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Published in:

01-06-2008

Surgical Resection of Stage IV Colorectal Cancer and Prognosis

Authors: Hiroshi Katoh, Keishi Yamashita, Yukihito Kokuba, Takeo Satoh, Heita Ozawa, Kazuhiko Hatate, Atsushi Ihara, Takatoshi Nakamura, Wataru Onosato, Masahiko Watanabe

Published in: World Journal of Surgery | Issue 6/2008

Abstract

Background

Colorectal cancer (CRC) harbors accumulated genetic alterations with cancer progression, which results in uncontrollable disease. To regulate the most malignant CRC, we have to know the most dismal phenotype of stage IV disease.

Methods

A retrospective review of the Kitasato University Hospital was performed (from 1990 to 2001) to extract the 162 resected stage IV CRC. Clinical variables were tested for their relationship to survival in a multivariate prognostic analysis and revealed the interaction of the prognostic factors.

Results

In stage IV CRC with noncurable resection, the most robust univariate predictors for poor prognosis were preoperative high value of CA19-9, peritoneal dissemination, depth of invasion, age, extent of liver metastases, pathologic lymph node metastasis status, and gender as tumor factors, and postoperative therapy, perioperative transfusion, and lymph node dissection extent as treatment factors. Among these factors, postoperative therapy (p < 0.0001), perioperative transfusion (0.0002), CA19-9 (0.001), extent of liver metastases (0.004), and peritoneal dissemination (0.02) were identified as independent prognostic factors by multivariate analysis. Interestingly, among the independent prognostic factors, treatment factors did not depend upon tumor factors and the combination of the three tumor factors (CA19-9, extent of liver metastases, and peritoneal dissemination) can clearly classify the patients into the definite prognostic groups.

Conclusion

Our results suggested that the most dismal CRC harbors three definite vectors that may represent the strongest phenotype of putative systemic immune (CA19-9), distant metastasis (extent of liver metastases), and local progression (peritoneal dissemination).

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Title: Surgical Resection of Stage IV Colorectal Cancer and Prognosis
Authors: Hiroshi Katoh
Keishi Yamashita
Yukihito Kokuba
Takeo Satoh
Heita Ozawa
Kazuhiko Hatate
Atsushi Ihara
Takatoshi Nakamura
Wataru Onosato
Masahiko Watanabe
Publication date: 01-06-2008
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 6/2008
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-008-9535-7

At a glance: The STEP trials

Springer Medicine

Surgical Resection of Stage IV Colorectal Cancer and Prognosis

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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