Emily K Elizabeth McCracken1, Gregory P Samsa2, Deborah A Fisher3, Norma E Farrow4, Karenia Landa4, Kevin N Shah5, Dan G Blazer5, Sabino Zani6. 1. Department of Surgery, Duke University Medical Center, Department of Surgery, Geisinger Medical Center, United States. 2. Department of Biostatistics & Bioinformatics, Duke University Medical Center, United States. 3. Division of Gastroenterology, Department of Medicine, Duke University Medical Center, United States. 4. Department of Surgery, Duke University Medical Center, United States. 5. Division of Advanced Oncologic and Gastrointestinal Surgery, Department of Surgery, Duke University Medical Center, United States. 6. Division of Advanced Oncologic and Gastrointestinal Surgery, Department of Surgery, Duke University Medical Center, United States. Electronic address: sabino.zani@duke.edu.
Abstract
BACKGROUND: Approximately 38% of patients with colorectal cancer will develop isolated liver metastases. Sidedness of colon tumor is identified in non-metastatic and unresected metastatic cancers as predictive of survival, yet its dedicated analysis in resected liver metastases is minimal. Our primary aim was to assess whether left-sided primary tumors improve prognosis in stage IV cancer patients undergoing curative-intent liver metastasectomy; it was hypothesized that it would. METHODS: This is a retrospective, observational cohort study from 1996 to 2016 in a single tertiary-care facility. Survival from diagnosis was calculated via Kaplan-Meier method and compared between the right and left sides via log-rank analysis. RESULTS: Median survival differs significantly between colorectal tumors of the right and left origins after hepatic metastasectomy in 612 patients. In patients with right-sided tumors, median survival from diagnosis was 4.5 years (IQR 4.1-5.3), and 6.3 years (IQR 5.6-6.9) in those with left tumors (HR 1.5, 95% CI 1.38-1.60, p < 0.001). CONCLUSION: As in studies on earlier-stage or unresected metastatic disease, tumor sidedness is an important prognostic factor in patient survival with liver metastasectomy. Clinical risk scores should include side of primary tumor. Further work is needed to determine the molecular basis for this difference.
BACKGROUND: Approximately 38% of patients with colorectal cancer will develop isolated liver metastases. Sidedness of colon tumor is identified in non-metastatic and unresected metastatic cancers as predictive of survival, yet its dedicated analysis in resected liver metastases is minimal. Our primary aim was to assess whether left-sided primary tumors improve prognosis in stage IV cancerpatients undergoing curative-intent liver metastasectomy; it was hypothesized that it would. METHODS: This is a retrospective, observational cohort study from 1996 to 2016 in a single tertiary-care facility. Survival from diagnosis was calculated via Kaplan-Meier method and compared between the right and left sides via log-rank analysis. RESULTS: Median survival differs significantly between colorectal tumors of the right and left origins after hepatic metastasectomy in 612 patients. In patients with right-sided tumors, median survival from diagnosis was 4.5 years (IQR 4.1-5.3), and 6.3 years (IQR 5.6-6.9) in those with left tumors (HR 1.5, 95% CI 1.38-1.60, p < 0.001). CONCLUSION: As in studies on earlier-stage or unresected metastatic disease, tumor sidedness is an important prognostic factor in patient survival with liver metastasectomy. Clinical risk scores should include side of primary tumor. Further work is needed to determine the molecular basis for this difference.
Authors: James S Tomlinson; William R Jarnagin; Ronald P DeMatteo; Yuman Fong; Peter Kornprat; Mithat Gonen; Nancy Kemeny; Murray F Brennan; Leslie H Blumgart; Michael D'Angelica Journal: J Clin Oncol Date: 2007-10-10 Impact factor: 44.544
Authors: Sophia C Kamran; Jeffrey W Clark; Hui Zheng; Darrell R Borger; Lawrence S Blaszkowsky; Jill N Allen; Eunice L Kwak; Jennifer Y Wo; Aparna R Parikh; Ryan D Nipp; Janet E Murphy; Lipika Goyal; Andrew X Zhu; A John Iafrate; Ryan B Corcoran; David P Ryan; Theodore S Hong Journal: Cancer Med Date: 2018-05-17 Impact factor: 4.452