Prognostic Impact of Primary Tumor Sidedness in Stage III Colorectal Cancer: Real-World Evidence from a Brazilian Cohort.
Clin Colorectal Cancer
; 23(1): 73-84, 2024 03.
Article
in En
| MEDLINE
| ID: mdl-38151358
ABSTRACT
BACKGROUND:
Primary tumor sidedness (PTS) is an independent prognostic factor in patients with metastatic colorectal cancer (CRC), with a worse prognosis for right-sided tumors. There are limited data on the prognostic impact of PTS in stage III CRC. The main objective of this study was to analyze the prognostic impact of PTS in stage III CRC. PATIENTS ANDMETHODS:
A retrospective and uni-institutional cohort study was performed in an oncology reference center. Patients with stage III CRC treated with a 5-fluorouracil and oxaliplatin-based chemotherapy regimen (mFLOX regimen) from October 2007 to February 2013 were included. The primary outcome was the probability of overall survival (OS) at 5 years stratified by PTS. Secondary outcomes were the probability of disease-free survival (DFS) at 5 years and an analysis of the prognostic impact of clinical and molecular biomarkers. KaplanâMeier curves were used, and Cox models were used to evaluate prognostic factors associated with OS and DFS.RESULTS:
Overall, 265 patients were evaluated. Transverse colon tumors, multicentric tumors, and undetermined primary subsites were excluded, resulting in 234 patients classified according to PTS 95 with right sidedness (40.6%) and 139 with left sidedness (59.4%). The median follow-up time was 66 months [interquartile range (IQR) 39-81]. The 5-year OS probabilities for right-sided and left-sided tumors were 67% (95% CI 58%-77%) and 82% (75%-89%), respectively [hazard ratio (HR) 2.02, 95% CI 1.18-3.46; P = .010]. The 5-year probabilities of DFS for right-sided and left-sided tumors were 58% (49%-69%) and 65% (58%-74%), respectively (HR 1.29, 0.84-1.97; P = 0.248).CONCLUSION:
These data suggest that there may be a worse prognosis (inferior OS at 5 years) for resected right-sided stage III CRC patients treated in the real world. However, these data need to be confirmed by prospective studies with a larger number of participants.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Colorectal Neoplasms
/
Colonic Neoplasms
Limits:
Humans
Country/Region as subject:
America do sul
/
Brasil
Language:
En
Journal:
Clin Colorectal Cancer
Journal subject:
GASTROENTEROLOGIA
/
NEOPLASIAS
Year:
2024
Document type:
Article
Country of publication:
United States