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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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- 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.
- Ingår i: The Lancet Regional Health. - : Elsevier. - 2666-7762. ; 3
- Tidskriftsartikel (refereegranskat)
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
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- art (ämneskategori)
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- Osterlund, Pia
- Salminen, Tapio
- Soveri, Leena-Ma ...
- Kallio, Raija
- Kellokumpu, Ilmo
- Lamminmäki, Anna ...
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- Halonen, Päivi
- Ristamäki, Raija
- Lantto, Eila
- Uutela, Aki
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- Ovissi, Ali
- Nordin, Arno
- Heervä, Eetu
- Lehtomäki, Kaisa
- Räsänen, Jari
- Murashev, Maija
- Aroviita, Laura
- Jekunen, Antti
- Lindvall-Anderss ...
- Nyandoto, Paul
- Kononen, Juha
- Lepistö, Anna
- Poussa, Tuija
- Muhonen, Timo
- Ålgars, Annika
- Isoniemi, Helena
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