Peritoneal Carcinomatosis Tied to Poor Survival in CRC

Linked to poor overall, progression-free survival versus other manifestations of metastatic CRC

TUESDAY, Dec. 13 (HealthDay News) -- For patients with metastatic colorectal cancer (mCRC), peritoneal carcinomatosis colorectal cancer (pcCRC) is associated with significantly shorter overall survival (OS) and progression-free survival (PFS), according to a study published online Dec. 12 in the Journal of Clinical Oncology.

Jan Franko, M.D., Ph.D., from Mercy Medical Center in Des Moines, Iowa, and colleagues characterized the outcomes in patients with pcCRC who were enrolled into two prospective randomized trials of chemotherapy, and compared their outcomes with those of other manifestations of mCRC (non-pcCRC group). In total, 2,095 participants were enrolled (364 of whom had pcCRC) and assessed for OS and PFS.

The investigators found that the pcCRC and non-pcCRC groups had similar characteristics with respect to median age, gender, and performance status, and significantly different characteristics with respect to the frequency of liver metastases (63 and 82 percent, respectively) and lung metastases (27 and 34 percent, respectively). Compared to the non-pcCRC group, the pcCRC group had significantly shorter median OS (12.7 versus 17.6 months; hazard ratio [HR], 1.3) and PFS (5.8 versus 7.2 months; HR, 1.2). Even after adjusting for age, performance status, liver metastases, and other factors, pcCRC had an unfavorable prognostic influence which was significant (HR for OS and PFS, 1.3 and 1.1, respectively). For both pcCRC and non-pcCRC patients, first line of treatment with infusional fluorouracil, leucovorin, and oxaliplatin was significantly better than irinotecan, leucovorin, and fluorouracil (HR for OS, 0.62 and 0.66, respectively).

"pcCRC is associated with a significantly shorter OS and PFS as compared with other manifestations of mCRC," the authors write.

One of the study authors disclosed financial ties to the pharmaceutical and biomedical industries.

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