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Elevated preoperative CA125 is associated with poor survival in patients with metastatic colorectal cancer undergoing primary tumor resection:a retrospective cohort study

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Gastroenterology Report 2022年第1期10卷 386-394页

作者： Jun-Hua Huang Hua-Shan Liu Tuo Hu Zong-Jin Zhang Xiao-Wen He Tai-Wei Mo Xiao-Feng Wen Ping Lan Lei Lian Xian-Rui Wu Department of Colorectal Surgery The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdongP.R.China Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdongP.R.China Department of Gastric Surgery The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdongP.R.China

Background The impact of the preoperative carbohydrate antigen 125(CA125)level on the survival of metastatic colorectal cancer(CRC)patients undergoing primary tumor resection(PTR)remains *** aim of this study was to assess the prognostic value in overall survival(OS)and cancer-specific survival(CSS)between patients with and without an elevated preoperative CA125 *** All metastatic CRC patients receiving PTR between 2007 and 2017 at the Sixth Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)were retrospectively *** and CSS rates were compared between patients with and without elevated preoperative CA125 *** Among 326 patients examined,46(14.1%)exhibited elevated preoperative CA125 levels and the remaining 280(85.9%)had normal preoperative CA125 *** with elevated preoperative CA125 levels had lower body mass index,lower preoperative albumin level,lower proportion of preoperative chemotherapy,higher carcinoembryonic antigen and carbohydrate antigen 19–9(CA19–9)levels,poorer differentiation,and more malignant histopathological type than patients with normal preoperative CA125 *** addition,patients with elevated preoperative CA125 levels exhibited more advanced pathological T and N stages,more peritoneal metastasis,and more vessel invasion than patients with normal preoperative CA125 ***,the primary tumor was more likely to be located at the colon rather than at the rectum in patients with elevated CA125 *** OS and CSS rates in patients with elevated preoperative CA125 levels were significantly lower than those in patients with normal preoperative CA125 *** Cox regression analysis revealed that an elevated preoperative CA125 level was significantly associated with poor prognosis in metastatic CRC patients undergoing *** hazard ratio(HR)in OS was 2.36(95%confidence interval[CI],1.67–3.33,P<0.001)and the HR in CSS was 2.50(95%CI,1.77–3.55,P<0.001).The survival anal

关键词： metastatic colorectal cancer primary tumor resection CA125 prognosis survival

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Updated evidence of primary tumor resection in stage Ⅳ breast cancer:a systematic review and meta-analysis

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Journal of Cancer Metastasis and Treatment 2023年第1期9卷 1-19页

作者： Zacharoula Sidiropoulou Ana Rita Martins Patricia Amaral Vasco Cardoso Sofia Boligo Vasco Fonseca Breast Unit General SurgeryCentro Hospitalar Lisboa OcidentalLisboa 2790-134Portugal Medical Oncology Centro Hospitalar Lisboa OcidentalLisboa 2790-134Portugal

Background:In stage Ⅳ breast cancer,surgical resection of the primary tumor was traditionally performed solely to palliate symptoms such as bleeding,infection,or *** ongoing discussion has shown that there are many research gaps in the current literature and differences in clinical ***,this systematic review and meta-analysis was designed to evaluate how primary tumor resection(PTR)affects the overall survival(OS)of patients with stage Ⅳ breast ***:A thorough literature search was completed using different databases(PubMed,Google Scholar,Scopus,ScienceDirect,and Cochrane Library)to find papers contrasting PTR with no *** quality of research articles was evaluated using the Cochrane Risk of Bias 2.0 Tool and the Newcastle-Ottawa Scale(NOS).Review Manager 5.4 was used to determine how much demographic and clinical factors contribute to heterogeneity through subgroup and meta-regression ***:Data derived from 44 observational studies(OS)and four randomized controlled trials(RCTs)including 227,889 patients were *** all cases,150,239 patients were included in the non-PTR group,and 70,795 patients in the PTR group(37 observational studies and 4 randomized control trials).The pooled outcomes of four RCT studies(Hazard Ratio(HR)=1.03,95%CI:0.67-1.58;I2=88%;P<0.0001;chi-square 24.57)favor *** pooled outcomes of 43 observational studies showed PTR significantly improved OS(HR=0.66,95%CI:0.61-0.71;I2=87%;P<0.00001;chi-square 359.12).Additionally,subgroup analysis that compared PTR with non-PTR in patients with stage IV breast cancer for progression free-survival(HR=0.89,95%CI:0.62-1.28;P=0.03;I2=71%)and locoregional progression-free survival(LPFS)(HR=0.33,95%CI:0.14-0.74;P=0.0004;I^(2)=87%)was found to be significant favoring the PTR *** progression-free survival(DPFS)had a non-significant relationship(HR=0.42,95%CI:0.29-0.60;P=0.12;I^(2)=53%),while overall,there was a significant relationship(HR=0.49,95%CI:0

关键词： PTR primary tumor resection breast cancerⅣstage breast cancer overall survival metastatic disease

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Influence of primary tumor location and resection on survival in metastatic colorectal cancer

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World Journal of Gastrointestinal Oncology 2020年第11期12卷 1296-1310页

作者： ZoéTharin Julie Blanc Ikram Charifi Alaoui Aurélie Bertaut François Ghiringhelli Department of Medical Oncology Centre Georges-François LeclercDijon 21000France Department of Bioastatistics Centre Georges-François LeclercDijon 21000France

BACKGROUND Patients with right sided colorectal cancer are known to have a poorer prognosis than patients with left sided colorectal cancer, whatever the cancer stage. To this day, primary tumor resection(PTR) is still controversial in a metastatic, non resectable *** To explore the survival impact of PTR in patients with metastatic colorectal cancer(mCRC) depending on *** We retrospectively collected data from all consecutive patients treated for mCRC at the Centre Georges Francois Leclerc Hospital. Univariate and multivariate Cox proportional hazard regression models were used to assess the influence of PTR on survival. We then evaluated the association between PTL and overall survival among patients who previously underwent or did not undergo PTR. A propensity score was performed to match *** Four hundred and sixty-six patients were included. A total of 153(32.8%) patients had unresected synchronous mCRC and 313(67.2%) patients had resected synchronous mCRC. The number of patients with right colic cancer, left colic cancer and rectal cancer was respectively 174(37.3%), 203(43.6%) and 89(19.1%). In the multivariate analysis only PTL, PTR, resection of hepatic and or pulmonary metastases and the use of oxaliplatin, EGFR inhibitors or bevacizumab throughout treatment were associated to higher overall survival rates. Survival evaluation depending on PTR and PTL found that PTR improved the prognosis of both left and right sided mCRC. Results were confirmed by using a weighted propensity *** In mCRC, PTR seems to confer a higher survival rate to patients whatever the PTL.

关键词： Colorectal cancer Metastatic primary tumor resection Chemotherapy primary tumor location Synchronous

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