Multicentre, Observational, Chilean Trial of Patients with Colorectal Cancer Stage III and IV: Escorrecto Gocchi 2008-01

Abstract

Background: Colorectal cancer (CRC) is one of the most important health problems worldwide. In Chile, mortality rates of colon and rectal cancer were 8 and 2.5 per 100.000 inhabitants, respectively, causing 1785 deaths in 2010. Chilean mortality rates have increased in the last 10 years, nevertheless this tendency has decreased in developed world. This mortality decrease could be explained by early diagnosis and effectiveness of treatments due to new regimens based on tumour molecular features. GOCCHI 2008-01 (ESCORRECTO) trial is a national, multicentre project. The aim is to describe the clinical and pathologic features, as well as mutational status of KRAS in patients with stage III and IV colorectal cancer in Chile. Methods: Data of patients with recent diagnosis colorectal cancer (stage III and IV) were recorded prospectively. KRAS mutational status was determined in tissue samples from the primary tumour. The utilised techniques were DNA sequencing (codon 12, 13 and 14 of gene) by PCR. Results: 255 patients were enrolled between June 2009 and June 2011. Data of Patients were collected from 14 centres along Chile. Mean age was 61.1 years (range: 18 - 83). 129 men and 126 women. 58.8% of the patients were stage III and 41.2% stage IV. Colonoscopy was the most employed diagnosis method (77.5%) and laparotomy was the second one (14.6%). Most of the tumours were localised in descendent colon and sigmoid (42%) following by rectum (31.8%). Staging studies included CT (73.1%) in most of the cases. In the subgroup of stage IV patients, the most frequent involved organ was liver (56.7%) and 34.8% of this group presented resectable lesions. 188 patients (73.7%) were treated by palliative or curative surgical procedures. Mean number of removed lymph nodes were 19 (range 0 - 67). 71.2% of biopsies showed a tubular adenocarcinoma and 73.8% had moderate grade of differentiation. 218 samples were analysed to determinate mutational status of KRAS. 86 biopsies (39.4%) presented KRAS mutation and 132 samples were non-mutated. Conclusion: ESCORRECTO is the first multicentre, nationwide, descriptive study in patients with CRC stage III and IV in Chile. Mutational status of KRAS showed to be similar to other percentages, which have been reported in other international trials. This trial has provided important information about disease demography, clinical presentation, diagnosis methods and treatment.