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Improved survival in metastatic colorectal cancer is associated with adoption of hepatic resection and improved chemotherapy
Journal of Clinical Oncology, 06/01/09

Kopetz S et al. – Study reports that profound improvements in outcome in metastatic colorectal cancer (CRC) seem to be associated with the sequential increase in the use of hepatic resection in selected pts (1998-2006) and advancements in medical therapy (2004-2006).

Methods

Aim was to review the outcomes for pts with mCRC in the light of surgical resections and development of new chemotherapies
A retrospective review of pts newly diagnosed with mCRC treated at 2 academic centers from 1990 through 2006
Landmark analysis evaluated the association of diagnosis year and liver resection with overall survival
Additional survival analysis of the Surveillance Epidemiology and End Results (SEER) database evaluated a similar population from 1990-2005

Results

2,470 pts with mCRC at diagnosis received their primary treatment at the 2 institutions during this time period
Median overall survival (OS) for pts:
- those diagnosed from 1990-1997 was 14.2 mo
- increased to 18.0 in 1998-2000
- to 18.6 in 2001 to 2003 and
- 29.3 mo in 2004 to 2006
5-yr OS increased from 9.1% in the earliest time period to 19.2% in 2001 to 2003
Improved outcomes from 1998 to 2004 were a result of an increase in hepatic resection which was performed in 20% of the pts
Improvements from 2004-2006 were temporally associated with increased utilization of new chemotherapeutics
In the SEER registry, OS for the 49,459 identified pts also increased in the most recent time period