title: Overall Survival and Metastasis Resections in Patients with Metastatic Colorectal Cancer Using Electronic Medical Records.
abstract: OBJECTIVE
  Treatment for patients with metastatic colorectal cancer is chemotherapy commonly combined with monoclonal antibodies against vascular endothelial growth factor (bevacizumab) or epidermal growth factor receptor (cetuximab or panitumumab), the efficacy of which has been proven in randomized controlled trials. The objective of the current retrospective study was to analyze the impact of targeted therapy, adverse events, and dose reduction on overall survival (OS) and metastasis resection rates.
  
  
  METHODS
  A hospital-based electronic informatics center was used to gather clinical data and outcome information in a "real-life" setting in a single academic hospital. A total of 178 patients were included in 2010-2013.
  
  
  RESULTS
  In patients whose tumors expressed the KRAS wild type, the longest median OS was observed with irinotecan-based chemotherapy combined with bevacizumab (38 months), or with cetuximab (41 months). In the KRAS-mutated group, the longest median OS was observed with oxaliplatin with or without bevacizumab (34 months). Beneficial liver metastasis resections were observed in 12 out of 20 patients. Patients with KRAS wild-type tumors who received cetuximab were the most likely to undergo surgery. Age was a negative predictor of OS. Patients whose chemotherapy dose was reduced to below 80% had lower OS compared to those remaining above 80%. Treatment delays in chemotherapy did not affect OS. Pulmonary embolism and infections were common but did not have an impact on OS.
  
  
  CONCLUSIONS
  A hospital-based electronic informatics center provides comparable OS results, even though adverse events were frequently observed in the present study.
authors.affiliation: Department of Oncology, University of Turku and Turku University Hospital, Hameentie 11, 20521, Turku, Finland. eaheer@utu.fi.
authors.forename: Eetu
authors.initials: E
authors.lastname: Heervä
authors.affiliation: Department of Digestive Surgery, University of Turku and Turku University Hospital, Hameentie 11, 20521, Turku, Finland.
authors.forename: Maija
authors.initials: M
authors.lastname: Lavonius
authors.affiliation: Department of Oncology, University of Turku and Turku University Hospital and Turku University Hospital Cancer Centre, Hameentie 11, 20521, Turku, Finland.
authors.forename: Panu
authors.initials: P
authors.lastname: Jaakkola
authors.affiliation: Department of Oncology, University of Turku and Turku University Hospital, Hameentie 11, 20521, Turku, Finland.
authors.forename: Heikki
authors.initials: H
authors.lastname: Minn
authors.affiliation: Department of Oncology, University of Turku and Turku University Hospital, Hameentie 11, 20521, Turku, Finland.
authors.forename: Raija
authors.initials: R
authors.lastname: Ristamäki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000235:genetics / Q000473:pathology* / Q000628:therapy*; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000009:adverse effects / Q000706:statistics & numerical data; D009154:Mutation; D009362:Neoplasm Metastasis; D016283:Proto-Oncogene Proteins p21(ras) / Q000235:genetics; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: C117307:KRAS protein, human; D016283:Proto-Oncogene Proteins p21(ras)
keywords: Chemotherapy; Colorectal cancer; Dose reduction; Electronic medical records; Targeted therapy