SCOT：肿瘤侧别与辅助化疗持续时间对无病生存（DFS）的影响。

SCOT: Tumor Sidedness and the Influence of Adjuvant Chemotherapy Duration on Disease Free Survival (DFS).

机构信息

The Christie, Manchester, United Kingdom.

出版信息

Clin Colorectal Cancer. 2023 Jun;22(2):231-237. doi: 10.1016/j.clcc.2023.02.005. Epub 2023 Feb 22.

DOI:10.1016/j.clcc.2023.02.005

PMID:36967267

Abstract

AIM

Patients with loco-regional right-sided colorectal tumors have a worse overall survival (OS). Here we investigate the difference in disease free survival (DFS) between colorectal patients with right and left sided tumors in the SCOT study.

METHODS

The SCOT study showed 3-months of oxaliplatin-containing adjuvant chemotherapy (OxFp) is non-inferior to 6-months for patients with stage III and high-risk stage II colorectal cancer. We divided the cohort into patients with left and right sided tumors, and evaluated the effect on DFS and the principle 3 versus 6-months analysis.

RESULTS

6088 patients with Stage III/high risk Stage II colorectal cancers were randomized between 27 March 2008 and 29 November 2013 from 244 centers internationally. In February 2017 (3-years FU) information on sidedness was available for 3309 patients (1238 R-sided, 2071 L-sided). Patients with right-sided tumors had a significantly worse DFS (3-year DFS right: 73.3% (se = 1.3%), left: 80.2% (se = 0.9%) HR 1.423 (95% CI 1.237-1.637; P < .0001). Adjusting for T and N-stage reduced the HR to 1.230 (95% CI 1.066-1.420, P = .005). The data did not suggest that sidedness affected the impact of chemotherapy duration on 3-year DFS (R: HR 1.024 [0.831-1.261], L: HR 0.944 [0.783-1.139]). Test for heterogeneity, P = .571. Further sub-set analysis was limited due to cohort size.

CONCLUSIONS

This is the first study to show that unselected patients with right-sided tumors had a worse DFS compared to left-sided tumors. Tumor sidedness did not impact upon the 3-months versus 6-months comparison in SCOT.

摘要

目的

局部右侧结直肠癌患者的总体生存率（OS）较差。在这里，我们在 SCOT 研究中研究了右侧和左侧结直肠肿瘤患者无病生存率（DFS）的差异。

方法

SCOT 研究表明，对于 III 期和高危 II 期结直肠癌患者，3 个月奥沙利铂联合辅助化疗（OxFp）与 6 个月奥沙利铂联合辅助化疗（OxFp）相比非劣效。我们将队列分为左侧和右侧肿瘤患者，并评估了 DFS 的影响和主要的 3 个月与 6 个月分析。

结果

2008 年 3 月 27 日至 2013 年 11 月 29 日，来自 244 个国际中心的 6088 例 III 期/高危 II 期结直肠癌患者被随机分组。2017 年 2 月（3 年 FU）时，有 3309 例患者（右侧 1238 例，左侧 2071 例）的侧位信息可用。右侧肿瘤患者的 DFS 明显较差（3 年 DFS 右侧：73.3%（se=1.3%），左侧：80.2%（se=0.9%）HR 1.423（95%CI 1.237-1.637；P<.0001）。调整 T 和 N 期后，HR 降至 1.230（95%CI 1.066-1.420，P=0.005）。数据表明，侧位与化疗持续时间对 3 年 DFS 的影响无关（右侧：HR 1.024[0.831-1.261]，左侧：HR 0.944[0.783-1.139]）。异质性检验，P=0.571。由于队列规模较小，进一步的亚组分析受到限制。