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Your search keyword '"Lehtomäki, Kaisa"' showing total 2 results
Start Over Author "Lehtomäki, Kaisa" Publisher elsevier
2 results on '"Lehtomäki, Kaisa"'

1. Repeated centralized multidisciplinary team assessment of resectability, clinical behavior, and outcomes in 1086 Finnish metastatic colorectal cancer patients (RAXO) : A nationwide prospective intervention study

Author

Osterlund, Pia, Salminen, Tapio, Soveri, Leena-Maija, Kallio, Raija, Kellokumpu, Ilmo, Lamminmäki, Annamarja, Halonen, Päivi, Ristamäki, Raija, Lantto, Eila, Uutela, Aki, Österlund, Emerik, Ovissi, Ali, Nordin, Arno, Heervä, Eetu, Lehtomäki, Kaisa, Räsänen, Jari, Murashev, Maija, Aroviita, Laura, Jekunen, Antti, Lindvall-Andersson, Renee, Nyandoto, Paul, Kononen, Juha, Lepistö, Anna, Poussa, Tuija, Muhonen, Timo, Ålgars, Annika, Isoniemi, Helena, Osterlund, Pia, Salminen, Tapio, Soveri, Leena-Maija, Kallio, Raija, Kellokumpu, Ilmo, Lamminmäki, Annamarja, Halonen, Päivi, Ristamäki, Raija, Lantto, Eila, Uutela, Aki, Österlund, Emerik, Ovissi, Ali, Nordin, Arno, Heervä, Eetu, Lehtomäki, Kaisa, Räsänen, Jari, Murashev, Maija, Aroviita, Laura, Jekunen, Antti, Lindvall-Andersson, Renee, Nyandoto, Paul, Kononen, Juha, Lepistö, Anna, Poussa, Tuija, Muhonen, Timo, Ålgars, Annika, and Isoniemi, Helena

Abstract

Background: Resection of colorectal cancer (CRC) metastases provides good survival but is probably underused in real-world practice. Methods: A prospective Finnish nationwide study enrolled treatable metastatic CRC patients. The intervention was the assessment of resectability upfront and twice during first-line therapy by the multidisciplinary team (MDT) at Helsinki tertiary referral centre. The primary outcome was resection rates and survival. Findings: In 2012-2018, 1086 patients were included. Median follow-up was 58 months. Multiple metastatic sites were present in 500 (46%) patients at baseline and in 820 (76%) during disease trajectory. In MDT assessments, 447 (41%) were classified as resectable, 310 (29%) upfront and 137 (18%) after conversion therapy. Sixhundred and ninety curative intent resections or local ablative therapies (LAT) were performed in 399 patients (89% of 447 resectable). Multiple metastasectomies for multisite or later developing metastases were performed in 148 (37%) patients. Overall, 414 liver, 112 lung, 57 peritoneal, and 107 other metastasectomies were performed. Median OS was 80.4 months in R0/1-resected (HR 0.15; CI95% 0.12-0.19), 39.1 months in R2-resected/LAT (0.39; 0.29-0.53) patients, and 20.8 months in patients treated with "systemic therapy alone" (reference), with 5-year OS rates of 66%, 40%, and 6%, respectively. Interpretation: Repeated centralized MDT assessment in real-world metastatic CRC patients generates high resectability (41%) and resection rates (37%) with impressive survival, even when multisite metastases are present or develop later.

Published
2021
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2. Computed tomography-determined high visceral adipose tissue and sarcopenic obesity and their associations with survival in vulnerable or frail older adults with cancer considered for systemic anticancer treatment.

Author

Tolonen A, Lehtomäki K, Kerminen H, Huhtala H, Bärlund M, Österlund P, and Arponen O

Abstract

Introduction: Treatment decisions are challenging in older adults with solid tumors. Geriatric 8 (G8)-screening and comprehensive geriatric assessment (CGA) are important but additional methods are needed. We examined the association of computed tomography (CT)-derived high visceral adipose tissue index (VATI) with or without low skeletal muscle index (SMI) on three-month and overall survival (OS)., Materials and Methods: Vulnerability was evaluated with G8 in patients ≥75 years referred for systemic anticancer treatment. Vulnerable/frail patients (G8 ≤ 14) received CGA and were included. VATI and SMI were retrospectively measured from CT scans. We examined associations between high VATI with or without low SMI and three-month and OS with Cox regression models and Kaplan-Meier estimation., Results: Seventy-nine patients with median age of 80 (range 75-91) years were evaluated. In the palliative-intent group (n = 58), three-month OS rates were 88 % and 58 % in the normal and high VATI groups, respectively (hazard ratio 4.3; 95 % confidence interval 1.3-14), and 88 % vs. 47 % in group without and with 'high VATI+low SMI', respectively (5.5; 1.9-17). The median OS was 12.7 vs. 9.5 months in normal VATI/SMI and 'high VATI+low SMI' (1.9; 1.1-3.2), respectively. In Cox multivariable models with established predictive factors (ECOG PS, Clinical Frailty Scale, and sex), only high VATI (4.9; 1.0-24) or 'high VATI+low SMI' (8.9; 1.7-46) remained significant predictors of three-month OS., Discussion: High VATI with or without low SMI were associated with impaired three-month OS in the palliative-intent group and with OS in the whole cohort independently of oncologic and geriatric functional status measures; thus, they may aid in treatment decision-making., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflicts of interest. The funders had no role in the design of the study, in the collection, analyses or interpretation of data, in the writing of the manuscript, or in the decision to publish the results. Additionally, O.A. received grants from the Osk. Huttunen Foundation, Sigrid Jusélius Foundation, Relander Foundation, Finnish Medical Foundation, Cancer Foundation Finland, and Orion Research Foundation., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2024
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