Abstract:
Objective This study aimed to investigate the differences in survival between groups of patients with metastatic colorectal carcinoma(CRC) who achieved different efficiencies after first-line chemotherapy, and to optimize treatment strategies for CRC patients.
Methods A retrospective study involving the data of 232 recurrent and metastatic colorectal cancer patients who had completed first-line chemotherapy was performed.The cases were divided into the following four groups, namely, patients with or without progression of disease(PD) and those with effectual chemotherapy or stable disease(SD).The median progression-free survival(mPFS) and median overall survival(mOS) in the two groups were compared and analyzed.Independent prognostic factors affecting survival were also compared.
Results The mOS and mPFS in all arms were 21.10 and 9.17 months, respectively.The mOS and mPFS of the arms with complete response(CR), partial response(PR), and SD were significantly longer than those of the PD arm(23.57 vs.10.67 months; 10.83 vs.2.83 months).However, no significant differences between the CR/PR and SD arm were observed(mOS, 23.57 vs.24.30 months; mPFS, 10.57 vs.10.87 months).Radical excision of the primary tumor, pathologic grading, treatment of recurrent and metastatic lesion, and disease control after first-line chemotherapy were independent prognostic factors of the overall survival.
Conclusion Our data show that an immediate shift to the second-line regimen is needed by metastatic CRC patients with PD after first-line chemotherapy.By contrast, patients with SD can continue the first-line chemotherapeutic regime.
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