title: [Metastatic colorectal cancer--analysis of treatment modalities and survival now and then].
abstract: OBJECTIVE
  In metastatic colorectal cancer (mCRC) available systemic treatment options substantially increased in the last decades. Nowadays, overall survival in mCRC patients ranges from 25 to 35 months as recent studies report. We compared treatment modalities and survival in mCRC patients who were treated at our center in two different periods.
  
  
  METHODS
  Within two sequential monocentric analyses patients with mCRC treated at our Comprehensive Cancer Center (CCC) between 07/1994 and 10/2007 (cohort 1) and from 11/2007 to 05/2010 (cohort 2) were evaluated for applied treatment, for best response to treatment and for survival (OS). For statistical analysis the Kaplan-Meier estimator was used.
  
  
  RESULTS
  Both patient cohorts showed comparable characteristics regarding median age (63 vs. 64 yrs), localization of primary tumor (colon 60% vs. rectum 40%) and number and site of distant metastasis (1 site [75%] vs. ≥ 2 site [25%]; liver-only metastasis [55%]). About half of all patients in each cohort received at least three consecutive chemotherapy regimens. In cohort 1, treatment mainly consisted of chemotherapy alone (>80%), whereas in cohort 2 chemotherapy was combined with a monoclonal antibody in nearly 70%. Rate of surgical resection of metastasis increased over time (8% vs. 17%). Median OS was 27.3 months (cohort 1) vs. 39.4 months (cohort 2).
  
  
  CONCLUSIONS
  The increasing availability of effective substances including monoclonal antibodies and individual approaches including secondary surgery of distant metastasis might explain that survival in pts with mCRC has substantially improved over the last decades.
authors.affiliation: Medizinische Klinik und Poliklinik III, CCC - Comprehensive Cancer Center, Klinikum der Ludwig-Maximilians-Universität München, Standort Großhadern.
authors.forename: M
authors.initials: M
authors.lastname: Michl
authors.affiliation: Medizinische Klinik und Poliklinik III, CCC - Comprehensive Cancer Center, Klinikum der Ludwig-Maximilians-Universität München, Standort Großhadern.
authors.forename: B
authors.initials: B
authors.lastname: Holtzem
authors.affiliation: Medizinische Klinik und Poliklinik III, CCC - Comprehensive Cancer Center, Klinikum der Ludwig-Maximilians-Universität München, Standort Großhadern.
authors.forename: J
authors.initials: J
authors.lastname: Koch
authors.affiliation: Medizinische Klinik und Poliklinik III, CCC - Comprehensive Cancer Center, Klinikum der Ludwig-Maximilians-Universität München, Standort Großhadern.
authors.forename: N
authors.initials: N
authors.lastname: Moosmann
authors.affiliation: Medizinische Klinik und Poliklinik III, CCC - Comprehensive Cancer Center, Klinikum der Ludwig-Maximilians-Universität München, Standort Großhadern.
authors.forename: J
authors.initials: J
authors.lastname: Holch
authors.affiliation: Medizinische Klinik und Poliklinik III, CCC - Comprehensive Cancer Center, Klinikum der Ludwig-Maximilians-Universität München, Standort Großhadern.
authors.forename: W
authors.initials: W
authors.lastname: Hiddemann
authors.affiliation: Medizinische Klinik und Poliklinik III, CCC - Comprehensive Cancer Center, Klinikum der Ludwig-Maximilians-Universität München, Standort Großhadern.
authors.forename: V
authors.initials: V
authors.lastname: Heinemann
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D004358:Drug Therapy / Q000379:methods*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents