Clinical impact of primary tumor location in patients with metastatic colorectal cancer (mCRC) treated with regorafenib or trifluridine/tipiracil as later-line.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 105-105
Author(s):  
Hiromichi Nakajima ◽  
Shota Fukuoka ◽  
Toshikazu Moriwaki ◽  
Toshiki Masuishi ◽  
Atsuo Takashima ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Prognostic Factor ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Primary Tumor ◽  
Univariate Analysis ◽  
Tumor Location ◽  
Primary Tumor Location ◽  
The Right ◽  
The Impact

105 Background: In the recent years, primary tumor location (PTL) is considered as an important prognostic and predictive factor in first-line treatment of mCRC. Although regorafenib (REG) and trifluridine/tipiracil (TFTD) have been available recently, the prognostic value of PTL in later-line with these agents is not well understood. TFTD improved survival regardless of PTL in the RECOURSE trial, while REG did not show survival benefit in the patients (pts) with rectal cancer in the CORRECT trial. Methods: We retrospectively evaluated pts with mCRC who were registered in a multicenter observational study (the REGOTAS study). The main inclusion criteria were ECOG PS of 0–2, refractory or intolerant to fluoropyrimidines, oxaliplatin, irinotecan, and anti-VEGF and anti-EGFR therapy (if KRAS wild type), and no prior use of REG and TFTD. The impact of PTL on overall survival (OS) were evaluated using Cox proportional hazards models based on baseline characteristics and propensity score matching. Results: A total of 550 pts (223 pts in the REG group, 327 pts in the TFTD group; 122 pts in the right-sided, 428 pts in the left-sided) were included in this study. Although the right-sided pts was significantly shorter OS compared with the left-sided pts by univariate analysis (hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.63-0.99, P = 0.04), multivariate analysis revealed that PTL was not an independent prognostic factor (HR 0.88, 95% CI 0.69-1.1, P = 0.26). The similar results were obtained in each treatment group. In subgroup analysis according to PTL, OS were comparable between REG and TFTD groups regardless of PTL (HR 0.93, 95% CI 0.62-1.39 in the right-sided; HR 1.08, 95% CI 0.83-1.39 in the left-sided [excluding rectum]; and HR 1.01, 95% CI 0.62-1.62 in the rectal cancer pts). These results were similar in sensitivity analysis using propensity score-matching. Conclusions: In the present study, PTL is not a prognostic factor in patient with mCRC treated with either REG or TFTD as later-line. No difference in OS was observed between REG and TFTD groups irrespective of PTL.

scholarly journals Clinical Impact of Primary Tumor Location in Metastatic Colorectal Cancer Patients Under Later-Line Regorafenib or Trifluridine/Tipiracil Treatment

2021 ◽  
Vol 11 ◽  
Author(s):  
Hiromichi Nakajima ◽  
Shota Fukuoka ◽  
Toshiki Masuishi ◽  
Atsuo Takashima ◽  
Yosuke Kumekawa ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Predictive Factor ◽  
Primary Tumor ◽  
Group Performance ◽  
Univariate Analysis ◽  
Tumor Location ◽  
Clinical Impact ◽  
Primary Tumor Location ◽  
The Impact

BackgroundPrimary tumor location (PTL) is an important prognostic and predictive factor in the first-line treatment of metastatic colorectal cancer (mCRC). Although regorafenib (REG) and trifluridine/tipiracil (FTD/TPI) have been introduced recently, the clinical impact of PTL in these treatments is not well understood.Materials and MethodsWe retrospectively evaluated patients with mCRC who were registered in a multicenter observational study (the REGOTAS study). The main inclusion criteria were Eastern Cooperative Oncology Group performance status (ECOG PS) of 0–2, refractory or intolerant to fluoropyrimidines, oxaliplatin, irinotecan, angiogenesis inhibitors, anti-epidermal growth factor receptor therapy (if RAS wild-type), and no prior use of REG and FTD/TPI. The impact of PTL on overall survival (OS) was evaluated using Cox proportional hazard models based on baseline characteristics.ResultsA total of 550 patients (223 patients in the REG group and 327 patients in the FTD/TPI group) were included in this study, with 122 patients with right-sided tumors and 428 patients with left-sided tumors. Although the right-sided patients had significantly shorter OS compared with the left-sided patients by univariate analysis (p = 0.041), a multivariate analysis revealed that PTL was not an independent prognostic factor (hazard ratio, 0.95; p = 0.64). In a subgroup analysis, the OS was comparable between the REG and FTD/TPI groups regardless of PTL (p for interactions = 0.60).ConclusionsIn the present study, PTL is not a prognostic and predictive factor in patients with mCRC under later-line REG or FTD/TPI therapy.

scholarly journals The Impact of Primary Tumor Location in Synchronous Metastatic Colorectal Cancer: Differences in Metastatic Sites and Survival

2019 ◽  
Vol 27 (5) ◽  
pp. 1580-1588 ◽  
Author(s):  
Nelleke P. M. Brouwer ◽  
Dave E. W. van der Kruijssen ◽  
Niek Hugen ◽  
Ignace H. J. T. de Hingh ◽  
Iris D. Nagtegaal ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Relative Survival ◽  
Tumor Location ◽  
Primary Tumor Location ◽  
Metastatic Sites ◽  
The Impact

