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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 11/2018

01-11-2018 | Original Article

Repeating of local therapy of distant metastases increases overall survival in patients with synchronous metastasized rectal cancer—a monocentric analysis

Authors: Marlen Haderlein, Sebastian Lettmaier, Melanie Langheinrich, Axel Schmid, Sabine Semrau, Markus Hecht, Michael Beck, Daniela Schmidt, Robert Grützmann, Rainer Fietkau, Axel Denz

Published in: International Journal of Colorectal Disease | Issue 11/2018

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Abstract

Purpose

The aim was to evaluate the outcome of treatment-naive patients with synchronous metastatic rectal cancer after chemotherapy with FOLFOXIRI followed by local therapeutic procedures of all tumor lesions as complete as possible.

Methods

We reviewed data of 30 patients with synchronous distant metastatic rectal cancer who underwent chemotherapy with FOLFOXIRI and subsequent local therapy in our institution.

Results

Median follow-up was 28 months (range: 8; 74). Cumulative overall survival (OS) and progression-free survival (PFS) was 93.3, 76.9, 55.6% and 46.2, 29.7, 29.7% after 1, 2, 4 years. Non-response to chemotherapy with FOLFOXIRI was associated with a highly significant decreased OS (p < 0.0001). The consistent use of local ablative procedures led to a statistically significant increase in OS (p < 0.0001), but not in PFS (p = 0.635). Patients with ≤ 4 distant metastases showed a better OS (p = 0.033).

Conclusions

Response to intensified first-line chemotherapy with FOLFOXIRI, treatment of the primary rectal tumor, and repeated thorough local ablative procedures in patients with synchronous metastasized rectal cancer may lead to long-term survival, even in a subset of patients with unresectable disease at initial diagnosis.
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Metadata
Title
Repeating of local therapy of distant metastases increases overall survival in patients with synchronous metastasized rectal cancer—a monocentric analysis
Authors
Marlen Haderlein
Sebastian Lettmaier
Melanie Langheinrich
Axel Schmid
Sabine Semrau
Markus Hecht
Michael Beck
Daniela Schmidt
Robert Grützmann
Rainer Fietkau
Axel Denz
Publication date
01-11-2018
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 11/2018
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-018-3113-8

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