% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Rahbari:143004,
      author       = {N. N. Rahbari and P. Carr$^*$ and L. Jansen$^*$ and J.
                      Chang-Claude$^*$ and J. Weitz and M. Hoffmeister$^*$ and H.
                      Brenner$^*$},
      title        = {{T}ime of {M}etastasis and {O}utcome in {C}olorectal
                      {C}ancer.},
      journal      = {Annals of surgery},
      volume       = {269},
      number       = {3},
      issn         = {0003-4932},
      address      = {[S.l.]},
      publisher    = {Ovid38850},
      reportid     = {DKFZ-2019-00629},
      pages        = {494 - 502},
      year         = {2019},
      abstract     = {The aim of this study was to evaluate outcomes of
                      metastases at various time intervals after colorectal cancer
                      (CRC) diagnosis.Earlier studies have indicated a short time
                      interval between CRC diagnosis and distant metastases to be
                      associated with poor prognosis. The majority of studies
                      assessed outcome from CRC diagnosis or metastasis resection
                      rather than from metastasis diagnosis and might be subject
                      to immortal time bias.Patients in the population-based DACHS
                      study were stratified: metastases at/within 1 month
                      (immediate), 2 to 6 months (early), 7 to 12 months
                      (intermediate), and >12 months (late) after CRC diagnosis.
                      The primary endpoint was overall survival (OS) from
                      metastasis diagnosis. Cox proportional hazards regression
                      models were used to calculate hazard ratios (HRs) and $95\%$
                      confidence intervals (CI). HRs were adjusted for important
                      confounders and immortal time.A total of 1027 patients were
                      included. T4 (P < 0.0001) and node-positive tumors (P <
                      0.0001) were more frequent in the immediate group. Lung
                      metastases (P < 0.0001) and single-site metastases (P <
                      0.0001) were more prevalent in the late group. In
                      multivariable analysis, immediate metastases were not
                      associated with poor OS compared to metastases at later time
                      points (late vs immediate: HR 1.21; $95\%$ CI, 0.98-1.48).
                      Subgroup analyses revealed poor OS of late versus immediate
                      metastases for females (1.45; 1.08-1.96), proximal colon
                      cancer (1.54; 1.09-2.16), and N0 (1.46; 1.00-2.12) or N1
                      disease (1.88; 1.17-3.05).Immediate or early metastases are
                      not associated with unfavorable outcome compared to late
                      metastases. These findings challenge the current notion of
                      poor outcome for CRC with immediate or early metastases.},
      cin          = {C070 / C120 / C020 / L101},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)C020-20160331 / I:(DE-He78)L101-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29064893},
      doi          = {10.1097/SLA.0000000000002564},
      url          = {https://inrepo02.dkfz.de/record/143004},
}