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Repeated centralize...
Repeated centralized multidisciplinary team assessment of resectability, clinical behavior, and outcomes in 1086 Finnish metastatic colorectal cancer patients (RAXO) : A nationwide prospective intervention study
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- Osterlund, Pia (författare)
- Karolinska Institutet,Tampere Univ Hosp, Dept Oncol, Teiskontie 35,POB 2000, Tampere 33520, Finland.;Univ Tampere, Tampere, Finland.;Helsinki Univ Hosp, Dept Oncol, Helsinki, Finland.;Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden.;Karolinska Univ Hosp, Stockholm, Sweden.
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- Salminen, Tapio (författare)
- Tampere Univ Hosp, Dept Oncol, Teiskontie 35,POB 2000, Tampere 33520, Finland.;Univ Tampere, Tampere, Finland.
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- Soveri, Leena-Maija (författare)
- Helsinki Univ Hosp, Dept Oncol, Helsinki, Finland.;Hyvinkaa Hosp & Home Care, Dept Palliat Care, Hyvinkaa, Finland.
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- Kallio, Raija (författare)
- Oulu Univ Hosp, Dept Oncol, Oulu, Finland.;Univ Oulu, Oulu, Finland.
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- Kellokumpu, Ilmo (författare)
- Cent Hosp Cent Finland, Dept Gastrointestinal Surg, Jyyaskyla, Finland.
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- Lamminmäki, Annamarja (författare)
- Kuopio Univ Hosp, Dept Oncol, Kuopio, Finland.;Univ Kuopio, Kuopio, Finland.
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- Halonen, Päivi (författare)
- Helsinki Univ Hosp, Dept Oncol, Helsinki, Finland.
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- Ristamäki, Raija (författare)
- Turku Univ Hosp, Dept Oncol, Turku, Finland.;Univ Turku, Turku, Finland.
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- Lantto, Eila (författare)
- Helsinki Univ Hosp, Dept Radiol, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland.;Paijat Home Cent Hosp, Dept Radiol, Lahti, Finland.
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- Uutela, Aki (författare)
- Univ Helsinki, Helsinki, Finland.;Helsinki Univ Hosp, Dept Transplantat & Liver Surg, Helsinki, Finland.
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- Österlund, Emerik (författare)
- Uppsala universitet,Experimentell och klinisk onkologi,Univ Helsinki, Helsinki, Finland.;Helsinki Univ Hosp, Dept Transplantat & Liver Surg, Helsinki, Finland.;Akad Sjukhuset, Uppsala, Sweden.
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- Ovissi, Ali (författare)
- Helsinki Univ Hosp, Dept Radiol, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland.
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- Nordin, Arno (författare)
- Univ Helsinki, Helsinki, Finland.;Helsinki Univ Hosp, Dept Transplantat & Liver Surg, Helsinki, Finland.
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- Heervä, Eetu (författare)
- Turku Univ Hosp, Dept Oncol, Turku, Finland.;Univ Turku, Turku, Finland.
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- Lehtomäki, Kaisa (författare)
- Tampere Univ Hosp, Dept Oncol, Teiskontie 35,POB 2000, Tampere 33520, Finland.;Univ Tampere, Tampere, Finland.
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- Räsänen, Jari (författare)
- Univ Helsinki, Helsinki, Finland.;Helsinki Univ Hosp, Dept Thorac Surg, Helsinki, Finland.
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- Murashev, Maija (författare)
- Satakunta Cent Hosp, Dept Oncol, Pori, Finland.
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- Aroviita, Laura (författare)
- Kanta Hame Cent Hosp, Dept Oncol, Hameenlinna, Finland.
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- Jekunen, Antti (författare)
- Vaasa Cent Hosp, Dept Oncol, Vaasa, Finland.
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- Lindvall-Andersson, Renee (författare)
- Aland Cent Hosp, Dept Oncol, Mariehamn, Finland.
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- Nyandoto, Paul (författare)
- Paijat Name Cent Hosp, Dept Oncol, Lahti, Finland.
