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.
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).
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.
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.
*Department of Medicine, Section of Hematology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
Departments of ‡Medical Oncology
**Radiation Oncology, Rutgers Cancer Institute of New Jersey
§Rutgers School of Public Health and Rutgers Cancer Institute of New Jersey
Departments of †Surgery
#Radiology, Rutgers Robert Wood-Johnson University Medical School, New Brunswick, NJ
This research was supported by the following grants to D.R.C.: NCI R01 CA200800, K08 CA172676, Breast Cancer Research Foundation.
D.R.C.: is the founder of Z53 Therapeutics Inc. The remaining authors declare no conflicts of nterest.
Reprints: Darren R. Carpizo, MD, PhD, Rutgers Cancer Institute of New Jersey, 195 Little Albany St. Rm 3040, New Brunswick, NJ 08903. E-mail: firstname.lastname@example.org.