Metastatic colo-rectal cancer: real life experience from an Indian tertiary care center
Abstract Background No data exist for the long-term outcome of metastatic colorectal cancer (mCRC) from the Southern part of Asia. The primary objective of the study is to evaluate the survival outcome of mCRC from an Indian tertiary care center. The study also aims to highlight the treatment patter...
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doaj-e88368c0e1e74ffebb8c2f53cb3074c92021-05-30T11:49:23ZengBMCBMC Cancer1471-24072021-05-0121111210.1186/s12885-021-08398-zMetastatic colo-rectal cancer: real life experience from an Indian tertiary care centerVinod Sharma0Atul Sharma1Vinod Raina2Deepak Dabkara3Bidhu Kalyan Mohanti4N. K. Shukla5Sushmita Pathy6Sanjay Thulkar7S. V. S. Deo8Sunil Kumar9Ranjit Kumar Sahoo10Department of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences (AIIMS)Department of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences (AIIMS)Department of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences (AIIMS)Department of Medical Oncology, Tata Memorial CenterDepartment of Radiotherapy, Dr BRA IRCH, All India Institute of Medical Sciences (AIIMS)Department of Surgical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences (AIIMS)Department of Radiotherapy, Dr BRA IRCH, All India Institute of Medical Sciences (AIIMS)Department of Radiodiagnosis, Dr BRA IRCH, All India Institute of Medical Sciences (AIIMS)Department of Surgical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences (AIIMS)Department of Surgical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences (AIIMS)Department of Medical Oncology, Dr BRA IRCH, All India Institute of Medical Sciences (AIIMS)Abstract Background No data exist for the long-term outcome of metastatic colorectal cancer (mCRC) from the Southern part of Asia. The primary objective of the study is to evaluate the survival outcome of mCRC from an Indian tertiary care center. The study also aims to highlight the treatment pattern practiced and the unique clinico-pathologic characteristics. Methods This is a single-center retrospective observational study done at a large referral tertiary care center in North India. All patients with synchronous or metachronous mCRC who received at least one dose of chemotherapy for metastatic disease, registered between 2003 to 2017 were included. Primary outcome measures were overall survival and progression-free survival and prognostic factors of overall survival. Descriptive analysis was done for the clinicopathological characteristics and treatment patterns. Kaplan Meier method for overall survival and progression-free survival. Cox regression analysis was performed for the determination of the prognostic factors for overall survival. Result Out of 377 eligible patients, 256 patients (68%) had de novo metastatic disease and the remaining 121 (32%) progressed to metastatic disease after initial treatment. The cohort was young (median age, 46 years) with the most common primary site being the rectum. A higher proportion of signet (9%) and mucinous histology (24%). The three common sites of metastasis were the liver, peritoneum, and lung. In the first line, most patients received oxaliplatin-based chemotherapy (70%). Only 12.5% of patients received biologicals in the first-line setting. The median follow-up and median overall survival of study cohort were 17 months and 18.5 months. The factors associated with poor outcome for overall survival on multivariate analysis were ECOG performance status of > 1, high CEA, low albumin, and the number of lines of chemotherapy received (< 2). Conclusion The outcome of mCRC is inferior to the published literature. We found a relatively higher proportion of patients with the following characteristics; younger, rectum as primary tumor location, the signet, and mucinous histology, higher incidence of peritoneum involvement. The routine use of targeted therapies is limited. Government schemes (inclusion of targeted therapies in the Ayushman scheme), NGO assistance, and availability of generic low-cost targeted drugs may increase the availability.https://doi.org/10.1186/s12885-021-08398-zMetastaticColorectal cancerReal life experienceIndia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Vinod Sharma Atul Sharma Vinod Raina Deepak Dabkara Bidhu Kalyan Mohanti N. K. Shukla Sushmita Pathy Sanjay Thulkar S. V. S. Deo Sunil Kumar Ranjit Kumar Sahoo |
spellingShingle |
Vinod Sharma Atul Sharma Vinod Raina Deepak Dabkara Bidhu Kalyan Mohanti N. K. Shukla Sushmita Pathy Sanjay Thulkar S. V. S. Deo Sunil Kumar Ranjit Kumar Sahoo Metastatic colo-rectal cancer: real life experience from an Indian tertiary care center BMC Cancer Metastatic Colorectal cancer Real life experience India |
author_facet |
Vinod Sharma Atul Sharma Vinod Raina Deepak Dabkara Bidhu Kalyan Mohanti N. K. Shukla Sushmita Pathy Sanjay Thulkar S. V. S. Deo Sunil Kumar Ranjit Kumar Sahoo |
author_sort |
Vinod Sharma |
title |
Metastatic colo-rectal cancer: real life experience from an Indian tertiary care center |
title_short |
Metastatic colo-rectal cancer: real life experience from an Indian tertiary care center |
title_full |
Metastatic colo-rectal cancer: real life experience from an Indian tertiary care center |
title_fullStr |
Metastatic colo-rectal cancer: real life experience from an Indian tertiary care center |
title_full_unstemmed |
Metastatic colo-rectal cancer: real life experience from an Indian tertiary care center |
title_sort |
metastatic colo-rectal cancer: real life experience from an indian tertiary care center |
publisher |
BMC |
series |
BMC Cancer |
issn |
1471-2407 |
publishDate |
2021-05-01 |
description |
Abstract Background No data exist for the long-term outcome of metastatic colorectal cancer (mCRC) from the Southern part of Asia. The primary objective of the study is to evaluate the survival outcome of mCRC from an Indian tertiary care center. The study also aims to highlight the treatment pattern practiced and the unique clinico-pathologic characteristics. Methods This is a single-center retrospective observational study done at a large referral tertiary care center in North India. All patients with synchronous or metachronous mCRC who received at least one dose of chemotherapy for metastatic disease, registered between 2003 to 2017 were included. Primary outcome measures were overall survival and progression-free survival and prognostic factors of overall survival. Descriptive analysis was done for the clinicopathological characteristics and treatment patterns. Kaplan Meier method for overall survival and progression-free survival. Cox regression analysis was performed for the determination of the prognostic factors for overall survival. Result Out of 377 eligible patients, 256 patients (68%) had de novo metastatic disease and the remaining 121 (32%) progressed to metastatic disease after initial treatment. The cohort was young (median age, 46 years) with the most common primary site being the rectum. A higher proportion of signet (9%) and mucinous histology (24%). The three common sites of metastasis were the liver, peritoneum, and lung. In the first line, most patients received oxaliplatin-based chemotherapy (70%). Only 12.5% of patients received biologicals in the first-line setting. The median follow-up and median overall survival of study cohort were 17 months and 18.5 months. The factors associated with poor outcome for overall survival on multivariate analysis were ECOG performance status of > 1, high CEA, low albumin, and the number of lines of chemotherapy received (< 2). Conclusion The outcome of mCRC is inferior to the published literature. We found a relatively higher proportion of patients with the following characteristics; younger, rectum as primary tumor location, the signet, and mucinous histology, higher incidence of peritoneum involvement. The routine use of targeted therapies is limited. Government schemes (inclusion of targeted therapies in the Ayushman scheme), NGO assistance, and availability of generic low-cost targeted drugs may increase the availability. |
topic |
Metastatic Colorectal cancer Real life experience India |
url |
https://doi.org/10.1186/s12885-021-08398-z |
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