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- Kononen, Juha (författare)
- Cent Hosp Cent Finland, Dept Oncol, Jyvaskyla, Finland.
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- Lepistö, Anna (författare)
- Univ Helsinki, Helsinki, Finland.;Helsinki Univ Hosp, Dept Gastrointestinal Surg, Helsinki, Finland.
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- Poussa, Tuija (författare)
- StatConsulting, Nokia, Finland.
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- Muhonen, Timo (författare)
- South Carelia Cent Hosp, Dept Oncol, Lappeenranta, Finland.
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- Ålgars, Annika (författare)
- Turku Univ Hosp, Dept Oncol, Turku, Finland.;Univ Turku, Turku, Finland.
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- Isoniemi, Helena (författare)
- Univ Helsinki, Helsinki, Finland.;Helsinki Univ Hosp, Dept Transplantat & Liver Surg, Helsinki, Finland.
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Karolinska Institutet Tampere Univ Hosp, Dept Oncol, Teiskontie 35,POB 2000, Tampere 33520, Finland;Univ Tampere, Tampere, Finland.;Helsinki Univ Hosp, Dept Oncol, Helsinki, Finland.;Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden.;Karolinska Univ Hosp, Stockholm, Sweden. (creator_code:org_t)
- Elsevier, 2021
- 2021
- Engelska.
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Ingår i: The Lancet Regional Health. - : Elsevier. - 2666-7762. ; 3
- Relaterad länk:
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Background: Resection of colorectal cancer (CRC) metastases provides good survival but is probably underused in real-world practice. Methods: A prospective Finnish nationwide study enrolled treatable metastatic CRC patients. The intervention was the assessment of resectability upfront and twice during first-line therapy by the multidisciplinary team (MDT) at Helsinki tertiary referral centre. The primary outcome was resection rates and survival. Findings: In 2012-2018, 1086 patients were included. Median follow-up was 58 months. Multiple metastatic sites were present in 500 (46%) patients at baseline and in 820 (76%) during disease trajectory. In MDT assessments, 447 (41%) were classified as resectable, 310 (29%) upfront and 137 (18%) after conversion therapy. Sixhundred and ninety curative intent resections or local ablative therapies (LAT) were performed in 399 patients (89% of 447 resectable). Multiple metastasectomies for multisite or later developing metastases were performed in 148 (37%) patients. Overall, 414 liver, 112 lung, 57 peritoneal, and 107 other metastasectomies were performed. Median OS was 80.4 months in R0/1-resected (HR 0.15; CI95% 0.12-0.19), 39.1 months in R2-resected/LAT (0.39; 0.29-0.53) patients, and 20.8 months in patients treated with "systemic therapy alone" (reference), with 5-year OS rates of 66%, 40%, and 6%, respectively. Interpretation: Repeated centralized MDT assessment in real-world metastatic CRC patients generates high resectability (41%) and resection rates (37%) with impressive survival, even when multisite metastases are present or develop later.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Nyckelord
- Colorectal cancer
- Metastatic
- Multidisciplinary
- Resection
- Resectability
- Multisite metastases
- Conversion
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas
- Av författaren/redakt...
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Osterlund, Pia
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Salminen, Tapio
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Soveri, Leena-Ma ...
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Kallio, Raija
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Kellokumpu, Ilmo
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Lamminmäki, Anna ...
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visa fler...
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Halonen, Päivi
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Ristamäki, Raija
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Lantto, Eila
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Uutela, Aki
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Österlund, Emeri ...
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Ovissi, Ali
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Nordin, Arno
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Heervä, Eetu
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Lehtomäki, Kaisa
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Räsänen, Jari
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Murashev, Maija
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Aroviita, Laura
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Jekunen, Antti
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Lindvall-Anderss ...
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Nyandoto, Paul
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Kononen, Juha
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Lepistö, Anna
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Poussa, Tuija
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Muhonen, Timo
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Ålgars, Annika
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Isoniemi, Helena
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Cancer och onkol ...
- Artiklar i publikationen
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The Lancet Regio ...
- Av lärosätet
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Uppsala universitet
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Karolinska Institutet