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. 2010 Jul 13;103(2):159-64.
doi: 10.1038/sj.bjc.6605737. Epub 2010 Jun 15.

Clinicopathological features and outcome in advanced colorectal cancer patients with synchronous vs metachronous metastases

L J M Mekenkamp  1 , M Koopman, S Teerenstra, J H J M van Krieken, L Mol, I D Nagtegaal, C J A Punt
Affiliations

Clinicopathological features and outcome in advanced colorectal cancer patients with synchronous vs metachronous metastases

L J M Mekenkamp et al. Br J Cancer. .

Abstract

Background: Synchronous metastases of colorectal cancer (CRC) are considered to be of worse prognostic value compared with metachronous metastases, but only few and conflicting data have been reported on this issue.

Methods: We retrospectively investigated patient demographics, primary tumour characteristics and overall survival (OS) in 550 advanced CRC patients with metachronous vs synchronous metastases, who participated in the phase III CAIRO study. For this purpose only patients with a prior resection of the primary tumour were considered.

Results: The clinical and pathological characteristics associated with poor prognosis that we observed more often in patients with synchronous metastases (n=280) concerned an abnormal serum lactate dehydrogenase (LDH) concentration (P=0.01), a worse WHO performance status (P=0.02), primary tumour localisation in the colon (P=0.002) and a higher T stage (P=0.0006). No significant difference in median OS was observed between patients with synchronous metastases and metachronous metastases (17.6 vs 18.5 months, respectively, P=0.24).

Conclusion: Despite unfavourable clinicopathological features in patients with synchronous metastases with a resected primary tumour compared to patients with metachronous metastases, no difference in the median OS was observed. Possible explanations include a (partial) chemoresistance in patients with metachronous disease because of previous adjuvant treatment, whereas differences between the two groups in screening procedures resulting in a lead time bias to diagnosis or in prognostic molecular markers remain speculative.

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Figures

Figure 1
Figure 1
Kaplan–Meier curve for overall survival of advanced CRC patients with metachronous (---) and synchronous (---) metastases in whom a resection of the primary tumour was performed.
See this image and copyright information in PMC

References

    1. Bockhorn M, Frilling A, Fruhauf NR, Neuhaus J, Molmenti E, Trarbach T, Malago M, Lang H, Broelsch CE (2008) Survival of patients with synchronous and metachronous colorectal liver metastases – is there a difference? J Gastrointest Surg 12: 1399–1405 - PubMed
    1. Colucci G, Gebbia V, Paoletti G, Giuliani F, Caruso M, Gebbia N, Carteni G, Agostara B, Pezzella G, Manzione L, Borsellino N, Misino A, Romito S, Durini E, Cordio S, Di SM, Lopez M, Maiello E, Montemurro S, Cramarossa A, Lorusso V, Di BM, Chiarenza M, Valerio MR, Guida T, Leonardi V, Pisconti S, Rosati G, Carrozza F, Nettis G, Valdesi M, Filippelli G, Fortunato S, Mancarella S, Brunetti C (2005) Phase III randomized trial of FOLFIRI vs FOLFOX4 in the treatment of advanced colorectal cancer: a multicenter study of the Gruppo Oncologico Dell’Italia Meridionale. J Clin Oncol 23: 4866–4875 - PubMed
    1. de Gramont A, Figer A, Seymour M, Homerin M, Hmissi A, Cassidy J, Boni C, Cortes-Funes H, Cervantes A, Freyer G, Papamichael D, Le BN, Louvet C, Hendler D, de BF, Wilson C, Morvan F, Bonetti A (2000) Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 18: 2938–2947 - PubMed
    1. Etienne-Grimaldi MC, Formento JL, Francoual M, Francois E, Formento P, Renee N, Laurent-Puig P, Chazal M, Benchimol D, Delpero JR, Letoublon C, Pezet D, Seitz JF, Milano G (2008) K-Ras mutations and treatment outcome in colorectal cancer patients receiving exclusive fluoropyrimidine therapy. Clin Cancer Res 14: 4830–4835 - PubMed
    1. Freyer G, Rougier P, Bugat R, Droz JP, Marty M, Bleiberg H, Mignard D, Awad L, Herait P, Culine S, Trillet-Lenoir V (2000) Prognostic factors for tumour response, progression-free survival and toxicity in metastatic colorectal cancer patients given irinotecan (CPT-11) as second-line chemotherapy after 5FU failure. CPT-11 F205, F220, F221 and V222 study groups. Br J Cancer 83: 431–437 - PMC - PubMed

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