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Primary tumor location impacts survival in colorectal cancer patients after resection of liver metastases
Author(s) -
Bingmer Katherine,
Ofshteyn Asya,
Bliggenstorfer Jonathan T.,
Kethman William,
Ammori John B.,
Charles Ronald,
Stein Sharon L.,
Steinhagen Emily
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26061
Subject(s) - medicine , colorectal cancer , proportional hazards model , primary tumor , epidemiology , gastroenterology , overall survival , oncology , multivariate analysis , cancer , metastasis
Background and Objectives Right‐sided colon cancers (R‐CC) are associated with worse outcomes compared to left‐sided colon cancers (L‐CC). We hypothesize that R‐CC with synchronous liver metastases who undergo resection of primary and metastatic sites have worse survival and that survival will vary significantly among R‐CC, L‐CC, and rectal cancer (ReC). Methods The Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2016 was used to identify colorectal cancer patients with liver metastases who underwent surgical resection of both primary and metastatic disease. Survival was analyzed by multivariate Cox regression. Results A total of 2275 patients were included; 38% R‐CC, 46% L‐CC, and 16% ReC. R‐CC primary tumors tended to be larger than 5 cm, higher grade, and mucinous (all P < .001). Compared to patients with R‐CC, both L‐CC and ReC had improved overall (HR 0.72; P < .001; HR 0.75, P = .006) and disease‐specific (HR 0.71, P < .001; HR 0.73, P = .008) survival. There was no difference in survival between L‐CC and ReC. Conclusions Patients with R‐CC have significantly worse survival than L‐CC or ReC. This provides additional evidence that R‐CC tumors are fundamentally different from L‐CC and ReC tumors. Future studies should determine factors responsible for this disparity, and identify targeted treatment based on primary tumor location.