Analysis of metastasectomy in CRC reveals benefits and disparities

Metastasectomy is associated with improved overall survival in patients with colorectal cancer (CRC) and concurrent lung and liver metastasis. However, this approach is not often utilised, as a study of the National Cancer Database showed. The authors concluded that future studies are needed to improve the identification of patients who may benefit from metastasectomy [1].

Dr Jude Khatib (University of Texas, TX, USA) explained that CRC is associated with concurrent lung and liver metastasis. The current study aimed to assess the trends in the utilisation of metastasectomy in patients with CRC and concurrent lung and liver metastasis, and the effect of this treatment option on survival.

Patients with stage 4 CRC who displayed concurrent liver and lung metastasis between 2010 and 2016 were selected from the National Cancer Database (n=10,106). Only 6.2% of this population underwent metastasectomy, whereas 93.8% did not. The patients that underwent metastasectomy were more likely to be younger than 50 years (P=0.009), women (P<0.001), and White (P=0.01). In addition, right-sided CRC was more common among these patients (P=0.001), and they were more likely to have received resection of the primary site (P<0.001). Furthermore, patients who received metastasectomy were significantly more likely to have private health insurance (P<0.001) and to receive treatment at an academic centre (P=0.03).

A matched analysis was performed to compare overall survival between patients who underwent metastasectomy and those who did not. This analysis demonstrated a significant survival benefit for patients who had received metastasectomy (23.2 vs 11.6 months; P<0.001). After multivariable analysis, this result remained significant (HR 0.74; P<0.001). It thus seems very important to discuss surgery of oligometastatic cancer to increase overall survival.

1. Khatib J, et al. Metastasectomy in colorectal cancer patients with concurrent lung and liver metastasis: Trends in utilization and impact on survival. Abstract 53, ASCO GI 2022, 20–22 January.

 

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Posted on 21 March, 202228 March, 2024