High-grade colorectal NEC: surgery bolsters chemotherapy

  • Fields AC & al.
  • Ann Surg Oncol
  • 31 Jan 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

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.