Leonardo Provenzano, Yong Xiang Gwee, Veronica Conca, Sara Lonardi, Silvia Bozzarelli, Emiliano Tamburini, Alessandro Passardi, Alberto Zaniboni, Federica Tosi, Giuseppe Aprile, Vincenzo Nasca, Alessandra Boccaccino, Margherita Ambrosini, Guglielmo Vetere, Martina Carullo, Marcello Guaglio, Luigi Battaglia, Joseph Jonathan Zhao, Daryl Kai Ann Chia, Wei Peng Yong, Patrick Tan, Jimmy So, Guowei Kim, Asim Shabbir, Chin-Ann Johnny Ong, Francesco Casella, Chiara Cremolini, Maria Bencivenga, Raghav Sundar, Filippo Pietrantonio
{"title":"揭示晚期胃肠道癌症恶性腹水的预后意义：腹膜癌肿负担的标志。","authors":"Leonardo Provenzano, Yong Xiang Gwee, Veronica Conca, Sara Lonardi, Silvia Bozzarelli, Emiliano Tamburini, Alessandro Passardi, Alberto Zaniboni, Federica Tosi, Giuseppe Aprile, Vincenzo Nasca, Alessandra Boccaccino, Margherita Ambrosini, Guglielmo Vetere, Martina Carullo, Marcello Guaglio, Luigi Battaglia, Joseph Jonathan Zhao, Daryl Kai Ann Chia, Wei Peng Yong, Patrick Tan, Jimmy So, Guowei Kim, Asim Shabbir, Chin-Ann Johnny Ong, Francesco Casella, Chiara Cremolini, Maria Bencivenga, Raghav Sundar, Filippo Pietrantonio","doi":"10.1177/17588359241289517","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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).</p><p><strong>Objectives: </strong>This study aims to investigate and elucidate the relationship between malignant ascites, PM and survival outcomes in both mCRC and mGC patients.</p><p><strong>Design: </strong>This is a retrospective analysis of prospectively collected clinical trial data of mCRC and mGC patients with PM.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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, <i>p</i> = 0.007; HR for overall survival (OS) 2.14, 95% CI: 1.57-3.01, <i>p</i> < 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, <i>p</i> < 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, <i>p</i> = 0.007).</p><p><strong>Conclusion: </strong>Ascites identifies a subgroup of patients with PM and poor outcomes, for whom tailored research are needed.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"16 ","pages":"17588359241289517"},"PeriodicalIF":4.3000,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536604/pdf/","citationCount":"0","resultStr":"{\"title\":\"Unveiling the prognostic significance of malignant ascites in advanced gastrointestinal cancers: a marker of peritoneal carcinomatosis burden.\",\"authors\":\"Leonardo Provenzano, Yong Xiang Gwee, Veronica Conca, Sara Lonardi, Silvia Bozzarelli, Emiliano Tamburini, Alessandro Passardi, Alberto Zaniboni, Federica Tosi, Giuseppe Aprile, Vincenzo Nasca, Alessandra Boccaccino, Margherita Ambrosini, Guglielmo Vetere, Martina Carullo, Marcello Guaglio, Luigi Battaglia, Joseph Jonathan Zhao, Daryl Kai Ann Chia, Wei Peng Yong, Patrick Tan, Jimmy So, Guowei Kim, Asim Shabbir, Chin-Ann Johnny Ong, Francesco Casella, Chiara Cremolini, Maria Bencivenga, Raghav Sundar, Filippo Pietrantonio\",\"doi\":\"10.1177/17588359241289517\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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).</p><p><strong>Objectives: </strong>This study aims to investigate and elucidate the relationship between malignant ascites, PM and survival outcomes in both mCRC and mGC patients.</p><p><strong>Design: </strong>This is a retrospective analysis of prospectively collected clinical trial data of mCRC and mGC patients with PM.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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, <i>p</i> = 0.007; HR for overall survival (OS) 2.14, 95% CI: 1.57-3.01, <i>p</i> < 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, <i>p</i> < 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, <i>p</i> = 0.007).</p><p><strong>Conclusion: </strong>Ascites identifies a subgroup of patients with PM and poor outcomes, for whom tailored research are needed.</p>\",\"PeriodicalId\":23053,\"journal\":{\"name\":\"Therapeutic Advances in Medical Oncology\",\"volume\":\"16 \",\"pages\":\"17588359241289517\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-11-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536604/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Medical Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17588359241289517\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Medical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17588359241289517","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
Unveiling the prognostic significance of malignant ascites in advanced gastrointestinal cancers: a marker of peritoneal carcinomatosis burden.
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.
期刊介绍：
Therapeutic Advances in Medical Oncology is an open access, peer-reviewed journal delivering the highest quality articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of cancer. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in medical oncology, providing a forum in print and online for publishing the highest quality articles in this area. This journal is a member of the Committee on Publication Ethics (COPE).
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