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Treatment and outcomes of oligometastatic colorectal cancer limited to lymph node metastases


Mathai, VK and Aung, SY and Wong, V and Dunn, C and Shapiro, J and Jalali, A and Wong, R and Lee, M and Tie, J and Ananda, S and Kosmider, S and Lim, SH and Caird, S and Burge, M and Dean, A and Gibbs, P and Nott, L, Treatment and outcomes of oligometastatic colorectal cancer limited to lymph node metastases, Clinical Colorectal Cancer, 20, (4) pp. e233-e239. ISSN 1533-0028 (2021) [Refereed Article]

Copyright Statement

Copyright 2021 Elsevier Inc.

DOI: doi:10.1016/j.clcc.2021.06.003


Introduction: The optimal management of isolated distant lymph node metastases (IDLNM) from a colorectal primary, is not clearly established. We aimed to analyze the outcomes of patients with IDLNM treated with systemic therapies plus locoregional therapy with curative intent versus systemic therapies with palliative intent.

Materials & methods: Clinical data were collected and reviewed from the Treatment of Recurrent and Advanced Colorectal Cancer registry, a prospective, comprehensive registry for metastatic colorectal cancer (mCRC) treated at multiple tertiary hospitals across Australia. Clinicopathological characteristics, treatment modalities and survival outcomes were analyzed in patients with IDLNM and compared to patients with disease at other sites.

Results: Of 3408 mCRC patients diagnosed 2009 to 2020, with median follow-up of 38.0 months, 93 (2.7%) were found to have IDLNM. Compared to mCRC at other sites, patients with IDLNM were younger (mean age: 62.1 vs. 65.6 years, P = .02), more likely to have metachronous disease (57.0% vs. 38.9%, P < .01), be KRAS wild-type (74.6% vs. 53.9%, P< .01) and BRAF mutant (12.9% vs. 6.2%, P = .01). Amongst mCRC patients with IDLNM, 24 (25.8%) received treatment with curative intent and had a significantly better overall median survival than those treated with palliative intent (73.5 months vs. 23.2 months, P = .01). These 24 patients had an overall median survival similar (62.7 months, P = .82) to patients with isolated liver or lung metastases also treated with curative intent.

Conclusion: Curative treatment strategies (radiotherapy or surgery), with or without systemic therapy, should be considered for mCRC patients with IDLNM where appropriate as assessed by the multidisciplinary team.

Item Details

Item Type:Refereed Article
Keywords:colorectal cancer, curative, lymph node, metastases, treatment
Research Division:Biomedical and Clinical Sciences
Research Group:Oncology and carcinogenesis
Research Field:Cancer therapy (excl. chemotherapy and radiation therapy)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Nott, L (Dr Louise Nott)
ID Code:152312
Year Published:2021
Deposited By:Menzies Institute for Medical Research
Deposited On:2022-08-17
Last Modified:2022-09-15

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