Therapeutic advances in medical oncology · 2024
Unveiling the prognostic significance of malignant ascites in advanced gastrointestinal cancers: a marker of peritoneal carcinomatosis burden.
СтатьяНазвание и аннотация: Перевод в очереди
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Provenzano Leonardo, Gwee Yong Xiang, Conca Veronica, Lonardi Sara, Bozzarelli Silvia, Tamburini Emiliano, Passardi Alessandro, Zaniboni Alberto, Tosi Federica, Aprile Giuseppe, Nasca Vincenzo, Boccaccino Alessandra, Ambrosini Margherita, Vetere Guglielmo, Carullo Martina, Guaglio Marcello, Battaglia Luigi, Zhao Joseph Jonathan, Chia Daryl Kai Ann, Yong Wei Peng, Tan Patrick, So Jimmy, Kim Guowei, Shabbir Asim, Ong Chin-Ann Johnny, Casella Francesco, Cremolini Chiara, Bencivenga Maria, Sundar Raghav, Pietrantonio Filippo
Аннотация
BACKGROUND: Ascites is common in advanced gastrointestinal cancers with peritoneal metastases (PM) and negatively impacts patient survival. No study to date has specifically evaluated the relationship between ascites, PM and survival outcomes in metastatic colorectal cancer (mCRC) and metastatic gastric cancer (mGC).
OBJECTIVES: This study aims to investigate and elucidate the relationship between malignant ascites, PM and survival outcomes in both mCRC and mGC patients.
DESIGN: This is a retrospective analysis of prospectively collected clinical trial data of mCRC and mGC patients with PM.
METHODS: We performed two pooled analyses, firstly of two Italian randomized trials enrolling patients with mCRC eligible for systemic therapy (TRIBE2; VALENTINO), and secondly of gastric cancer and peritoneal metastasis (GCPM) patients who underwent bi-directional therapeutic treatment comprising systemic and peritoneal-directed therapies.
RESULTS: Of 900 mCRC patients, 39 (4.3%) had PM with malignant ascites. Compared to the group without PM, median progression-free and overall survival were significantly inferior in the ascites group (hazard ratio (HR) for progression-free survival (PFS) 1.68, 95% confidence interval (CI): 1.21-2.35, p = 0.007; HR for overall survival (OS) 2.14, 95% CI: 1.57-3.01, p < 0.001), but not in the group of PM without ascites (HR for PFS 1.10, 95% CI: 0.91 - 1.34; HR for OS 1.04, 95% CI: 0.84 - 1.30). Of 170 patients with GCPM, those with ascites had higher median Peritoneal Cancer Index scores (23 vs 9, p < 0.001). Median OS was significantly inferior among those with ascites compared to those without (13.0 vs 21.0 months, HR 1.71, 95% CI: 1.16-2.52, p = 0.007).
CONCLUSION: Ascites identifies a subgroup of patients with PM and poor outcomes, for whom tailored research are needed.
OBJECTIVES: This study aims to investigate and elucidate the relationship between malignant ascites, PM and survival outcomes in both mCRC and mGC patients.
DESIGN: This is a retrospective analysis of prospectively collected clinical trial data of mCRC and mGC patients with PM.
METHODS: We performed two pooled analyses, firstly of two Italian randomized trials enrolling patients with mCRC eligible for systemic therapy (TRIBE2; VALENTINO), and secondly of gastric cancer and peritoneal metastasis (GCPM) patients who underwent bi-directional therapeutic treatment comprising systemic and peritoneal-directed therapies.
RESULTS: Of 900 mCRC patients, 39 (4.3%) had PM with malignant ascites. Compared to the group without PM, median progression-free and overall survival were significantly inferior in the ascites group (hazard ratio (HR) for progression-free survival (PFS) 1.68, 95% confidence interval (CI): 1.21-2.35, p = 0.007; HR for overall survival (OS) 2.14, 95% CI: 1.57-3.01, p < 0.001), but not in the group of PM without ascites (HR for PFS 1.10, 95% CI: 0.91 - 1.34; HR for OS 1.04, 95% CI: 0.84 - 1.30). Of 170 patients with GCPM, those with ascites had higher median Peritoneal Cancer Index scores (23 vs 9, p < 0.001). Median OS was significantly inferior among those with ascites compared to those without (13.0 vs 21.0 months, HR 1.71, 95% CI: 1.16-2.52, p = 0.007).
CONCLUSION: Ascites identifies a subgroup of patients with PM and poor outcomes, for whom tailored research are needed.