title: Major surgery in patients with metastatic colorectal cancer in Western europe.
abstract: OBJECTIVE
  Given the potential interference between treatment for metastatic colorectal cancer (mCRC) and surgical procedures, we sought to determine the prevalence of major surgery following mCRC diagnosis in clinical practice.
  
  
  METHODS
  This cohort study used physician-surveyed data from the LifeLink™ Oncology Analyzer database for mCRC patients in five European countries (France, Germany, Italy, Spain, and the United Kingdom [UK]). All patients aged ≥21 years at mCRC diagnosis and with data collected during 2009 were included. Major surgical procedures were examined descriptively by the purpose and location of surgery.
  
  
  RESULTS
  The study sample included 3,249 mCRC patients; 515, 862, 656, 649, and 567 were from France, Germany, Italy, Spain, and the UK, respectively. Following mCRC diagnosis, at least one major surgical procedure for any purpose was seen in 30.5% (UK), 35.2% (Germany), 35.6% (Spain), 36.3% (France), and 38.4% (Italy) of patients, with a mean of 1.3 (UK) to 1.6 (France) procedures. The rate of major surgery for curative purposes was the highest in Italy (13.4%), followed by France (12.8%), Spain (10.3%), and Germany (9.2%); the lowest was in the UK (7.2%). Major surgery performed on the primary tumor (12.4-27.1% of patients, depending on the country) and metastasis (6.4-14.6%) made up the majority of all surgical procedures.
  
  
  CONCLUSIONS
  Major surgery is highly prevalent following mCRC diagnosis, suggesting an important role in meeting the goals of mCRC treatment. The role of pharmacological treatment options and their potential to interfere with both surgery use and surgical outcomes should be considered when evaluating mCRC treatment strategies.
authors: Global Health Economics, Amgen Inc, CA 91320-1799, USA. zhongyun@amgen.com
authors: Zhongyun
authors: Z
authors: Zhao
authors: Elise
authors: E
authors: Pelletier
authors: Beth
authors: B
authors: Barber
authors: Monali
authors: M
authors: Bhosle
authors: Song
authors: S
authors: Wang
authors: David
authors: D
authors: Klingman
authors: Sue
authors: S
authors: Gao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult