Defining patient outcomes in stage IV colorectal cancer: a prospective study with baseline stratification according to disease resectability status
Defining patient outcomes in stage IV colorectal cancer: a prospective study with baseline stratification according to disease resectability status
复制标题
定义 IV 期结直肠癌患者的结局：根据疾病可切除性状态进行基线分层的前瞻性研究
DOI：
--
复制
发表时间：
2010
影响因子：
8.8
通讯作者：
A. Gillbanks
中科院分区：
文献类型：
--
作者：
D. Watkins;I. Chau;D. Cunningham;S. Mudan;N. Karanjia;G. Brown;S. Ashley;A. Norman;A. Gillbanks
背景：IV期结直肠癌包括一个广泛的患者群体，其中可以使用治愈和姑息治疗策略。在第二阶段的研究，主要是为了评估卡培他滨和奥沙利铂的疗效，我们能够前瞻性地检查的结果与IV期结直肠癌患者根据基线可切除性status.Methods：在招募，患者被分为三个亚组根据肝脏疾病的可切除性和治疗意图：姑息化疗（亚组A），转换治疗（亚组B）或新辅助治疗（亚组C）。所有患者均接受卡培他滨2000 mg m-2第1-14天和奥沙利铂130 mg m-2第1天化疗，每3周重复一次。影像学检查每4个周期重复一次，其中可行的肝切除术后进行4或8个周期的化疗。结果：128例入组患者，74，22和32分为亚组A，B和C，分别。亚组B中10例（45%）患者和亚组C中19例（59%）患者尝试了根治性肝切除术。A、B和C亚组的中位总生存期分别为14.6、24.5和52.9个月。对于亚组B和C中尝试根治性切除的患者，亚组B的3年无进展生存率为10%，亚组C为37%。结论：这项前瞻性研究显示了根据基线可切除性状态的结果的广泛差异，并强调了改良分期系统区分这些患者亚组的潜在临床价值。
Background:Stage IV colorectal cancer encompasses a broad patient population in which both curative and palliative management strategies may be used. In a phase II study primarily designed to assess the efficacy of capecitabine and oxaliplatin, we were able to prospectively examine the outcomes of patients with stage IV colorectal cancer according to the baseline resectability status.Methods:At enrolment, patients were stratified into three subgroups according to the resectability of liver disease and treatment intent: palliative chemotherapy (subgroup A), conversion therapy (subgroup B) or neoadjuvant therapy (subgroup C). All patients received chemotherapy with capecitabine 2000 mg m–2 on days 1–14 and oxaliplatin 130 mg m–2 on day 1 repeated every 3 weeks. Imaging was repeated every four cycles where feasible liver resection was undertaken after four or eight cycles of chemotherapy.Results:Of 128 enrolled patients, 74, 22 and 32 were stratified into subgroups A, B and C, respectively. Attempt at curative liver resection was undertaken in 10 (45%) patients in subgroup B and 19 (59%) in subgroup C. The median overall survival was 14.6, 24.5 and 52.9 months in subgroups A, B and C, respectively. For patients in subgroups B and C who underwent an attempt at curative resection, 3-year progression-free survival was 10% in subgroup B and 37% for subgroup C.Conclusions:This prospective study shows the wide variation in outcome according to baseline resectability status and highlights the potential clinical value of a modified staging system to distinguish between these patient subgroups.
登录
查看更多内容
影响因子：
9
作者：
Fong, Y;Fortner, J;Blumgart, LH
通讯作者：
Blumgart, LH
影响因子：
45.3
作者：
Goldberg, RM;Sargent, DJ;Alberts, SR
通讯作者：
Alberts, SR
影响因子：
5.2
作者：
Iwatsuki, S;Dvorchik, I;Starzl, TE
通讯作者：
Starzl, TE
影响因子：
158.5
作者：
Hurwitz, H;Fehrenbacher, L;Kabbinavar, F
通讯作者：
Kabbinavar, F
影响因子：
45.3
作者：
Alberts, SR;Horvath, WL;Donohue, JH
通讯作者：
Donohue, JH