Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Hepatopancreatobiliary Surgery Department I, China.
Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Hepatopancreatobiliary Surgery Department I, China.
Eur J Surg Oncol. 2019 Aug;45(8):1349-1356. doi: 10.1016/j.ejso.2019.04.017. Epub 2019 Apr 25.
Location of the primary tumor side has become an increasingly prognostic factor for colorectal liver metastasis. The present study was to perform a meta-analysis to investigate if primary right-sided tumor impacted on long-term survival outcome of colorectal liver metastases following local treatment.
Eligible trials were identified from the Embase, PubMed, Web of Science and the Cochrane database that were published before October in 2018. English language trials that compared long-term survival outcome of primary left-sided tumor with right-sided tumor colorectal liver metastases following local treatment were included. Hepatic resection for colorectal liver metastases was investigated. The main study outcomes included overall survival and disease free survival of primary right-sided colorectal liver metastases following local treatment. The risk factors of largest tumor size, primary node metastases, multiple tumor and RAS mutation were also analyzed. A systematic review and meta-analysis was done using a fixed-effects model. Hazard ratio with a 95% confidence interval was used to measure the pooled effect.
A total of twelve studies with 6387 patients were included. For primary right-sided colorectal liver metastases patients following hepatic resection, the overall pooled HR for 5-year overall survival rate was 1.354 (95% CI: 1.238-1.482; p = 0.000; I = 33.7%, p = 0.138). The pooled HR for 5-year disease free survival rate of primary right-sided CRLM in the included studies calculated using the fix-effects model was 1.104 (95% CI: 0.987-1.235; p = 0.084; I = 0%, p = 0.477).
It demonstrated that primary right-sided for colorectal liver metastases location was a significantly worse prognostic factor in terms of overall survival.
原发肿瘤侧别的位置已成为结直肠癌肝转移的一个越来越重要的预后因素。本研究旨在进行一项荟萃分析，以调查局部治疗后原发右侧肿瘤是否影响结直肠癌肝转移的长期生存结果。
从 Embase、PubMed、Web of Science 和 Cochrane 数据库中检索到 2018 年 10 月之前发表的符合条件的试验。纳入比较局部治疗后原发左侧肿瘤与右侧肿瘤结直肠癌肝转移的长期生存结果的英语语言试验。研究对象为接受肝切除术的结直肠癌肝转移患者。主要研究结果包括局部治疗后原发右侧结直肠癌肝转移患者的总生存和无病生存。还分析了最大肿瘤大小、原发淋巴结转移、多发肿瘤和 RAS 突变等危险因素。采用固定效应模型进行系统评价和荟萃分析。使用风险比（HR）及其 95%置信区间（CI）来衡量汇总效应。
共纳入 12 项研究，共计 6387 例患者。对于接受肝切除术的原发右侧结直肠癌肝转移患者，5 年总生存率的总体汇总 HR 为 1.354（95%CI：1.238-1.482；p=0.000；I=33.7%，p=0.138）。使用固定效应模型计算的纳入研究中 5 年无病生存率的汇总 HR 为 1.104（95%CI：0.987-1.235；p=0.084；I=0%，p=0.477）。
这表明原发右侧结直肠癌肝转移的位置在总体生存方面是一个显著较差的预后因素。
