Evidence map›Paper›PMID 37528303›Full record

ArticleAnnals of surgical oncology2023

Survival of Patients with Deficient Mismatch Repair Versus Proficient Mismatch Repair Metastatic Colorectal Cancer Receiving Curative-Intent Local Treatment of Metastases in a Nationwide Cohort.

Koen Zwart, Frederieke H van der Baan, Cornelis J A Punt, G Emerens Wensink, Karen Bolhuis, Miangela M Laclé, Wilhelmina M U van Grevenstein, Jeroen Hagendoorn, Ignace H de Hingh, Miriam Koopman and 2 more

Open access · hybridAbstract read
In one paragraph

Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

Koen ZwartDepartment of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Frederieke H van der BaanDepartment of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Cornelis J A PuntDepartment of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
G Emerens WensinkDepartment of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Karen BolhuisDepartment of Medical Oncology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Miangela M LacléDepartment of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Wilhelmina M U van GrevensteinDepartment of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Jeroen HagendoornDepartment of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Ignace H de HinghDepartment of Surgery, Catharina Hospital, Eindhoven, The Netherlands.
Miriam KoopmanDepartment of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Geraldine VinkDepartment of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Jeanine RoodhartDepartment of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. J.roodhart@umcutrecht.nl.
University Medical Center Utrecht · NLUtrecht University · NLNetherlands Comprehensive Cancer Organisation · NLThe Netherlands Cancer Institute · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt is unclear whether curative-intent local therapy of metastases is of similar benefit for the biological distinct subgroup of patients with deficient mismatch repair (dMMR) metastatic colorectal cancer (mCRC) compared with proficient mismatch repair (pMMR) mCRC. PATIENTS AND

methodsIn this nationwide study, recurrence-free (RFS) and overall survival (OS) were analyzed in patients with dMMR versus pMMR mCRC who underwent curative-intent local treatment of metastases between 2015 and 2018. Subgroup analyses were performed for resection of colorectal liver metastases (CRLM) and cytoreductive surgery ± hyperthermic intraperitoneal chemotherapy (CRS ± HIPEC). Multivariable regression was conducted.

resultsMedian RFS was 11.1 months [95% confidence interval (CI) 8.5-41.1 months] for patients with dMMR tumors compared with 8.9 months (95% CI 8.1-9.8 months) for pMMR tumors. Two-year RFS was higher in patients with dMMR versus pMMR (43% vs. 21%). Results were similar within subgroups of local treatment (CRLM and CRS ± HIPEC). Characteristics differed significantly between patients with dMMR and pMMR mCRC; however, multivariable analysis continued to demonstrate dMMR as independent factor for improved RFS [hazard ratio (HR): 0.57, 95% CI 0.38-0.87]. Median OS was 33.3 months for dMMR mCRC compared with 43.5 months for pMMR mCRC, mainly due to poor survival of patients with dMMR in cases of recurrence in the preimmunotherapy era.

conclusionPatients with dMMR eligible for curative-intent local treatment of metastases showed a comparable to more favorable RFS compared with patients with pMMR, with a clinically relevant proportion of patients remaining free of recurrence. This supports local treatment as a valuable treatment option in patients with dMMR mCRC and can aid in shared decision-making regarding upfront local therapy versus immunotherapy.

Indexed as

Colonic NeoplasmsColorectal NeoplasmsRectal NeoplasmsDNA Mismatch RepairHumansPrognosisProportional Hazards Models

Identifiers

PMID37528303
PMCPMC10506947
OpenAlexW4385450248

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.