT study
Presenter: Julien Taieb
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
1670 - Treatment pattern and outcomes of trifluridine/tipiracil therapy for metastatic colorectal cancer in the real-world data from the JFMC50 study
Presenter: Takeshi Kawakami
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
1088 - Phase II trial to evaluate efficacy and tolerance of regorafenib monotherapy in patients (pts) over 70 with previously treated metastatic colorectal adenocarcinoma (mCRC) FFCD 1404 - REGOLD
Presenter: thomas Aparicio
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
2548 - Prospective Evaluation of Regorafenib Dose Escalation Strategy with Low Starting Dose in Patients with Colorectal Cancer
Presenter: Toshiki Masuishi
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
3244 - Regorafenib for metastatic colorectal carcinoma: a registry-based analysis
Presenter: Katerina Kopeckova
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