Prognostic Factors in Stage IV Colorectal Cancer Patients With Resection of Liver and/or Pulmonary Metastases: A Population-Based Cohort Study

Abstract

ImportanceCurrently, surgical resection of distant metastatic lesions has become the preferred treatment for select colorectal cancer (CRC) patients with liver metastasis (LM) and/or pulmonary metastasis (PM). Metastasectomy is the most common curative method. However, evidence of the factors affecting the prognosis of CRC patients after resection of LM and/or PM is still insufficient.ObjectiveTo explore the prognostic factors of CRC patients with LM and/or PM who have undergone resection of metastatic tumors and to provide reliable selection factors for surgical treatment in patients affected by LM and/or PM from CRC.MethodsThe SEER database was used to identify eligible CRC LM and/or PM patients who underwent resection of the primary tumor and distant metastases from January 1, 2010, to December 31, 2018. The Kaplan–Meier method was used to calculate survival, and comparisons were performed using the log-rank test for univariate analysis. A Cox proportional hazards regression model was used to identify prognostic factors for the multivariate analysis. The outcomes included overall survival (OS) and cancer-specific survival (CSS).ResultsA total of 3,003 eligible colorectal cancer patients with LM and/or PM were included in this study. The 3-year and 5-year OS rates were 53% and 33.6%, respectively, and the 3-year and 5-year CSS rates were 54.2% and 35.3%, respectively. In the adjusted multivariate analysis, age < 65 years (OS: p=0.002, CSS: p=0.002) was associated with better long-term outcomes, and primary tumors located on the left side of the colon (OS: p=0.004, CSS: p=0.006) or rectum (OS: p=0.004, CSS: p=0.006), T3 stage (OS: p<0.001, CSS: p<0.001), number of regional lymph nodes examined ≥ 12 (OS: p<0.001, CSS: p=0.001), and CRC LM (OS: p<0.001, CSS: p<0.001) were positive prognostic factors for survival after resection of metastatic tumors.ConclusionAge < 65 years is associated with better long-term outcomes in colorectal cancer patients with LM and/or PM, analogously to the left sided primary tumor, T3 stage, number of regional lymph nodes examined ≥ 12 and liver metastases.

CT-based radiomics for predicting Ki-67 expression in lung cancer: a systematic review and meta-analysis

“…Integrating radiomics into current prognostic workflows for predicting Ki-67 expression in lung cancer involves incorporating radiomic features extracted from imaging data, such as CT scans, into existing prognostic models. This process requires the development of algorithms that capture intricate patterns related to Ki-67 expression, with subsequent validation against established indicators and clinical outcomes ( 43 , 44 ). Collaboration between radiologists, oncologists, and data scientists is crucial for optimization, standardization, and the establishment of protocols.…”

Role of long non-coding RNA ELFN1-AS1 in carcinogenesis

“…Colorectal cancer (CRC) ranks third in incidence and deaths among men and women as of 2022 [ 25 ]. Considering the substantial burden CRC imposes on the healthcare system, it is imperative to investigate the underlying mechanisms of CRC development to advance novel methods for disease management [ 26 ]. Experiments and analysis conducted by Yimin Li et al [ 24 ] showed that ELFN1-AS1 interacted with DNA methyltransferase 3 alpha (DNMT3a) and enhancer of zeste homolog 2 (EZH2), both of which are involved in histone and DNA methylation processes.…”

The microbiome types of colorectal tissue are potentially associated with the prognosis of patients with colorectal cancer

“…The incidence and mortality of colorectal cancer (CRC) have increased significantly in recent years, ranking the 3rd and 5th among all malignant tumors, respectively ( Siegel et al, 2020 ; Zhao et al, 2020 ; Lu et al, 2021 ). Most patients are in the middle and late stages when diagnosed, which seriously threatens the survival and quality of life of patients ( Dekker et al, 2019 ; Cienfuegos-Jimenez et al, 2021 ; Peng et al, 2022 ). The 5-year relative survival ranges from more than 90% in stage I patients to slightly more than 10% in stage IV patients ( Brenner et al, 2014 ; Biswas et al, 2021 ).…”