Effect of surgical resection (SR) of primary tumor in advanced colorectal cancer (CRC) on outcome: A Canadian province’s experience
Notice bibliographique
Résumé
15016 Background: Advances in anticancer therapy have led to improved outcomes for patients with advanced CRC. The potential benefit of SR of primary tumor in these patients remains unknown. We have recently demonstrated that SR of primary tumor in patients with newly diagnosed advanced CRC has been associated with survival benefit irrespective of chemotherapy (ASCO 2008 GI Symposium). We present here an update analysis. Methods: Medical records of patients with metastatic CRC diagnosed from 1992–2000 in Saskatchewan province were reviewed. Patients with unresectable T4M0 disease were excluded. A multivariate analysis was done using Cox regression model and various clinicopathologic variables were tested for their prognostic significance. Kaplan-Meier curves were used to determine survival. Results: A total 813 eligible patients were identified. Patients median age was 71 yrs (24–98) and M: F was 56:44. Five hundred-ninety four (73%) patients underwent SR of the primary tumor. Among 594 patients, 248 (41%) were operated for tumor related symptoms. Thirty-nine (6.5%) died within 30 days of surgery. Of 813 patients, 314 (39%) patients received 5FU-based chemotherapy and 84 (10%) received a second line therapy. Median overall survival (OS) of all patients was 7.3 months. Patients who received chemotherapy had a median OS of 14.8 months compared with 4.1 months if they did not receive chemotherapy (p<0.0001). Patients who underwent SR of primary tumor had a median OS of 9.7 months compared with 3.3 months in patients who did not have surgery (p<0.0001). Patients who had SR and received chemotherapy had a significantly better median OS of 16.7 months compared with 8.7 months if they received chemotherapy but did not have surgery (P<0.0001). On multivariate analysis 5FU-based chemotherapy (HR 0.48; 95% CI: 0.40–0.56), SR of primary tumor (HR 0.49; 95%CI: 0.42–0.59), and metastectomy (HR 0.58; 95% CI: 0.46–0.71) were correlated with a better survival in patients with advanced CRC. Conclusions: SR of primary tumor in patients with advanced CRC has been associated with significant improvement in survival independent of systemic chemotherapy. A future prospective trial is warranted to assess the role of SR of primary tumor in the era of targeted therapy. No significant financial relationships to disclose.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».