Right-sided CRC tied to poorer survival only in stage IV disease

  • Wang CB, et al.
  • Front Oncol
  • 19 Feb 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • Overall, patients with right-sided colorectal cancer (CRC) appear to have inferior survival vs those with left-sided cancer; however, stratified analysis reveals the survival difference applies only in patients with late-stage disease.

Why this matters

  • A growing body of evidence suggests a link between tumor location and OS in patients with CRC.

Study design

  • Study to investigate an association between right-sided and left-sided disease and survival outcomes in patients with CRC.
  • Data were sourced from the Mayo Clinic Colon and Rectal Cancer Registry pertaining to 26,908 patients with colon and rectal cancer. 
  • Funding: None disclosed.

Key results

  • 76.6 months median survival for right-sided tumors vs 93.0 for left-sided.
  • Median survival by tumor location:
    • 101.3 months for rectal cancers.
    • 87.5 months for left-sided cancers.
    • 76.6 months for right-sided cancers.
  • In a multivariate Cox regression analysis model:
    • No significant difference in overall mortality for left- vs right-sided disease in patients with early (stage I-III) disease: HR, 0.99; 95% CI, 0.93-1.04; P=.6443.
    • Significant difference in overall mortality for left- vs right-sided disease in patients with late-stage (stage IV) disease: HR, 0.73; 95% CI, 0.67-0.80; P<.001.>

Limitations

  • Retrospective data.
  • Study did not incorporate treatment-related variables.  

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