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M. Faisal



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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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      203P - Combined pulmonary metastasectomy and chemotherapy in patients with colorectal lung metastases and concurrent extrapulmonary disease (ID 282)

      12:30 - 13:00  |  Presenting Author(s): M. Faisal

      • Abstract

      Background:
      Lung metastases from colorectal cancer (CRC) with the presence of concurrent extra-pulmonary disease is considered a very poor prognosis. Chemotherapy was the only advised treatment. Nowadays with the evolution in surgical oncology techniques, imaging and medical oncology treatment, a better management is present for stage IV colorectal cancer with a prolonged overall survival. We aim to evaluate the benefit of adding surgical resection to chemotherapy in patients with colorectal lung metastasis and extra-pulmonary diseases.

      Methods:
      We extracted the data of 1423 colorectal cancer patients with pulmonary and extra-pulmonary metastases from 2010 to 2013, using SEER database. Ninety-nine (7%) patients had combined chemotherapy and pulmonary metastasectomy, while 1324 (93%) of them received chemotherapy only.

      Results:
      Patients who received combination of chemotherapy and pulmonary metastasectomy had better 1-year survival rates (83.5%), compared to those who received chemotherapy only (68.3%). We observed a statistically significant difference between the two modalities in white patients, patients aged between 40 to 59 years, tumors arising in sigmoid colon or rectum, patients with elevated CEA levels, and those with metastasis to the lungs only or both lung and liver.Table: (Abstract: 203P)

      VariablesCombined TherapyChemotherapyp value (difference in modalitiesp value (difference in combined therapy)
      Sex
       Male79.4%66.6%0.007**0.399
       Female87.1%70.6%<0.001**
      Age
       20–3966.7%77.8%0.2190.201
       40–5989.7%74.2%<0.001**
       60–7973.0%66.2%0.159
       ≥80100%43.2%0.221
      Race
       White86.7%69.3%<0.001**0.687
       Black74.3%65.4%0.061
       Others77.9%66.1%0.036**
      Primary Site
       Cecum76.1%69.0%0.7500.003*
       Ascending Colon70.0%58.0%0.401
       Hepatic0%55.1%0.361
       Flexure Transverse Colon100%55.5%0.605
       Splenic Flexure60.3%59.2%0.937
       Descending Colon75.3%64.3%0.068
       Sigmoid Colon85.5%68.5%0.002**
       Rectum100%74%<0.001**
      Distant Metastasis
       Lung Only94.5%78.9%0.002**0.007*
       Lung and Liver77.4%64.7%0.002**
       Lung and Brain100%25.3%0.198
       Lung and Bone50.8%65.9%0.783
      CEA Level
       Normal95.7%81.4%0.3780.446
       Elevated79.9%66.2%<0.001**


      Conclusions:
      Combining pulmonary metastasectomy with chemotherapy in CRC patients with pulmonary and extrapulmonary metastases shows higher 1-year relative survival rates when compared to using chemotherapy alone.

      Clinical trial identification:


      Legal entity responsible for the study:
      Inas Uthman

      Funding:
      Has not received any funding

      Disclosure:
      All authors have declared no conflicts of interest.