Conditional survival analysis of metastatic colorectal cancer patients living ≥24 months: A single institutional study

Nadia D. Ali, Kristen Donohue, Shadi Zandieh, Chunxia Chen, Dirk Moore, Elizabeth Poplin, Mihir M. Shah, John Nosher, Bin Gui, Salma Jabbour, Kristen Spencer, Darren Carpizo

Research output: Contribution to journalArticle

Abstract

Objectives:The survival of patients with metastatic colorectal cancer (CRC) has been increasing over recent decades due to improvements in chemotherapy and surgery. There is a need to refine prognostic information to more accurately predict survival as patients survive for any given length of time to assist multidisciplinary cancer management teams in treatment decisions.Materials and Methods:We performed a single center retrospective analysis of patients treated with metastatic CRC (unresectable and resectable) who survived >24 months between 2005 and 2015 (N=155). Patient tumor and treatment related variables were collected. Overall survival (OS) estimates conditional on surviving >24 months were compared with actuarial survival estimates of a cohort of patients (33,104 resected, 39,382 unresected) from the National Cancer Database (NCDB).Results:With a median follow-up of 44.2 months, the median OS of resected patients (n=86) was not reached. The median OS of unresected patients was 75.9 months. The conditional survival probabilities of living 1, 2, or 3 years longer after 24 months of survival are 92%, 72%, and 52%, respectively, in unresectable patients and 98%, 92%, and 89% in patients who were resected. The corresponding NCDB 1, 2, and 3 year actuarial survival was 38%, 20%, and 11% for unresected patients and 68%, 46%, and 32% for resected.Conclusions:These results indicate that CRC patients who survive 24 months with metastatic colorectal cancer have an excellent prognosis and surgery may be appropriate in a subset of patients initially deemed unresectable.

Original languageEnglish (US)
Pages (from-to)512-518
Number of pages7
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume42
Issue number6
DOIs
StatePublished - Jun 1 2019

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Survival Analysis
Colorectal Neoplasms
Survival
Neoplasms
Databases
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Keywords

  • colorectal cancer
  • colorectal cancer conditional survival analysis
  • stage IV colorectal cancer
  • surgical resection stage IV colorectal cancer

Cite this

Ali, Nadia D. ; Donohue, Kristen ; Zandieh, Shadi ; Chen, Chunxia ; Moore, Dirk ; Poplin, Elizabeth ; Shah, Mihir M. ; Nosher, John ; Gui, Bin ; Jabbour, Salma ; Spencer, Kristen ; Carpizo, Darren. / Conditional survival analysis of metastatic colorectal cancer patients living ≥24 months : A single institutional study. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 2019 ; Vol. 42, No. 6. pp. 512-518.
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abstract = "Objectives:The survival of patients with metastatic colorectal cancer (CRC) has been increasing over recent decades due to improvements in chemotherapy and surgery. There is a need to refine prognostic information to more accurately predict survival as patients survive for any given length of time to assist multidisciplinary cancer management teams in treatment decisions.Materials and Methods:We performed a single center retrospective analysis of patients treated with metastatic CRC (unresectable and resectable) who survived >24 months between 2005 and 2015 (N=155). Patient tumor and treatment related variables were collected. Overall survival (OS) estimates conditional on surviving >24 months were compared with actuarial survival estimates of a cohort of patients (33,104 resected, 39,382 unresected) from the National Cancer Database (NCDB).Results:With a median follow-up of 44.2 months, the median OS of resected patients (n=86) was not reached. The median OS of unresected patients was 75.9 months. The conditional survival probabilities of living 1, 2, or 3 years longer after 24 months of survival are 92{\%}, 72{\%}, and 52{\%}, respectively, in unresectable patients and 98{\%}, 92{\%}, and 89{\%} in patients who were resected. The corresponding NCDB 1, 2, and 3 year actuarial survival was 38{\%}, 20{\%}, and 11{\%} for unresected patients and 68{\%}, 46{\%}, and 32{\%} for resected.Conclusions:These results indicate that CRC patients who survive 24 months with metastatic colorectal cancer have an excellent prognosis and surgery may be appropriate in a subset of patients initially deemed unresectable.",
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Conditional survival analysis of metastatic colorectal cancer patients living ≥24 months : A single institutional study. / Ali, Nadia D.; Donohue, Kristen; Zandieh, Shadi; Chen, Chunxia; Moore, Dirk; Poplin, Elizabeth; Shah, Mihir M.; Nosher, John; Gui, Bin; Jabbour, Salma; Spencer, Kristen; Carpizo, Darren.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 42, No. 6, 01.06.2019, p. 512-518.

Research output: Contribution to journalArticle

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T1 - Conditional survival analysis of metastatic colorectal cancer patients living ≥24 months

T2 - A single institutional study

AU - Ali, Nadia D.

AU - Donohue, Kristen

AU - Zandieh, Shadi

AU - Chen, Chunxia

AU - Moore, Dirk

AU - Poplin, Elizabeth

AU - Shah, Mihir M.

AU - Nosher, John

AU - Gui, Bin

AU - Jabbour, Salma

AU - Spencer, Kristen

AU - Carpizo, Darren

PY - 2019/6/1

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N2 - Objectives:The survival of patients with metastatic colorectal cancer (CRC) has been increasing over recent decades due to improvements in chemotherapy and surgery. There is a need to refine prognostic information to more accurately predict survival as patients survive for any given length of time to assist multidisciplinary cancer management teams in treatment decisions.Materials and Methods:We performed a single center retrospective analysis of patients treated with metastatic CRC (unresectable and resectable) who survived >24 months between 2005 and 2015 (N=155). Patient tumor and treatment related variables were collected. Overall survival (OS) estimates conditional on surviving >24 months were compared with actuarial survival estimates of a cohort of patients (33,104 resected, 39,382 unresected) from the National Cancer Database (NCDB).Results:With a median follow-up of 44.2 months, the median OS of resected patients (n=86) was not reached. The median OS of unresected patients was 75.9 months. The conditional survival probabilities of living 1, 2, or 3 years longer after 24 months of survival are 92%, 72%, and 52%, respectively, in unresectable patients and 98%, 92%, and 89% in patients who were resected. The corresponding NCDB 1, 2, and 3 year actuarial survival was 38%, 20%, and 11% for unresected patients and 68%, 46%, and 32% for resected.Conclusions:These results indicate that CRC patients who survive 24 months with metastatic colorectal cancer have an excellent prognosis and surgery may be appropriate in a subset of patients initially deemed unresectable.

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