The impact of primary tumor location in patients with metastatic colorectal cancer: a Korean Cancer Study Group CO12-04 study
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: Colorectal cancer is associated with different anatomical, biological, and clinical characteristics. We determined the impact of the primary tumor location in patients with metastatic colorectal cancer (mCRC). Methods: Demographic data and clinical information were collected from 1,115 patients from the Republic of Korea, who presented with mCRC between January 2009 and December 2011, using web-based electronic case report forms. Associations between the primary tumor location and the patient’s clinical characteristics were assessed, and factors inf luencing overall survival were analyzed using Cox proportional hazards regression models. Results: Of the 1,115 patients recruited to the study, 244 (21.9%) had right colon cancer, 483 (43.3%) had left colon cancer, and 388 (34.8%) had rectal cancer. Liver and lung metastases occurred more frequently in patients with left colon and rectal cancer (p = 0.005 and p = 0.006, respectively), while peritoneal and ovarian metastases occurred more frequently in patients with right and left colon cancer (p < 0.001 and p = 0.031, respectively). The median overall survival of patients with tumors originating in the right colon was significantly shorter than that of patients whose tumors had originated in the left colon or rectum (13.7 months [95% confidence interval (CI), 12.0 to 15.5] vs. 18.0 months [95% CI, 16.3 to 19.7] or 19.9 months [95% CI, 18.5 to 21.3], respectively; p = 0.003). Tumor resection, the number of metastatic sites, and primary tumor location correlated with overall survival in the univariate and multivariate analyses. Conclusions: Primary tumor location influences the metastatic sites and prognosis of patients with mCRC.
Abstract
Background/Aims: Colorectal cancer is associated with different anatomical, biological, and clinical characteristics. We determined the impact of the primary tumor location in patients with metastatic colorectal cancer (mCRC). Methods: Demographic data and clinical information were collected from 1,115 patients from the Republic of Korea, who presented with mCRC between January 2009 and December 2011, using web-based electronic case report forms. Associations between the primary tumor location and the patient’s clinical characteristics were assessed, and factors inf luencing overall survival were analyzed using Cox proportional hazards regression models. Results: Of the 1,115 patients recruited to the study, 244 (21.9%) had right colon cancer, 483 (43.3%) had left colon cancer, and 388 (34.8%) had rectal cancer. Liver and lung metastases occurred more frequently in patients with left colon and rectal cancer (p = 0.005 and p = 0.006, respectively), while peritoneal and ovarian metastases occurred more frequently in patients with right and left colon cancer (p < 0.001 and p = 0.031, respectively). The median overall survival of patients with tumors originating in the right colon was significantly shorter than that of patients whose tumors had originated in the left colon or rectum (13.7 months [95% confidence interval (CI), 12.0 to 15.5] vs. 18.0 months [95% CI, 16.3 to 19.7] or 19.9 months [95% CI, 18.5 to 21.3], respectively; p = 0.003). Tumor resection, the number of metastatic sites, and primary tumor location correlated with overall survival in the univariate and multivariate analyses. Conclusions: Primary tumor location influences the metastatic sites and prognosis of patients with mCRC.
참고문헌 (40)
- Torre LA, "Global cancer statistics, 2012", CA Cancer J Clin, 65, pp.87~108 (2015)
- 정규원, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2012", Cancer Research and Treatment, 47(2), pp.127~141 (2015), 대한암학회[DOI]
- Greystoke A, "How many diseases are colorectal cancer?", Gastroenterol Res Pract, 2012, pp.564741~ (2012)
- Bertario L, "Survival of patients with hereditary colorectal cancer : comparison of HNPCC and colorectal cancer in FAP patients with sporadic colorectal cancer", Int J Cancer, 80, pp.183~187 (1999)
- Pino MS, "The chromosomal instability pathway in colon cancer", Gastroenterology, 138, pp.2059~2072 (2010)
- Markowitz SD, "Molecular origins of cancer : molecular basis of colorectal cancer", N Engl J Med, 361, pp.2449~2460 (2009)
- Sauer R, "Preoperative versus postoperative chemoradiotherapy for rectal cancer", N Engl J Med, 351, pp.1731~1740 (2004)
- Tournigand C, "FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer : a randomized GERCOR study", J Clin Oncol, 22, pp.229~237 (2004)
- Hurwitz H, "Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer", N Engl J Med, 350, pp.2335~2342 (2004)
