الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
This retrospective study reviewed the clinical data of metastatic colorectal cancer patients presented to Clinical Oncology Department, Assiut University hospital in the period from January 2015 to December 2019 to determine progression free survival (PFS) and overall survival (OS) in metastatic colorectal cancer in relation to age, BMI and tumor sidedness, describing their predictive influence on systemic therapy outcome. Total number of 165 patients included 99 (60%) females and 66 (40%) males. Median age of the enrolled patients was 42 years; 102 patients (61.9%) were in age group < 50 years, 57 patients (34.5%) were in age group 50-69 years and 6 patients (3.6%) were in age group >70 years. Median BMI of the enrolled patients was 23.73, most of the included patients were in the normal weight category with 90 patients (54.5%), followed by overweight category with 33 patients (20%) followed by underweight and obese category with 21 patients (12.7%) each. The most common primary site was rectum with 84 patients (50.9%), followed by left colon with 44patients (26.7%), followed by right colon with 37 patients (22.4%). Classical adenocarcinoma was the most common histopathological subtype with 123 patients (74.5%). There were 96 patients (58.2%) presented with synchronous metastasis and 69 patients (41.8%) presented with metachronous metastasis. Age at the time of diagnosis was prognostic for PFS (P-value: 0.003) and OS (P-value: 0.002) with worse survival in patients younger than 50 years and older than 70 years than patients in middle age group from 50-69 years. Also, age was predictive of the response to targeted therapy plus chemotherapy, as patients with age group 50-69 years had statistically significant more responders to target + chemotherapy (81.8%) than age group < 50 years (46.7%), (P-value: 0.002). Mean ± SD age of responders to target +chemotherapy was 47.87±10.87 and of non-responders was 33.6±11.1 (P-value: <0.001). But age wasn’t predictive of response to chemotherapy alone. BMI was prognostic for PFS; as PFS was higher in patients in overweight category, followed by normal weight category, followed by obese category, lastly underweight category (P-value:<0.001). OS was numerically higher in overweight category, but wasn’t statistically significant. BMI was predictive for response to target therapy+ chemotherapy as mean ±SD BMI of responders to target+ chemotherapy (24.15±2.69) was more than non-responders (22.03±6.5) and it was statistically significant (P-value:0.049). But, it wasn’t predictive to response to chemotherapy alone. Tumor sidedness was a prognostic factor for both PFS (P-value: 0.001) and OS (P-value: 0.01), as survival was significantly higher in patients with left colon cancer, followed by rectal cancer followed by right colon cancer. Tumor sidedness was predictive for response to target therapy + chemotherapy as patients with left colon cancer had statistically significant more responders to target+ chemotherapy (100%) than patients with rectal cancer (50%) and right colon cancer (50%), (P-value:0.001). Also, was predictive for response to chemotherapy as patients with rectal cancer had statistically significant more responders to chemotherapy (64.3%) than patients with right colon cancer (63.2%) and left colon cancer (6%), (P-value:0.002). In metastatic colorectal cancer: Age was a prognostic factor for PFS and OS, and was a predictive for response to chemotherapy plus targeted therapy . BMI was a prognostic factor for PFS, but wasn’t prognostic for OS. BMI was predictive for response to targeted therapy plus chemotherapy. Tumor sidedness was a prognostic factor for PFS and OS, and was predictive for response to targeted therapy + chemotherapy, also was predictive for response to chemotherapy.