Cristian D Valenzuela1, Omeed Moaven2, Rohin Gawdi1, John A Stauffer3, Nico R Del Piccolo3, Tan To Cheung4, Carlos U Corvera5, Andrew D Wisneski5, Charles Cha6, Christopher W Mangieri1, Nima P Zarandi1, Justin Dourado1, Kathleen C Perry1, Gregory Russell7, Perry Shen8. 1. Department of Surgical Oncology, Comprehensive Cancer Center, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA. 2. Department of Surgical Oncology, Comprehensive Cancer Center, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA; Department of Surgical Oncology, Mayo Clinic in Florida, Jacksonville, FL, USA. 3. Department of Surgical Oncology, Mayo Clinic in Florida, Jacksonville, FL, USA. 4. Department of Surgery, University of Hong Kong, Hong Kong, China. 5. Department of Hepatobiliary & Pancreatic Surgery, University of California San Francisco, San Francisco, CA, USA. 6. Department of Surgery, Yale School of Medicine, New Haven, CT, USA. 7. Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA. 8. Department of Surgical Oncology, Comprehensive Cancer Center, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA. Electronic address: pshen@wakehealth.edu.
Abstract
BACKGROUND: Primary laterality of colorectal cancer is thought to be associated with differences in outcomes. Liver metastasis is the most common site of solitary colorectal cancer spread. However, how primary colorectal cancer laterality affects outcomes in colorectal liver metastasis remains unclear. METHODS: The Colorectal Liver Operative Metastasis International Collaborative (COLOMIC) of operative hepatectomy cases for colorectal liver metastasis was compiled from five participating institutions. This included consecutive cases from 2000 to 2018 at all sites. A total of 884 patients were included in this study. Univariate, multivariate, and Kaplan-Meier analyses were performed. RESULTS: Patients with left-sided versus right-sided cancers had significantly better overall survival: 49.4 vs. 41.8 months (p < 0.05). Patients with KRAS mutations had significantly worse median overall survival compared to KRAS wild-type (43.6 vs 56.1 months; p < 0.001). In left-sided cancers, KRAS mutations were associated with significantly worse median overall survival compared to KRAS wild-type cancers (43.6 vs 56.6 months; p < 0.01). This association was absent in patients with right-sided primary tumors. Multivariate Cox regression analysis revealed different variable sets (non-overlapping) were associated with overall survival, when comparing left-sided and right-sided cancers. CONCLUSION: Understanding how primary tumor laterality and related biological aspects affect long-term outcomes can potentially inform treatment decisions for patients with colorectal liver metastases.
BACKGROUND: Primary laterality of colorectal cancer is thought to be associated with differences in outcomes. Liver metastasis is the most common site of solitary colorectal cancer spread. However, how primary colorectal cancer laterality affects outcomes in colorectal liver metastasis remains unclear. METHODS: The Colorectal Liver Operative Metastasis International Collaborative (COLOMIC) of operative hepatectomy cases for colorectal liver metastasis was compiled from five participating institutions. This included consecutive cases from 2000 to 2018 at all sites. A total of 884 patients were included in this study. Univariate, multivariate, and Kaplan-Meier analyses were performed. RESULTS: Patients with left-sided versus right-sided cancers had significantly better overall survival: 49.4 vs. 41.8 months (p < 0.05). Patients with KRAS mutations had significantly worse median overall survival compared to KRAS wild-type (43.6 vs 56.1 months; p < 0.001). In left-sided cancers, KRAS mutations were associated with significantly worse median overall survival compared to KRAS wild-type cancers (43.6 vs 56.6 months; p < 0.01). This association was absent in patients with right-sided primary tumors. Multivariate Cox regression analysis revealed different variable sets (non-overlapping) were associated with overall survival, when comparing left-sided and right-sided cancers. CONCLUSION: Understanding how primary tumor laterality and related biological aspects affect long-term outcomes can potentially inform treatment decisions for patients with colorectal liver metastases.
Authors: Aurélien Dupré; Hassan Z Malik; Robert P Jones; Rafael Diaz-Nieto; Stephen W Fenwick; Graeme J Poston Journal: Eur J Surg Oncol Date: 2017-11-21 Impact factor: 4.424
Authors: Márcio C Marques; Héber S C Ribeiro; Wílson L Costa; Victor Hugo F de Jesus; Mariana P de Macedo; Alessandro L Diniz; André L Godoy; Igor C Farias; Samuel Aguiar; Rachel S P Riechelmann; Maria Dirlei F S Begnami; Felipe J F Coimbra Journal: J Surg Oncol Date: 2018-04-02 Impact factor: 3.454
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Authors: J C von Einem; V Heinemann; L Fischer von Weikersthal; U Vehling-Kaiser; M Stauch; H G Hass; T Decker; S Klein; S Held; A Jung; T Kirchner; M Haas; J Holch; M Michl; P Aubele; S Boeck; C Schulz; C Giessen; S Stintzing; D P Modest Journal: J Cancer Res Clin Oncol Date: 2014-05-10 Impact factor: 4.553