Impact of treatment modality on clinical outcome in metastatic colorectal cancer patients stratified by metastatic sites Hsin-Wu Lai James Cheng-Chung Wei Hung-Chang Hung Chun-Che Lin 10.6084/m9.figshare.7611512.v1 https://tandf.figshare.com/articles/journal_contribution/Impact_of_treatment_modality_on_clinical_outcome_in_metastatic_colorectal_cancer_patients_stratified_by_metastatic_sites/7611512 <p><b>Objectives</b>: To investigate the impact of location of metastases, and therapeutic modality on clinical outcomes in patients with metastatic colorectal cancer (CRC).</p> <p><b>Methods</b>: Data for metastatic CRC patients were sourced from the Surveillance, Epidemiology, and End Results (SEER) database (SEER ID: 15309-Nov2017). Patients were classified as follows: Group 1 patients had only liver metastasis; Group 2 patients had liver and lung metastasis; Group 3 patients had more than two metastasis sites. Patients were treated with surgery alone, radiation alone, or surgery plus radiation. The main study outcomes were (1) cancer-specific mortality and (2) survival benefit associated with treatment modality.</p> <p><b>Results</b>: A total number of 15,510 patients were included in this study. In Groups 1 and 2, patients treated with surgery plus radiation had a higher cumulative survival compared to other treatment groups (<i>p</i>-value <.001). Group 3 patients showed no significant difference in cumulative survival between the different treatment modalities (<i>p</i>-value = .218). Group 1 patients who received surgery plus radiation had a significantly lower risk of mortality compared to the other treatment groups (<i>p</i>-value <.001), and Group 2 patients who either received radiation treatment alone or surgery plus radiation had a significantly lower risk for mortality than patients who received other treatment modalities (<i>p</i>-value <.001). Multivariate analysis adjusting for known prognostic factors such as tumor sidedness and race did not alter the observed risk conferred by metastasis sites and treatment modalities.</p> <p><b>Conclusion</b>: Stratification by metastases sites, and by treatment modality can help multidisciplinary teams to reach a treatment consensus for metastatic CRC.</p> 2019-01-21 18:11:47 Colorectal cancer metastases surgical resection radiotherapy Surveillance Epidemiology End Results program (SEER)