Outcome of 123 patients (pts) with peritoneal carcinomatosis (PC)—Limited metastases from colorectal cancer (CRC) and appendiceal adenocarcinoma (ADC): The British Columbia Cancer Agency (BCCA) experience.
Bibliographic record
Abstract
3547 Background: Pts with PC-limited metastases from CRC or appendiceal ADC are uncommon and seem to have less favourable outcomes. There is limited data to describe the efficacy of modern chemotherapy (CT) in this setting. The aim of this study is to evaluate the outcome of pts with PC-only metastases from CRC or appendiceal primaries referred to the BCCA. Methods: Pts with a diagnosis of colon (C), rectal (R), ileocecal (IC) or appendiceal (A) ADC with PC without distant metastases diagnosed between 1994 and 2007 were identified from the BCCA CRC Outcomes Unit. Data were obtained from chart review. Analysis was by log-rank comparison and Cox-regression. Results: Among 123 eligible pts, median age was 68 and median overall survival (OS) 10.2 months (mo). 55% of pts received CT. 5 pts were treated with complete surgical cytoreduction (CSC), 23 with incomplete debulking and 95 had no or only palliative surgery. In univariate analysis, age < 70 (n = 57) was associated with a longer OS (11.8 vs. 7.8 mo, p = 0.004). Appendiceal site was associated with the best prognosis (38.2 vs. 9.2 R, vs. 9.7 C vs. 8.1 mo IC, p = 0.006). CT was associated with improved OS (12.1 vs. 6.8 mo p = 0.03). No difference observed in OS between pts treated with 5FU (n = 23) and FOLFOX (n = 18) or FOLFIRI (n = 25) (16.7 vs. 11.8 vs. 11.8 mo). The addition of bevacizumab (bev) (n = 12) to CT was associated with significant improved median OS (21.4 vs. 9.3 mo, p = 0.02). CSC was associated with a trend for improved OS compared to palliative surgery/no surgery and incomplete debulking (21.4 vs. 9.8 vs. 7.8 mo, p = 0.052). By Cox regression, age, site, and bev retained independent significance. Conclusions: For pts with PC-limited metastases, age < 70 and appendiceal site were associated with a better prognosis. No benefit was associated with incomplete debulking while selected pts with CSC appeared to have longer survival. Pts treated with CT plus bev had an OS of 21.4 mo, similar to that observed with cytoreductive surgery and comparable to the expected outcome of pts with typical metastatic CRC. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Roche Roche
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".