Abstract Purpose We explored differences in survival between primary tumor locations, hereby focusing on the role of metastatic sites in synchronous metastatic colorectal cancer (mCRC). Methods Data for patients diagnosed with synchronous mCRC between 1989 and 2014 were retrieved from the Netherlands Cancer registry. Relative survival and relative excess risks (RER) were analyzed by primary tumor location (right colon (RCC), left colon (LCC), and rectum). Metastatic sites were reported per primary tumor location. Survival was analyzed for metastatic sites combined and for single metastatic sites. Results In total, 36,297 patients were included in this study. Metastatic sites differed significantly between primary tumor locations, with liver-only metastases in 43%, 54%, and 52% of RCC, LCC, and rectal cancer patients respectively (p < 0.001). Peritoneal metastases were most prevalent in RCC patients (33%), and lung metastases were most prevalent in rectal cancer patients (28%). Regardless of the location of metastases, patients with RCC had a worse survival compared with LCC (RER 0.81, 95% CI 0.78–0.83) and rectal cancer (RER 0.73, 95% CI 0.71–0.76). The survival disadvantage for RCC remained present, even in cases with metastasectomy for liver-only disease (LCC: RER 0.66, 95% CI 0.57–0.76; rectal cancer: RER 0.84, 95% CI 0.66–1.06). Conclusions This study showed significant differences in relative survival between primary tumor locations in synchronous mCRC, which can only be partially explained by distinct metastatic sites. Our findings support the concept that RCC, LCC and rectal cancer should be considered distinct entities in synchronous mCRC.

scholarly journals Primary tumor location affects recurrence-free survival for patients with colorectal liver metastases after hepatectomy: A propensity score matching analysis

2020 ◽  
Author(s):  
Yuanping Zhang ◽  
Yongjin Wang ◽  
Yichuan Yuan ◽  
Jiliang Qiu ◽  
Yuxiong Qiu ◽  
...  
Keyword(s):  
Propensity Score ◽  
Liver Metastases ◽  
Primary Tumor ◽  
Colorectal Liver Metastases ◽  
Tumor Location ◽  
Recurrence Free Survival ◽  
Primary Tumors ◽  
Free Survival ◽  
Primary Tumor Location ◽  
Before And After

Abstract Background: Whether primary tumor location of colorectal cancer (CRC) affects survival of patients after resection of liver metastases remains controversial. This study was conducted to investigate the differences in clinicopathological characteristics and prognosis between right-sided CRC and left-sided CRC patients with liver metastases after hepatectomy. Methods: From 2002 to 2018, 611 patients with colorectal liver metastases (CRLM) who underwent hepatectomy at our center were reviewed. Primary tumors located from cecum to transverse colon were defined as right-sided group (n = 141); tumors located from splenic flexure to rectum were defined as left-sided group (n = 470). Patients were compared between two groups before and after a 1:1 propensity score matching (PSM) analysis. Results: Before PSM, median survival time and 5-year overall survival (OS) rate in right-sided group were 77 months and 56.3%, and those in left-sided group were 64 months and 51.1%, respectively. After PSM, median survival time and 5-year OS rate in right-sided group were 77 months and 55.9%, and those in left-sided group were 58.8 months and 47.3%, respectively. The OS rates did not differ between two groups before and after PSM (P = 0.575; P = 0.453). However, significant different recurrence-free survival (RFS) rate was found before and after PSM between right-sided and left-sided group (P = 0.028, P = 0.003). Conclusions: Compared to patients with left-sided primary tumors, patients with right-sided primary tumors had a worse RFS but similar OS. Careful preoperative evaluation, intensive preoperative chemotherapy and frequent follow-up to detect early recurrence might be justified for CRLM patients with right-sided primary tumors.

Bevacizumab effectiveness and primary tumor location in metastatic colorectal cancer patients.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 683-683 ◽  
Author(s):  
Wen-zhuo He ◽  
Qiong Yang ◽  
Chang Jiang ◽  
Fang-xin Liao ◽  
Shou-sheng Liu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Metastatic Colorectal Cancer ◽  
Cancer Patients ◽  
Primary Tumor ◽  
Tumor Location ◽  
First Line ◽  
Primary Tumor Location ◽  
Colon Cancers

683 Background: There is currently no consensus about whether bevacizumab effectiveness is associated with the primary tumor location of metastatic colorectal cancer (mCRC). The aim of this study was to assess whether the primary tumor location was a predictor for bevacizumab treatment. Methods: From 2004 to 2013, 740 patients with mCRC treated with oxaliplatin / 5-FU / leucovorin (mFOLFOX6) or irinotecan / 5-FU / leucovorin (FOLFIRI) (CT group) and 244 patients treated with bevacizumab plus mFOLFOX6 or FOLFIRI (CT + B group) as first-line setting were included from Sun yat-sen university cancer center. Right-side colon cancers included those occurring in the cecum, ascending colon or transverse colon. Left-side colon cancers included those from descending or sigmoid colon. The primary outcome was overall survival (OS). Kaplan-Meier curves with log-rank tests were used to detect difference. All statistical tests were two sided. Results: 222 right-side colon, 259 left-side colon and 259 rectal cancer patients were included in CT group while 78 right-side colon, 86 left-side colon and 80 rectal cancer patients were included in CT + B group. Patients in CT + B group had similar OS compare with CT group only when the primary tumor located at right-side colon (median OS was 19.6 months for CT + B group versus 19.5 months for CT group, P = 0.269). For left-side colon cancer, significantly longer OS were observed in CT + B than CT group (22.3 months versus 21.9 months, P = 0.014). For rectal cancer patients, those in CT + B group also had longer OS than CT group (25.9 months versus 21.1 months, P = 0.005). Conclusions: Our data suggested that patients with right-side colon cancer could not get survival benefit from the addition of bevacizumab to first-line chemotherapy. Further data from randomized trials are needed to test our hypothesis. [Table: see text]

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