1.
Nomogram predicted disease free survival for colorectal liver metastasis patients with preoperative chemotherapy followed by hepatic resection.
Liu, W, Wang, K, Han, Y, Liang, JY, Li, YH, Xing, BC
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 2019;(11):2070-2077
Abstract
BACKGROUND Hepatic resection is regarded to as a potentially curative option for colorectal cancer liver metastases (CRLM), but it is associated with a high rate of recurrence. The present study intended to establish an effective nomogram to predict disease free survival (DFS) and select candidates of hepatic resection. METHODS The nomogram was based on a retrospective study on 447 CRLM patients treated with preoperative chemotherapy followed by hepatic resection using a multicentric database between January 1st, 2010 and December 31st, 2017. Results were validated using bootstrap resampling on 117 patients. The predictive accuracy and discriminative ability of the nomogram were determined by concordance index (C-index) and calibration curve. Overall survival, disease free survival, and local recurrence rate for patients with colorectal cancer were measured. RESULTS Based on multivariate analysis of the primary cohort, independent factors for DFS included tumor size larger than 5 cm, multiple liver metastases(>1), RAS mutation, primary lymph node metastasis and tumor size increase after preoperative chemotherapy. These five factors were all considered in the nomogram. The C-index of the nomogram for predicting survival was 0.675. With external validation, the C-index of the nomogram for the prediction of the DFS was 0.77, which demonstrated that this model has a good level of discriminative ability. For the 382 patients (66.7%) who developed recurrence, the optimal cutoff point for early recurrence was determined to be 12 months after hepatic resection. CONCLUSIONS The proposed nomogram demonstrated accurate prognostic prediction of DFS for CRLM patients with preoperative chemotherapy followed by hepatic resection.
2.
Bevacizumab plus irinotecan, 5-fluorouracil, and leucovorin (FOLFIRI) as the second-line therapy for patients with metastatic colorectal cancer, a multicenter study.
Deng, T, Zhang, L, Liu, XJ, Xu, JM, Bai, YX, Wang, Y, Han, Y, Li, YH, Ba, Y
Medical oncology (Northwood, London, England). 2013;(4):752
Abstract
Poor prognosis is associated with patients with metastatic colorectal cancer. To seek effective methods, we examine the efficacy and safety of bevacizumab plus FOLFIRI as a second-line chemotherapy in Chinese patients with metastatic colorectal cancer (mCRC). A total of 55 patients with previous failure of oxaliplatin-based chemotherapy were included in this study, from October 2010 to February 2012. All patients received bevacizumab (5 mg/kg) plus FOLFIRI every other week until disease progression or intolerable toxicity occurred. The response rate was 31%, and the disease-controlled rate was 76.4%. The median progression-free survival was 6 months, and the median overall survival was 17 months. Adverse events (AEs) related to chemotherapy were mild to moderate. Only the incidence of grade 3-4 neutropenia reached to 25.5%. The incidence of AEs related to bevacizumab was low. These AEs included grade 3-4 toxicities of hypertension and proteinuria 5.4 and 3.6%, respectively. Bevacizumab plus FOLFIRI is an effective and safe regimen as a second-line treatment for patients with mCRC in China.