- Saltz LB, "Bevacizumab in combination with oxaliplatin-based chemotherapy as first-line therapy in metastatic colorectal cancer : a randomized phase III study", J Clin Oncol, 26, pp.2013~2019 (2008)
- Van Cutsem E, "Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer", N Engl J Med, 360, pp.1408~1417 (2009)
- Douillard JY, "Panitumumab-FOLFOX4 treatment and RAS mutations in colorectal cancer", N Engl J Med, 369, pp.1023~1034 (2013)
- Augestad KM, "Metastatic spread pattern after curative colorectal cancer surgery : a retrospective, longitudinal analysis", Cancer Epidemiol, 39, pp.734~744 (2015)
- Amri R, "Variations in metastasis site by primary location in colon cancer", J Gastrointest Surg, 19, pp.1522~1527 (2015)
- Riihimaki M, "Patterns of metastasis in colon and rectal cancer", Sci Rep, 6, pp.29765~ (2016)
- Hugen N, "Metastatic pattern in colorectal cancer is strongly influenced by histological subtype", Ann Oncol, 25, pp.651~657 (2014)
- Sun C, "Association of CD98, integrin β1, integrin β3 and Fak with the progression and liver metastases of colorectal cancer", Pathol Res Pract, 210, pp.668~674 (2014)
- Li FY, "Colorectal cancer, one entity or three", J Zhejiang Univ Sci B, 10, pp.219~229 (2009)
- Meguid RA, "Is there a difference in survival between right- versus leftsided colon cancers?", Ann Surg Oncol, 15, pp.2388~2394 (2008)
- Benedix F, "Comparison of 17, 641patients with right-and left-sided colon cancer : differences in epidemiology, perioperative course, histology, and survival", Dis Colon Rectum, 53, pp.57~64 (2010)
- Weiss JM, "Mortality by stage for right-versus left-sided colon cancer : analysis of surveillance, epidemiology, and end results : medicare data", J Clin Oncol, 29, pp.4401~4409 (2011)
- Boisen MK, "Primary tumor location and bevacizumab effectiveness in patients with metastatic colorectal cancer", Ann Oncol, 24, pp.2554~2559 (2013)
- Loupakis F, "Primary tumor location as a prognostic factor in metastatic colorectal cancer", J Natl Cancer Inst, 107 (2015)
- von Einem JC, "Left-sided primary tumors are associated with favorable prognosis in patients with KRAS codon 12", 13 wild-type metastatic colorectal cancer treated with cetuximab plus chemotherapy : an analysis of the AIO KRK-0104 trial, 2014, pp.140, 1607~1614
- Wang F, "Right-sided colon cancer and left-sided colorectal cancers respond differently to cetuximab", Chin J Cancer, 34, pp.384~393 (2015)
- Brule SY, "Location of colon cancer (right-sided versus left-sided) as a prognostic factor and a predictor of benefit from cetuximab in NCIC CO.17", Eur J Cancer, 51, pp.1405~1414 (2015)
- Cancer Genome Atlas Network, "Comprehensive molecular characterization of human colon and rectal cancer", Nature, 487, pp.330~337 (2012)
- Fearon ER, "Molecular genetics of colorectal cancer", Annu Rev Pathol, 6, pp.479~507 (2011)
- Yamauchi M, "Assessment of colorectal cancer molecular features along bowel subsites challenges the conception of distinct dichotomy of proximal versus distal colorectum", Gut, 61, pp.847~854 (2012)
- Bae JM, "Molecular subtypes of colorectal cancer and their clinicopathologic features, with an emphasis on the serrated neoplasia pathway", Arch Pathol Lab Med, 140, pp.406~412 (2016)
- Shia J, "Morphological characterization of colorectal cancers in The Cancer Genome Atlas reveals distinct morphology-molecular associations : clinical and biological implications", Mod Pathol, 30, pp.599~609 (2017)
- Fearon ER, "A genetic model for colorectal tumorigenesis", Cell, 61, pp.759~767 (1990)
- Young J, "Features of colorectal cancers with high-level microsatellite instability occurring in familial and sporadic settings : parallel pathways of tumorigenesis", Am J Pathol, 159, pp.2107~2116 (2001)
- Ang PW, "Comprehensive profiling of DNA methylation in colorectal cancer reveals subgroups with distinct clinicopathological and molecular features", BMC Cancer, 10, pp.227~ (2010)
- Popat S, "Systematic review of microsatellite instability and colorectal cancer prognosis", J Clin Oncol, 23, pp.609~618 (2005)
- Ogino S, "CpG island methylator phenotype, microsatellite instability, BRAF mutation and clinical outcome in colon cancer", Gut, 58, pp.90~96 (2009)
- Popovici V, "Identification of a poor-prognosis BRAF-mutant-like population of patients with colon cancer", J Clin Oncol, 30, pp.1288~1295 (2012)
- Schmoll HJ, "ESMO Consensus guidelines for management of patients with colon and rectal cancer : a personalized approach to clinical decision making", Ann Oncol, 23, pp.2479~2516 (2012)
- Park JH, "The beneficial effect of palliative resection in metastatic colorectal cancer", Br J Cancer, 108, pp.1425~1431 (2013)
- Gulack BC, "Surgical resection of the primary tumor in stage IV colorectal cancer without metastasectomy is associated with improved overall survival compared with chemotherapy", radiation therapy alone, 2016, pp.59, 299~305