X-Y Wang1,2, R Zhang1,2, Z Wang1,2, Y Geng1,2, J Lin1,2, K Ma1,2, J-L Zuo1,2, L Lu1,2, J-B Zhang3, W-W Zhu1,2, J-H Chen1,2. 1. Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China. 2. Institutes of Cancer Metastasis, Fudan University, Shanghai, China. 3. Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
Abstract
BACKGROUND: Primary tumour location is emerging as an important prognostic factor in localized and metastatic colorectal cancers. However, its prognostic role in colorectal liver metastasis (CRLM) after hepatectomy remains controversial. A systematic review and meta-analysis was undertaken to evaluate its prognostic value. METHODS: References were identified through searches of PubMed, Embase, Web of Science and the Cochrane Library comparing overall or disease-free survival after hepatic resection between patients with CRLM originating from right- or left-sided colorectal cancers. Data were pooled using hazard ratios (HRs) and 95 per cent confidence intervals according to a random-effects model. Meta-regression and subgroup analyses were conducted to assess the effect of underlying confounding factors on HR estimates and to adjust for this. RESULTS: The final analysis included 21 953 patients from 45 study cohorts. Compared with left-sided primary tumour location, right-sided location was associated with worse overall survival (HR 1·39, 95 per cent c.i. 1·28 to 1·51; P < 0·001; prediction interval 1·00 to 1·93), and also tended to have a negative impact on disease-free survival (HR 1·18, 1·06 to 1·32; P = 0·004; prediction interval 0·79 to 1·75). Subgroup analysis showed that the negative effect of right-sided primary tumour location on overall survival was more prominent in the non-Asian population (HR 1·47, 1·33 to 1·62) than the Asian population (HR 1·18, 1·05 to 1·32) (P for interaction <0·01). CONCLUSION: This study demonstrated a prognostic role for primary tumour location in patients with CRLM receiving hepatectomy, especially regarding overall survival. Adding primary tumour location may provide important optimization of prognosis prediction models for CRLM in current use.
BACKGROUND: Primary tumour location is emerging as an important prognostic factor in localized and metastatic colorectal cancers. However, its prognostic role in colorectal liver metastasis (CRLM) after hepatectomy remains controversial. A systematic review and meta-analysis was undertaken to evaluate its prognostic value. METHODS: References were identified through searches of PubMed, Embase, Web of Science and the Cochrane Library comparing overall or disease-free survival after hepatic resection between patients with CRLM originating from right- or left-sided colorectal cancers. Data were pooled using hazard ratios (HRs) and 95 per cent confidence intervals according to a random-effects model. Meta-regression and subgroup analyses were conducted to assess the effect of underlying confounding factors on HR estimates and to adjust for this. RESULTS: The final analysis included 21 953 patients from 45 study cohorts. Compared with left-sided primary tumour location, right-sided location was associated with worse overall survival (HR 1·39, 95 per cent c.i. 1·28 to 1·51; P < 0·001; prediction interval 1·00 to 1·93), and also tended to have a negative impact on disease-free survival (HR 1·18, 1·06 to 1·32; P = 0·004; prediction interval 0·79 to 1·75). Subgroup analysis showed that the negative effect of right-sided primary tumour location on overall survival was more prominent in the non-Asian population (HR 1·47, 1·33 to 1·62) than the Asian population (HR 1·18, 1·05 to 1·32) (P for interaction <0·01). CONCLUSION: This study demonstrated a prognostic role for primary tumour location in patients with CRLM receiving hepatectomy, especially regarding overall survival. Adding primary tumour location may provide important optimization of prognosis prediction models for CRLM in current use.
Authors: Stefan Sponholz; Selma Oguzhan; Mesut Mese; Moritz Schirren; Andreas Kirschbaum; Joachim Schirren Journal: Int J Colorectal Dis Date: 2021-03-12 Impact factor: 2.571
Authors: Renato Gomes Campanati; João Bernardo Sancio; Lucas Mauro de Andrade Sucena; Marcelo Dias Sanches; Vivian Resende Journal: Arq Bras Cir Dig Date: 2021-06-11
Authors: Nadine L de Boer; Koen Rovers; Jacobus W A Burger; Eva V E Madsen; Alexandra R M Brandt-Kerkhof; Niels F M Kok; Johannes H W de Wilt; Philip H de Reuver; Amanda Bos; Ignace H J T de Hingh; Cornelis Verhoef Journal: Cancer Med Date: 2020-07-02 Impact factor: 4.452