Causal Model of Survival After Pulmonary Metastasectomy of Colorectal Cancer: A Nationwide Prospective Registry
| Autor: | Raul Embun, Juan J. Rivas de Andrés, Sergi Call, Beatriz de Olaiz Navarro, Jorge L. Freixinet, Sergio Bolufer, Jose R. Jarabo, Nuria Pajuelo, Laureano Molins, Juan J. Rivas, Francisco Rivas-Doyague, Jorge Hernández-Ferrández, Félix Heras, Javier de la Cruz, Matilde Rubio, Esther Fernández, Miguel Carbajo, Rafael Peñalver, José R. Jarabo, Diego González-Rivas, Carlos Pagés, David Smith, Richard Wins, Antonio Arnau, Andrés Arroyo, Carmen Marrón, Akiko Tamura, Montse Blanco, Beatriz de Olaiz, Gemma Muñoz, José M. García Prim, Carlos Rombolá, Santiago García-Barajas, Alberto Rodríguez-Fuster, Javier Ruiz-Zafra, Guillermo Carriquiry, Moisés Rosenberg, Emilio Canalís |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Lung Neoplasms Colorectal cancer Cohort Studies 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Medicine Prospective Studies Registries Prospective cohort study Survival analysis business.industry Hazard ratio Metastasectomy Cancer medicine.disease Confidence interval Carcinoembryonic Antigen Surgery 030228 respiratory system 030220 oncology & carcinogenesis Female Lymph Nodes Colorectal Neoplasms Cardiology and Cardiovascular Medicine business Cohort study |
| Zdroj: | The Annals of Thoracic Surgery. 101:1883-1890 |
| ISSN: | 0003-4975 |
| Popis: | Background Although numerous existing studies have analyzed the prognostic factors of patients who have had surgical intervention for lung metastases of colorectal carcinoma (CRC), many of the results obtained until now have been contradictory. As a consequence, there is no established consensus about which group of prognostic factors could have a greater value when considered together. Methods This was a multicenter prospective cohort study that included all patients who underwent a first pulmonary metastasectomy of CRC, with radical intent, during a 2-year period (March 2008 to February 2010). The follow-up continued until March 2013, and an analysis of disease-specific survival (DSS), determined from the first pulmonary metastasectomy, was implemented. The selection of the best submodel was taken based on their coefficient of determination ( R 2 ) and how parsimonious they were depending on the number of variables included. Results The series, consisting of 522 patients, presented the following survival rates: median, 54.9 months; 3-year DSS, 69.4% (95% confidence interval [CI], 65% to 73.8%); and 5-year DSS, 46.1% (95% CI, 38.5% to 53.7%). The resulting survival model consisted of disease-free interval of 12 months or less (hazard ratio [HR], 1.76; 95% CI, 1.21 to 2.54; p = 0.003), carcinoembryonic antigen level exceeding 5 ng/mL (HR, 1.50; 95% CI, 1.04 to 2.17; p = 0.028), bilateral lung disease (HR, 1.81; 95% CI, 1.20 to 2.75; p = 0.005), and thoracic lymph node involvement (HR, 2.71; 95% CI, 1.44 to 5.12; p = 0.002). Conclusions According to these results from the Spanish Group of Lung Metastases of Colo-Rectal Cancer, the combination of these four variables—disease-free interval, carcinoembryonic antigen level, laterality, and thoracic lymph node involvement—constitutes the first-choice survival causal model based on the clinical and pathologic factors most frequently referenced in literature. |
| Databáze: | OpenAIRE |
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