- 期刊
Prognosis for Patients with Peritoneal Metastases-only Colorectal Cancer after Systemic Therapy: An Institutional Experience
第四期大腸直腸癌純腹膜轉移的預後——單一機構治療經驗
摘要
Purpose. Prognosis of metastatic colorectal cancer (mCRC) differs by metastatic site. We present our preliminary treatment result for patients with peritoneal metastases-only colorectal cancer (pcCRC). Methods. For this study, 11 patients diagnosed as having pcCRC who had received systemic therapy from January 2014 to December 2017 were recruited. They received follow-up until April 2019. Patients' characteristics including gene mutation profiles, regimens of therapy, and clinical outcomes were evaluated. Results. The median age was 65 years (37-71 years). The primary tumor was located in the right colon (4 patients) or left colon (7 patients). Ten patients underwent primary tumor resection, and all patients received systemic therapy. Of the 11 patients, 1 exhibited a KRAS codon 12 mutation, 1 exhibited a KRAS codon 13 mutation, 1 exhibited a BRAF codon V600E mutation, and 9 exhibited epidermal growth factor receptor overexpression. The median progression-free survival was 10.6 months (3.7-19.8 months), and overall survival was 13.8 months (5.1-19.8 months). Conclusions. Although chemotherapy regimens with new chemotherapeutic and molecular targeting agents improved the mCRC outcome, our research suggested that the pcCRC might be associated with poor clinical outcomes among patients with mCRC. Further comparison studies and prospective randomized trials based on carcinomatosis status should be considered.
並列摘要
目的：轉移性的大腸直腸癌會依據轉移位置的不同，而有不同的預後。此研究呈現單一醫療機構純粹腹膜轉移之轉移性大腸直腸癌的預後。方法：此研究收集11位接受全身性治療的純粹腹膜轉移大腸直腸癌患者，從2014年1月到2017年12月。追蹤時間是到2019年4月。本研究分析患者的資料，包含基因的變異、使用何種全身性治療藥物、以及臨床成果。結果：患者年齡中位數為65歲（範圍是37歲到71歲）。最初腫瘤的位置，其中4位患者在右半大腸，而剩餘7位患者在左半。10位患者接受了原發位腫瘤切除手術，而所有的患者都接受了全身性的治療。在11位患者中，有一位是KRAS codon 12突變，一位是KRAS codon 13突變，一位是BRAF codon V600E突變，而其中有9位是表皮生長因子受體（EGFR）的過度表現。這11位患者的預後，無惡化存活時間中位數為10.6個月（範圍為3.7到19.8個月），總生存期的中位數為13.8個月（範圍是5.1到19.8個月）。結論：即使近年來新的化療及標靶藥物的出現，讓轉移性大腸直腸癌的預後有顯著進展，但在純粹腹膜轉移這類的病人上，預後還是不盡理想。希望未來能有更多的研究針對腹膜轉移這群患者。