Background
Methods
Participants
Surgical indication for colorectal metastasis
Assessments
Statistical analysis
Results
Participants
Patient characteristics before chemotherapy
n = 108 | |||
---|---|---|---|
Age | Median (range) | 65 (34–83) | |
Gender (male/female) | 58/50 | ||
Performance status | (0, 1, 2, 3) | (91, 16, 1, 0) | |
Body mass indexa
| 23.3 (13.7–36.9) | ||
Primary tumor site | |||
Colon/rectum | 75/33 | ||
Right-sided/left-sided | 51/57 | ||
Residual of primary tumor | 17 (15.7%) | ||
History of liver resection for metastasis | 27 (25.0%) | ||
Number of liver metastasisa
| 5 (0–28) | ||
Target lesion of chemotherapy | |||
Primary tumor | 19 (17.6%) | ||
Lymph node | 28 (25.9%) | ||
Peritoneum | 18 (16.7%) | ||
Lung | 29 (26.9%) | ||
Liver | 43 (39.8%) | ||
KRAS status | Wild | 67 (62.0%) | |
First line chemotherapy | FOLFOX/FOLFIRI | 30/78 | |
Add-on targeting agent | VEGFR | 41 (38.0%) | |
EGFR | 38 (35.1%) | ||
None | 29 (26.9%) | ||
Preoperative statusa
| |||
White blood cell | (mm3)(mm3) | 6000 (3400–9950) | |
Neutrophil | (mm3)(mm3) | 3887 (1659–3750) | |
Lymphocyte | (mm3)(mm3) | 1352 (512–2195) | |
Albumin | (g/dl) | 3.8 (2.4–4.7) | |
Total bilirubin | (mg/dl) | 0.46 (0.19–3.82) | |
Aspartate aminotransferase | (IU/L) | 23 (12–203) | |
Lactate dehydrogenase | (IU/L) | 196 (21–1949) | |
Blood urea nitrogen | (mg/dL) | 13.7 (4.7–27.7) | |
Creatinine | 0.68 (0.42–1.59) | ||
C-reactive protein | (mg/dL) | 0.45 (0.1–8.94) | |
Carcinoembryonic antigen | (mg/L) | 18.0 (4.7–65.3) | |
CA19-9 | (mg/L) | 35.7 (6.5–129.4) |
Hematotoxicity and nutritional status at 2 months
Well-nourished (n = 69) | Bad-nourished (n = 39) |
p value | |
---|---|---|---|
Age (median, range) | 63 (34–83) | 66 (36–80) | 0.67 |
Gender (male) | 38 | 20 | 0.7 |
WHO performance status (> 2) | 6 (8.7%) | 11 (28.2) | < 0.01 |
Body mass index (median, range) | 24.1 (18.6–33.8) | 23.1 (13.3–28.8) | 0.47 |
Primary site | |||
Rectum | 23 | 10 | 0.4 |
Right-sided (n = 51) | 27 | 24 | 0.03 |
Left-sided (n = 57) | 40 | 17 | 0.15 |
Residual of primary tumor | 12 | 5 | 0.53 |
First line regimen | |||
FOLFOX/FOLFIRI | 19/56 | 11/22 | 0.94 |
Add-on targeting agent | |||
VEGFR (n = 41) | 30 (43.5%) | 11 (28.2%) | 0.11 |
EGFR (n = 38) | 26 (37.7%) | 12 (30.8%) | 0.47 |
None (n = 29) | 13 (18.8%) | 16 (41.0%) | 0.01 |
Adverse eventa
| |||
Hematotoxicity | |||
Grade 2 | 13 (18.8%) | 12 (30.8%) | 0.11 |
Grade 3 | 4 (5.8%) | 4 (10.3%) | 0.39 |
Grade 4 | 0 (0%) | 1 (2.6%) | 0.18 |
Non-hematotoxicity | |||
Grade 2 | 11 (15.9%) | 15 (38.5%) | < 0.01 |
Grade 3 | 7 (10.1%) | 6 (15.4%) | 0.42 |
Grade 4 | 1 (1.4%) | 0 (0%) | 0.68 |
Tumor markerb
| |||
CEA | 16.8 (3.7–45.1) | 6.9 (2.9–14.4) | 0.39 |
CA19-9 | 19.6 (2.3–46.9) | 15.6 (6.9–81.2) | 0.19 |
Patients’ outcomes and nutritional status at 6 months
Well-nourished (n = 67) | Bad-nourished (n = 41) |
p value | ||
---|---|---|---|---|
Age | (Median, range) | 64 (35–80) | 68 (34–83) | 0.23 |
Gender | 37 | 21 | 0.68 | |
WHO performance status | (> 2) | 6 (9.0%) | 16 (39.0) | < 0.01 |
Body mass indexa
| (Median, range) | 24.1 (17.9–35.0) | 23.1 (20.1–28.8) | 0.67 |
Perioral food intake | 67 (100%) | 36 (87.9%) | 0.02 | |
Primary site | ||||
Rectum | 22 | 18 | 0.25 | |
Right-sided | (n = 51) | 26 | 24 | 0.04 |
Left-sided | (n = 57) | 44 | 13 | < 0.01 |
Residual of primary tumor | 13 | 4 | 0.18 | |
Continuing regimen | ||||
FOLFOX/FOLFIRI | 16/51 | 13/29 | 0.38 | |
Performing chemotherapy cycles during 6 months | 21 (6–24) | 11 (4–24) | < 0.01 | |
Add-on targeting agent | ||||
VEGFR | (n = 48) | 34 (50.7%) | 14 (34.1%) | 0.09 |
EGFR | (n = 26) | 11 (16.4%) | 15 (36.6%) | 0.02 |
None | (n = 34) | 22 (32.8%) | 12 (29.3%) | 0.7 |
Adverse event | ||||
Hematotoxicity | ||||
Grade 2 | 21 (31.3%) | 20 (48.8%) | 0.18 | |
Grade 3 | 6 (9.0%) | 8 (19.5%) | 0.03 | |
Grade 4 | 0 (0%) | 1 (2.4%) | 0.72 | |
Non-hematotoxicity | ||||
Grade 2 | 21 (31.3%) | 21 (51.2%) | 0.04 | |
Grade 3 | 4 (6.0%) | 10 (24.4%) | < 0.01 | |
Grade 4 | 1 (1.5%) | 1 (2.4%) | 0.73 | |
Discontinueb
| 4 | 14 | < 0.01 | |
Dose reduction | 4 | 10 | < 0.01 | |
Conversion to surgical treatment | 6 | 1 | < 0.18 | |
Tumor markerc
| ||||
CEA (mg/L) | 5.3 (2.85–15.05) | 27.75 (7.98–78.9) | < 0.01 | |
CA19-9 (mg/L) | 15 (7.05–71.25) | 33.3 (6.15–1040.13) | 0.25 |