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Japanese Journal of Clinical Oncology 2008 38(10):689-694; doi:10.1093/jjco/hyn086
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© The Author (2008). Published by Oxford University Press. All rights reserved

Impact of Baseline Sum of Longest Diameter in Target Lesions by RECIST on Survival of Patients with Metastatic Colorectal Cancer

Nozomu Machida1, Takayuki Yoshino1, Narikazu Boku1, Shuichi Hironaka1, Yusuke Onozawa1, Akira Fukutomi1, Kentaro Yamazaki1, Hirofumi Yasui1, Keisei Taku1 and Masahiro Asaka2

1 Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Sunto-gun, Shizuoka
2 Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

For reprints and all correspondence: Narikazu Boku, Division of Gastrointestinal Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, Japan. E-mail: n.boku{at}scchr.jp

Received April 11, 2008; accepted July 27, 2008

Objective: In patients with metastatic colorectal cancer (mCRC), several prognostic factors such as performance status (PS), number of metastatic sites, carcinoembryonic antigen (CEA), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) have been reported. The objective of this study was to clarify the prognostic impact of Baseline Sum of Longest Diameter (BSLD) of target lesions by Response Evaluation Criteria in Solid Tumor (RECIST) in patients with mCRC.

Methods: The subjects of this study were consecutive 103 patients with mCRC who had been received the first line systemic chemotherapy between September 2002 and March 2005.

Results: The chemotherapy regimens included leucovorin-modulated 5-fluorouracil (5-FU) (n = 27) and 5-FU plus irinotecan (n = 76). The median overall survival time was 547 days. The median BSLD was 14.3 cm (range, 1.1–54.7). In univariate analysis, identified prognostic variables on survival were PS (0, 1 versus 2), number of metastatic sites (1 versus >1), peritoneal dissemination (+ versus –), pleural effusion (PE) and/or ascites, white blood cell (≥ versus <10 000/mm3), ALP (≥ versus <300 IU), LDH (≥ versus <300 IU), CEA (≥ versus <5 ng/ml), chemotherapy regimen, presence of liver metastasis, and BSLD. In multivariate analysis with covariates of the above significant factors, BSLD (≥ versus <10 cm) (HR 0.431, 95% CI 0.237–0.785, P = 0.0059), PS (HR 0.248, 95% CI 0.107–0.577, P = 0.0012), PE and/or ascites (HR 0.402, 95% CI 0.228–0.708, P = 0.0016) were independent prognostic factors.

Conclusion: BSLD of target lesions by RECIST representing tumor volume might be an independent prognostic factor of patients with mCRC after systemic chemotherapy.

Key Words: RECIST • colorectal cancer • prognostic factor


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