Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
Department of Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, R.O.C.
Anticancer Res. 2023 Nov;43(11):5127-5138. doi: 10.21873/anticanres.16713.
BACKGROUND/AIM: The study aimed to determine the effectiveness of cetuximab and panitumumab on the survival of patients with metastatic colorectal cancer or those who had undergone conversion surgery and to identify their prognostic factors.
This retrospective cohort study used data from patients with metastatic colorectal cancer who received cetuximab or panitumumab as first-line targeted agent-based therapy. Overall survival and conversion surgery rates were evaluated, and the prognostic factors were determined.
A total of 1,749 and 318 patients received cetuximab or panitumumab with chemotherapy, respectively. Overall survival and conversion surgery rates were similar between the cetuximab [hazard ratio (HR)=0.96] and panitumumab groups (HR=1.00). The prognostic factors associated with metastasectomy significantly lowered mortality among patients with metastatic colorectal cancer (HR=0.61). Older age (≥70 years), tumor stage 4B and 4C, right-sided tumors, mucinous adenocarcinoma, primary tumor resection, and the number of positive lymph nodes were associated with higher mortality and lower conversion surgery rates.
Though panitumumab- and cetuximab-based therapies showed no differences, several factors, such as age over 70 years old, tumor stage 4B and 4C, undifferentiated carcinoma, mucinous carcinoma, right-sided tumor, number of positive lymph nodes, obstruction, and primary tumor resection increased the mortality risk of patients. This study underscores the importance of metastasectomy in current treatment guidelines and future clinical trials.
背景/目的：本研究旨在确定西妥昔单抗和帕尼单抗对转移性结直肠癌患者或接受转化手术患者的生存效果，并确定其预后因素。
本回顾性队列研究使用了接受西妥昔单抗或帕尼单抗作为一线基于靶向药物治疗的转移性结直肠癌患者的数据。评估了总生存率和转化手术率，并确定了预后因素。
共有 1749 例和 318 例患者分别接受了西妥昔单抗或帕尼单抗联合化疗。西妥昔单抗组（危险比[HR]=0.96）和帕尼单抗组的总生存率和转化手术率相似（HR=1.00）。与转移性结直肠癌患者死亡相关的转移瘤切除术的预后因素显著降低（HR=0.61）。年龄较大（≥70 岁）、肿瘤分期 4B 和 4C、右侧肿瘤、黏液性腺癌、原发肿瘤切除和阳性淋巴结数量与死亡率较高和转化手术率较低相关。
尽管西妥昔单抗和帕尼单抗治疗方案无差异，但70 岁以上、肿瘤分期 4B 和 4C、未分化癌、黏液腺癌、右侧肿瘤、阳性淋巴结数量、梗阻和原发肿瘤切除等因素增加了患者的死亡风险。本研究强调了转移瘤切除术在当前治疗指南和未来临床试验中的重要性。
