Mahamid Ahmad, Abu-Zaydeh Omar, Kazlow Esther, Froylich Dvir, Sawaied Muneer, Goldberg Natalia, Berger Yael, Khoury Wissam, Sadot Eran, Haddad Riad
Department of Surgery, Carmel Medical Center, Haifa 3436212, Israel.
The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3200003, Israel.
J Clin Med. 2023 Aug 11;12(16):5242. doi: 10.3390/jcm12165242.
(1) Background: There is an abundance of literature available on predictors of survival for patients with colorectal liver metastases (CRLM) but minimal information available on the relationship between the primary tumor location and CRLM survival. The studies that focus on the primary tumor location and CRLM survival exhibit a great deal of controversy and inconsistency with regard to their results (some studies show statistically significant connections between the primary tumor location and prognosis versus other studies that find no significant relationship between these two factors). Furthermore, the majority of these studies have been conducted in the West and have studied more diverse and heterogenous populations, which may be a contributing factor to the conflicting results. (2) Methods: We included patients who underwent liver resection for CRLM between December 2004 and January 2019 at two university-affiliated medical centers in Israel: Carmel Medical Center (Haifa) and Rabin Medical Center (Petach Tikvah). Primary tumors located from the cecum up to and including the splenic flexure were labeled as right-sided primary tumors, whereas tumors located from the splenic flexure down to the anal verge were labeled as left-sided primary tumors. (3) Results: We identified a total of 501 patients. Of these patients, 225 had right-sided primary tumors and 276 had left-sided primary tumors. Patients with right-sided tumors were significantly older at the time of liver surgery compared to those with left-sided tumors (66.1 + 12.7 vs. 62 + 13.1, = 0.002). Patients with left-sided tumors had slightly better overall survival rates than those with right-sided tumors. However, the differences were not statistically significant (57 vs. 50 months, = 0.37 after liver surgery). (4) Conclusions: The primary tumor location does not significantly affect patient survival after liver resection for colorectal liver metastasis in the Mediterranean population.
(1) 背景：关于结直肠癌肝转移（CRLM）患者生存预测因素的文献丰富，但关于原发肿瘤位置与CRLM患者生存之间关系的信息却很少。关注原发肿瘤位置与CRLM患者生存的研究在结果方面存在大量争议和不一致（一些研究显示原发肿瘤位置与预后之间存在统计学上的显著关联，而其他研究则发现这两个因素之间没有显著关系）。此外，这些研究大多在西方进行，研究的人群更加多样化和异质性，这可能是导致结果相互矛盾的一个因素。(2) 方法：我们纳入了2004年12月至2019年1月期间在以色列两所大学附属医院（海法的卡梅尔医疗中心和佩塔提克瓦的拉宾医疗中心）接受CRLM肝切除术的患者。位于盲肠至脾曲（包括脾曲）的原发肿瘤被标记为右侧原发肿瘤，而位于脾曲至肛缘的肿瘤被标记为左侧原发肿瘤。(3) 结果：我们共确定了501例患者。其中，225例有右侧原发肿瘤，276例有左侧原发肿瘤。与左侧肿瘤患者相比，右侧肿瘤患者在肝手术时年龄显著更大（66.1±12.7岁对62±13.1岁，P = 0.002）。左侧肿瘤患者的总生存率略高于右侧肿瘤患者。然而，差异无统计学意义（肝手术后分别为57个月和50个月，P = 0.37）。(4) 结论：在地中海人群中，原发肿瘤位置对结直肠癌肝转移肝切除术后患者生存无显著影响。
