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Right versus left sided metastatic colorectal cancer: Teasing out clinicopathologic drivers of disparity in survival.
Mendis, Shehara; Beck, Sophie; Lee, Belinda; Lee, Margaret; Wong, Rachel; Kosmider, Suzanne; Shapiro, Jeremy; Yip, Desmond; Steel, Simone; Nott, Louise; Jennens, Ross; Lipton, Lara; Burge, Matthew; Field, Kathryn; Ananda, Sumitra; Wong, Hui-Li; Gibbs, Peter.
Afiliación
  • Mendis S; Footscray Hospital, Western Health, Footscray, Victoria, Australia.
  • Beck S; Walter & Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia.
  • Lee B; Walter & Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia.
  • Lee M; Royal Melbourne Hospital, Parkville, Victoria, Australia.
  • Wong R; Faculty of Medicine & Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
  • Kosmider S; Footscray Hospital, Western Health, Footscray, Victoria, Australia.
  • Shapiro J; Walter & Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia.
  • Yip D; Royal Melbourne Hospital, Parkville, Victoria, Australia.
  • Steel S; Faculty of Medicine & Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
  • Nott L; Box Hill Hospital, Eastern Health, Box Hill, Victoria, Australia.
  • Jennens R; Walter & Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia.
  • Lipton L; Box Hill Hospital, Eastern Health, Box Hill, Victoria, Australia.
  • Burge M; Faculty of Nursing & Health Sciences, Monash University, Clayton, Victoria, Australia.
  • Field K; Footscray Hospital, Western Health, Footscray, Victoria, Australia.
  • Ananda S; Cabrini Health, Malvern, Victoria, Australia.
  • Wong HL; Canberra and Calvary Hospitals, Garran, Australian Capital Territory, Australia.
  • Gibbs P; ANU Medical School, The Canberra Hospital, Garran, Australian Capital Territory, Australia.
Asia Pac J Clin Oncol ; 15(3): 136-143, 2019 Jun.
Article en En | MEDLINE | ID: mdl-30761750
BACKGROUND: Metastatic colorectal cancer (mCRC) patients with a right-sided primary (RC) have an inferior survival to mCRC arising from a left-sided primary (LC). Previous analyses have suggested multiple factors contribute. METHODS: The Treatment of Recurrent and Advanced Colorectal Cancer (TRACC) Registry prospectively captured data on consecutive mCRC patients. RC were defined as tumors proximal to the splenic flexure; LC were those at and distal to the splenic flexure and included rectal cancers. Patient, tumor, treatment, and survival data were analyzed stratified by side. RESULTS: Of 2306 patients enrolled from July 2009-March 2018, 747 (32%) had an RC. Patients with RC were older, more likely to be female and have a Charlson score ≥3. RC were more frequently BRAF mutated, deficient in mismatch repair, associated with peritoneal metastases, and less likely to receive chemotherapy. Progression-free survival on first-line systemic therapy was inferior for RC patients (8.1 vs. 10.8 months, hazard ratio [HR] for progression in RC 1.38, P < 0.001). Median overall survival for all RC patients was inferior (19.6 vs. 27.5 months, HR for death in RC 1.44, P < 0.001), and inferior within the treated (21 vs. 29.5 months, HR 1.52, P < 0.001) and untreated subgroups (5.9 vs. 10.3 months, HR 1.38, P = 0.009). Primary side remained a significant factor for overall survival in multivariate analysis. CONCLUSION: Our data from a real-world population confirms the poorer prognosis associated with RC. Primary tumor location remains significantly associated with overall survival even when adjusting for multiple factors, indicating the existence of further side-based differences that are as yet undefined.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Asia Pac J Clin Oncol Asunto de la revista: NEOPLASIAS Año: 2019 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Australia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Asia Pac J Clin Oncol Asunto de la revista: NEOPLASIAS Año: 2019 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Australia