Major surgeries in patients with metastatic colorectal cancer in the United States.

e19633 Background: The objective of this study was to examine the proportion of major surgeries in patients with colorectal cancer after diagnosis of metastatic disease (mCRC). Methods: Using a large U.S. medical claims database from a nationally commercially-insured population, patients with diagnosed mCRC between January 2004 and March 2010 were identified. The first metastasis diagnosis date served as the index date. Patients were followed from the index date until end of data collection, death, or end of the study period (March 31, 2010), whichever occurred first. Major surgery was defined according to the list of major surgeries developed by the National Committee for Quality Assurance (NCQA) using Current Procedural Terminology (CPT) procedure codes. Major surgeries were examined by anatomic locations: 1) colon or rectum; 2) liver or lung; and 3) all other anatomic sites. Major surgeries on colon or rectum were assessed separately, since they likely include a high percentage of interventions to remove primary tumors. The proportion of major surgeries was descriptively analyzed. Results: A total of 4,768 mCRC patients who met the study inclusion and exclusion criteria between January 2004 and March 2010 were included in the analyses. Average age was 60.0 years and 45.9% of patients were female. Average length of follow-up observation time was over one year (414 days). Overall, 42.3% of patients had at least one major surgery on anatomic sites other than colon/rectum after mCRC diagnosis. By anatomic locations, 17.6% of patients had major surgeries on liver or lung (13.4% on liver and 4.9% on lung); and 32.3% had major surgeries on all other anatomic sites. Major surgeries on colon or rectum occurred in 35.9% of patients (32.9% on colon and 4.1% on rectum). Conclusions: Major surgeries are highly prevalent in patients with mCRC from this commercially insured population after mCRC diagnosis. This might have implications for anticancer drug therapy in mCRC patients.