Abstract
BackgroundWhether 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.MethodsFrom 2002 to 2018, 611 patients with colorectal liver metastases (CRLM) who underwent hepatectomy at our center were reviewed. Primary tumors located from the cecum to transverse colon were defined as right-sided group (n = 141); tumors located from the 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.ResultsBefore 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).ConclusionsCompared 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.
Highlights
Whether primary tumor location of colorectal cancer (CRC) affects survival of patients after resection of liver metastases remains controversial
In Colorectal liver metastases (CRLM) patients undergoing hepatic resection, many factors such as tumor size of liver metastases, tumor number, and serum carcinoembryonic antigen (CEA) level are associated with outcomes [5]
We aimed to explore the impact of primary tumor location of CRC on clinical characteristics and survival for CRLM patients undergoing hepatectomy
Summary
Whether primary tumor location of colorectal cancer (CRC) affects survival of patients after resection of liver metastases remains controversial. Colorectal liver metastases (CRLM) present in 20–25% of patients at the time of diagnosis and in approximately 60% of patients during the course of the disease [3]. Despite improvements in the comprehensive management of patients with CRLM in recent years, liver resection remains the most effective treatment with the potential for long-term survival and cure for CRLM patients [4]. Primary tumor factors including lymph node status, pathology grade, and genetic status may influence the survival [6, 7]. Genetic status of primary tumor was found to predict resection margin and pathologic response in CRLM patients treated with neoadjuvant chemotherapy [8, 9]
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