High-grade colorectal NEC: surgery bolsters chemotherapy

  • Fields AC & al.
  • Ann Surg Oncol
  • 31.01.2019

  • von Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • In patients with high-grade colorectal neuroendocrine carcinoma (HGNEC), chemotherapy combined with resection of the primary tumor led to better survival than chemotherapy alone.

Why this matters

  • HGNECs are rare, but on the rise, and the optimal treatment strategy is unknown.

Study design

  • Analysis of 1208 patients with HGNEC (50% women; median age, 65 years), drawn from the National Cancer Database: 37.4% had primary tumors of the rectum, 62.5% had primary tumors of the colon.
  • Funding: None.

Key results

  • 61.3% of patients underwent surgery of the primary tumor, 64.4% underwent chemotherapy, and 21.2% underwent radiation therapy.
  • Factors associated with improved survival included surgical resection (HR, 0.54; P<.001 chemotherapy p and primary tumor in the rectum>
  • There was no significant association between radiation therapy and overall survival.
  • When the analysis was limited to patients with metastatic disease, there was a still a significant association between survival and surgical resection (HR, 0.51; P<.001 and chemotherapy p>

Limitations

  • Retrospective analysis.
  • Records did not include extent of metastatic disease, which can affect treatment choice.