Sasaki Kazunari, Andreatos Nikolaos, Margonis Georgios A, He Jin, Weiss Matthew, Johnston Fabian, Wolfgang Christopher, Antoniou Efstathios, Pikoulis Emmanouil, Pawlik Timothy M
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Second, Department of Propaedeutic Surgery, Laiko Hospital, University of Athens, Athens, Greece.
J Surg Oncol. 2016 Dec;114(7):803-809. doi: 10.1002/jso.24425.
The prognostic impact of primary colorectal cancer (CRC) location following resection of colorectal liver metastasis (CRLM) remains largely unknown. We sought to characterize the prognostic implications of primary tumor location among patients who underwent curative-intent hepatectomy for CRLM.
Tumors of the cecum, ascending, and transverse colon were defined as right-sided; tumors of the sigmoid flexure, descending, and sigmoid colon were defined as left-sided. Clinicopathologic and long-term survival data were collected and assessed using univariable and multivariable analyses.
About 475 patients who underwent CRLM resection at a single institution were included; most patients had left-sided tumors (n = 284). Median and 5-year RFS was 20.2 months and 28.0%, respectively. Patients who had a left-sided primary tumor had a shorter RFS compared with patients who had a right-sided tumor (P = 0.01). Although site of and time to recurrence did not differ between the two groups (P > 0.05), patients with right-sided primary tumors were more likely to recur with advanced disease (i.e., ≥4 recurrent lesions) (P < 0.01). In turn, patients with right-sided tumors had both worse OS (P = 0.03) and worse survival after recurrence (P = 0.01).
While patients with right-sided tumors experienced longer RFS, when these patients did recur following CRLM resection, disease extent was more advanced. In turn, OS following recurrence was shorter among patients with right-sided CRC. J. Surg. Oncol. 2016;114:803-809. © 2016 2016 Wiley Periodicals, Inc.
结直肠肝转移（CRLM）切除术后，原发性结直肠癌（CRC）的位置对预后的影响在很大程度上仍不清楚。我们试图明确在接受根治性肝切除术治疗CRLM的患者中，原发性肿瘤位置的预后意义。
将盲肠、升结肠和横结肠的肿瘤定义为右侧肿瘤；将乙状结肠弯曲部、降结肠和乙状结肠的肿瘤定义为左侧肿瘤。收集临床病理和长期生存数据，并采用单变量和多变量分析进行评估。
纳入了在单一机构接受CRLM切除术的约475例患者；大多数患者患有左侧肿瘤（n = 284）。中位无复发生存期（RFS）和5年RFS分别为20.2个月和28.0%。与患有右侧肿瘤的患者相比，患有左侧原发性肿瘤的患者RFS较短（P = 0.01）。尽管两组之间复发部位和复发时间无差异（P>0.05），但右侧原发性肿瘤患者更有可能出现晚期复发疾病（即≥4个复发病灶）（P<0.01）。相应地，右侧肿瘤患者的总生存期（OS）较差（P = 0.03），复发后的生存率也较差（P = 0.01）。
虽然右侧肿瘤患者的RFS较长，但在CRLM切除术后这些患者复发时，疾病范围更广泛。相应地，右侧CRC患者复发后的OS较短。《外科肿瘤学杂志》2016年；114:803 - 809。©2016 2016威利期刊公司
