Araujo Camila S, Venchiarutti Moniz Camila M, Bonadio Renata C, Watarai Gabriel Y, Rojas Jéssica, Nogueira Pedro V S, Martinez Jéssica K, Moraes Priscila M G, Braghiroli Maria I, Sabbaga Jorge, Hoff Paulo M
Department of Oncology, ICESP - Instituto do Cancer do Estado de São Paulo, University of São Paulo, São Paulo, Brazil.
Department of Oncology, ICESP - Instituto do Cancer do Estado de São Paulo, University of São Paulo, São Paulo, Brazil; IDOR -Instituto D'Or de Pesquisa e Ensino, São Paulo, Brazil.
Clin Colorectal Cancer. 2021 Jun;20(2):e100-e108. doi: 10.1016/j.clcc.2020.09.009. Epub 2020 Oct 20.
The impact of sidedness in the high-risk stage II colorectal cancer (CRC) setting is uncertain. Although controversial, available data suggest a possible modest benefit of adjuvant chemotherapy (CT) in the adjuvant scenario. The aim of this study is to analyze the overall survival (OS) and recurrence-free survival (RFS) according to the tumor side.
In this single-center retrospective cohort, we analyzed patients treated between January 2011 and December 2018. We evaluated OS and RFS of high-risk patients according to the tumor side and considering adjuvant CT exposure and clinical and molecular features.
A total of 1047 patients with stage II CRC were evaluated. Of these, 540 had high-risk criteria and microsatellite stability (MSS) or unknown status. One hundred fifty-seven (29%) patients had right-sided tumors, and 352 (65.2%) had left-sided tumors. Most patients received adjuvant CT, and the majority of them had T3 stage tumors, ≥ 12 lymph node resection, left tumor, MSS, and moderate differentiation. OS did not differ according to tumor side (5-year OS rates: 81.9% for right-sided tumors vs. 83% for left-sided tumors; hazard ratio, 0.91; 95% confidence interval, 0.55-1.53; P = .744). Adjuvant CT was associated with a superior RFS and OS, with 5-year OS rates of 87.7% versus 76.1% in the no-adjuvant group (hazard ratio, 0.46; 95% CI, 0.28-0.73; P = .001).
The tumor side did not influence the outcomes in this study. Adjuvant CT was associated with improved RFS and OS in patients with high-risk stage II CRC, with a total gain of 11.6% in 5-year OS.
在高危II期结直肠癌（CRC）患者中，肿瘤位于左侧或右侧对预后的影响尚不确定。尽管存在争议，但现有数据表明辅助化疗（CT）在辅助治疗中可能有一定益处。本研究旨在分析根据肿瘤位置的总生存期（OS）和无复发生存期（RFS）。
在这项单中心回顾性队列研究中，我们分析了2011年1月至2018年12月期间接受治疗的患者。我们根据肿瘤位置、辅助CT暴露情况以及临床和分子特征评估了高危患者的OS和RFS。
共评估了1047例II期CRC患者。其中，540例符合高危标准且微卫星稳定（MSS）或状态未知。157例（29%）患者肿瘤位于右侧，352例（65.2%）患者肿瘤位于左侧。大多数患者接受了辅助CT，其中大多数患者肿瘤为T3期、淋巴结清扫≥12枚、肿瘤位于左侧、MSS且分化程度中等。OS在肿瘤位于左侧或右侧的患者中无差异（5年OS率：右侧肿瘤患者为81.9%，左侧肿瘤患者为83%；风险比，0.91；95%置信区间，0.55 - 1.53；P = 0.744）。辅助CT与更好的RFS和OS相关，无辅助治疗组的5年OS率为76.1%，辅助治疗组为87.7%（风险比，0.46；95% CI，0.28 - 0.73；P = 0.001）。
在本研究中，肿瘤位置不影响预后。辅助CT与高危II期CRC患者的RFS和OS改善相关，5年OS总体提高了11.6%。
