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133. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

26.04. - 29.04.2016, Berlin

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Colorectal carcinoma: Proposal for a new M1 subclassification

Meeting Abstract

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  • Susanne Merkel - Universitätsklinikum Erlangen, Chirurgische Klinik, Erlangen, Deutschland
  • Klaus Weber - Universitätsklinikum Erlangen, Chirurgische Klinik, Erlangen, Deutschland
  • Roland Croner - Universitätsklinikum Erlangen, Chirurgische Klinik, Erlangen, Deutschland
  • Henriette Golcher - Universitätsklinikum Erlangen, Chirurgische Klinik, Erlangen, Deutschland
  • Jonas Göhl - Universitätsklinikum Erlangen, Chirurgische Klinik, Erlangen, Deutschland
  • Abbas Agaimy - Universitätsklinikum Erlangen, Pathologisches Institut, Erlangen, Deutschland
  • Sabine Semrau - Universitätsklinikum Erlangen, Strahlenklinik, Erlangen, Deutschland
  • Jürgen Siebler - Universitätsklinikum Leipzig, Institut für Pathologie, Leipzig, Deutschland
  • Axel Wein - Universitätsklinikum Erlangen, Chirurgische Klinik, Erlangen, Deutschland
  • Werner Hohenberger - Universitätsklinikum Erlangen, Chirurgische Klinik, Erlangen, Deutschland
  • Christian Wittekind - Universitätsklinikum Leipzig, Institut für Pathologie, Leipzig, Deutschland

Deutsche Gesellschaft für Chirurgie. 133. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 26.-29.04.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16dgch402

doi: 10.3205/16dgch402, urn:nbn:de:0183-16dgch4020

Published: April 21, 2016

© 2016 Merkel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Background: In 2010, the seventh edition of the TNM cancer staging system of the UICC and the AJCC introduced a subdivision of M1 in the TNM classification of colorectal carcinomas. For the eighth TNM edition which will be released in the autumn of 2016 and will become effective in January 2017 new proposals are appreciated. The aim of our study was to define a new optimized proposal for M1 subclassification for colorectal carcinomas based on data of a large single-center cohort of patients.

Materials and methods: In a total of 814 consecutive patients with stage IV colorectal carcinoma treated between 1995 and 2013 prognostic factors were analyzed in univariate and multivariate analyses. Treatment was planned individually in a multidisciplinary tumor board. The patients were followed up until 01 January 2015.

Results: Advanced age, treatment in the earlier period 1995-2003, involvement of multiple metastatic sites, missing CEA, and non-curative resection were found to be independent prognostic factors. In patients with only one metastatic site, survival was superior in patients with liver or lung metastasis (2-year survival 50.7% and 64.9%), moderate in patients with metastasis of the peritoneum or non-regional lymph nodes (2-year survival 36.5% and 44.7%) and poor in patients with other rarely metastatic involved organs (2-year survival 21.4%). The new proposal defines M1a, Metastasis confined to one organ: liver or lung (2-year survival 51.6%); M1b, Metastasis confined to one organ: peritoneum or non-regional lymph nodes, or Metastasis confined to liver plus lung (2-year survival 39.4%); and M1c, Metastasis confined to one organ: all other sites, or Metastasis in more than one organ, but not liver plus lung (2-year survival 21.6%).

Conclusion: The new proposal can identify three prognostic groups in stage IV colorectal carcinomas with significant differences in survival.

Table 1 [Tab. 1], Figure 1 [Fig. 1]