The impact of primary tumor location on long-term survival in patients undergoing hepatic resection for metastatic colon cancer Journal Article
| Authors: | Creasy, J. M.; Sadot, E.; Koerkamp, B. G.; Chou, J. F.; Gonen, M.; Kemeny, N. E.; Saltz, L. B.; Balachandran, V. P.; Kingham, T. P.; DeMatteo, R. P.; Allen, P. J.; Jarnagin, W. R.; D’Angelica, M. I. |
| Article Title: | The impact of primary tumor location on long-term survival in patients undergoing hepatic resection for metastatic colon cancer |
| Abstract: | Background: The impact of primary tumor location on overall survival (OS), recurrence-free survival (RFS), and long-term outcomes has not been well established in patients undergoing potentially curative resection of colorectal liver metastases (CRLM). Methods: A single-institution database was queried for initial resections for CRLM 1992–2004. Primary tumor location determined by chart review (right = cecum to transverse; left = splenic flexure to sigmoid). Rectal cancer (distal 16 cm), multiple primaries, and unknown location were excluded. Kaplan–Meier and Cox regression methods were used. Cure was defined as actual 10-year survival with either no recurrence or resected recurrence with at least 3 years of disease-free follow-up. Results: A total of 907 patients were included with a median follow-up of 11 years; 578 patients (64%) had left-sided and 329 (36%) right-sided primaries. Median OS for patients with a left-sided primary was 5.2 years (95% confidence interval [CI] 4.6–6.0) versus 3.6 years (95% CI 3.2–4.2) for right-sided (p = 0.004). On multivariable analysis, the hazard ratio for right-sided tumors was 1.22 (95% CI 1.02–1.45, p = 0.028) after adjusting for common clinicopathologic factors. Median RFS was marginally different stratified by primary location (1.3 vs. 1.7 years; p = 0.065). On multivariable analysis, location of primary was not significantly associated with RFS (p = 0.105). Observed cure rates were 22% for left-sided and 20% for right-sided tumors. Conclusions: Among patients undergoing resection of CRLM, left-sided primary tumors were associated with improved median OS. However, long-term survival and recurrence-free survival were not significantly different stratified by primary location. Patients with left-sided primary tumors displayed a prolonged clinical course suggestive of more indolent biology. © 2017, Society of Surgical Oncology. |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 25 |
| Issue: | 2 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2018-02-01 |
| Start Page: | 431 |
| End Page: | 438 |
| Language: | English |
| DOI: | 10.1245/s10434-017-6264-x |
| PROVIDER: | scopus |
| PUBMED: | 29181680 |
| PMCID: | PMC7480216 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 6 February 2018 -- Source: Scopus |
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