Ann Surg Treat Res.  2024 Nov;107(5):264-273. 10.4174/astr.2024.107.5.264.

Primary tumor sidedness is not prognostic factor in resectable colorectal cancer liver metastasis: a retrospective observational cohort study

• Jo SJ
• Kim J
• Shin JK
• Rhu J
• Huh JW
• Choi Gs
• Joh JW

• KMID: 2560740
• DOI: http://doi.org/10.4174/astr.2024.107.5.264

Abstract

Purpose
Right-sided tumors have been reported to have a poorer survival rate than left-sided tumors; however, there remains debate regarding whether sidedness is an independent prognostic factor in colorectal cancer liver metastasis (CRLM). This study aimed to assess the impact of sidedness on prognosis in resectable CRLM and to identify prognostic factors.
Methods
Patients who underwent liver resection for CRLM at Samsung Medical Center from January 2008 to December 2021 were included in the investigation. Overall survival (OS) and progression-free survival (PFS) were analyzed, and prognostic factors were identified.
Results
A total of 497 patients were included in the study, with 106 on the right side and 391 on the left side. The rightsided group had a higher percentage of synchronous tumors (90.6% vs. 80.3%, P = 0.020). In survival analysis, the right side showed lower 5-year OS (49.7% vs. 54.2, P = 0.305) and 5-year PFS (57.1% vs. 60.2%, P = 0.271), but the differences were not statistically significant. In the analysis of prognostic factors, synchronous tumor (odds ratio [OR], 5.01; P < 0.001), CEA (OR, 1.46; P = 0.016), and maximum tumor size of hepatic metastasis (OR, 1.09; P = 0.026) were associated with OS.
Conclusion
In resectable CRLM, there was no difference in prognosis based on sidedness. CEA level, synchronous tumor, and maximum tumor size of hepatic metastasis were identified as prognostic factors.

Keyword

Colorectal cancer liver metastasis; Prognosis; Sidedness

Figure

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  Fig. 1 Kaplan-Meier survival graph according to sidedness. (A) Overall survival. (B) Progression-free survival. (C) Overall survival categorized as right, left, and rectum. (D) Progression-free survival categorized as right, left, and rectum.

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  Fig. 2 Kaplan-Meier survival graph according to sidedness in synchronous and metachronous tumors. (A) Overall survival in synchronous tumors. (B) Progression-free survival in synchronous tumors. (C) Overall survival in metachronous tumors. (D) Progression-free survival in metachronous tumors.

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  Fig. 3 Kaplan-Meier survival graph according to hepatectomy timing in synchronous tumors. (A) Overall survival. (B) Progression-free survival.

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