Li Ching-Chun, Chang Tsung-Kun, Chen Yen-Cheng, Tsai Hsiang-Lin, Huang Ching-Wen, Su Wei-Chih, Ma Cheng-Jen, Yin Tzu-Chieh, Chen Po-Jung, Wang Jaw-Yuan
Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Cancer Manag Res. 2022 Apr 23;14:1541-1549. doi: 10.2147/CMAR.S355318. eCollection 2022.
The prognosis of metastatic colorectal cancer (mCRC) depends on the metastatic site and systemic therapy regimen. Peritoneal metastases are associated with a relatively unfavorable prognosis among patients with mCRC. In this article, we present the treatment outcomes of patients with peritoneal carcinomatosis (PC)-only, liver metastasis (LiM)-only, and lung metastasis (LuM)-only CRC.
Overall, 206 mCRC patients with single-site metastasis and who had received treatment from January 2014 to December 2018 were recruited. Among 206 patients with mCRC, 15 had PC-only mCRC, 145 had LiM-only mCRC, and 46 had LuM-only mCRC. They attended regular follow-ups until November 2020, and the median follow-up period was 24.7 months (5.1-41.3 months). Patients' characteristics, including clinical data, gene mutation profiles, and clinical outcomes, were evaluated. All patients with PC-only CRC were treated with first-line bevacizumab and FOLFIRI, and the irinotecan dose escalation depended on polymorphism.
Of the 206 patients, no statistical difference was observed between the PC-only, LiM-only, and LuM-only groups in terms of age, primary tumor location, mutation status, mutation status, and epidermal growth factor receptor overexpression (all > 0.05). Patients with PC-only CRC had a median progression-free survival (mPFS) of 18.0 months and a median overall survival (mOS) of 24.6 months. Patients with LiM-only or LuM-only CRC had mPFS of 18.2 and 26.6 months and mOS of 25.0 and 44.5 months, respectively. No significant differences regarding PFS and OS (both > 0.05) between the three groups of patients with mCRC were observed.
Our study revealed that in patients with PC-only mCRC treatment of first-line bevacizumab and FOLFIRI through irinotecan dose escalation according to polymorphism could confer such patients with comparable outcomes to that of patients with LiM-only and LuM-only mCRC.
转移性结直肠癌（mCRC）的预后取决于转移部位和全身治疗方案。在mCRC患者中，腹膜转移与相对较差的预后相关。在本文中，我们展示了仅发生腹膜癌（PC）、仅发生肝转移（LiM）和仅发生肺转移（LuM）的结直肠癌患者的治疗结果。
总体而言，招募了206例在2014年1月至2018年12月期间接受治疗的单部位转移的mCRC患者。在206例mCRC患者中，15例为仅PC的mCRC，145例为仅LiM的mCRC，46例为仅LuM的mCRC。他们接受定期随访直至2020年11月，中位随访期为24.7个月（5.1 - 41.3个月）。评估了患者的特征，包括临床数据、基因突变谱和临床结局。所有仅PC的结直肠癌患者均接受一线贝伐单抗和FOLFIRI治疗，伊立替康剂量递增取决于基因多态性。
在206例患者中，仅PC组、仅LiM组和仅LuM组在年龄、原发肿瘤位置、KRAS基因突变状态、NRAS基因突变状态和表皮生长因子受体过表达方面均未观察到统计学差异（均P > 0.05）。仅PC的结直肠癌患者的中位无进展生存期（mPFS）为18.0个月，中位总生存期（mOS）为24.6个月。仅LiM或仅LuM的结直肠癌患者的mPFS分别为18.2个月和26.6个月，mOS分别为25.0个月和44.5个月。在三组mCRC患者之间，未观察到PFS和OS有显著差异（均P > 0.05）。
我们的研究表明，对于仅PC的mCRC患者，通过根据基因多态性进行伊立替康剂量递增的一线贝伐单抗和FOLFIRI治疗，可使这些患者获得与仅LiM和仅LuM的mCRC患者相当的结局。
