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International Journal of Colorectal Disease

, Volume 33, Issue 9, pp 1215–1223 | Cite as

The influence of tumour site on prognosis in metastatic colorectal carcinomas with primary tumour resection

  • Susanne Merkel
  • Vera S. Schellerer
  • Axel Wein
  • Sabine Semrau
  • Carol Geppert
  • Jonas Göhl
  • Werner Hohenberger
  • Klaus Weber
  • Robert Grützmann
Original Article
  • 138 Downloads

Abstract

Purpose

The aim of our study was to compare the characteristics and prognosis between right- and left-sided metastatic colorectal carcinomas.

Methods

Data from 937 patients with stage IV colorectal carcinomas (synchronous distant metastasis) who had a resection of the primary tumour between 1985 and 2014 were analysed. Carcinomas in the caecum to transverse colon were defined as right-sided (n = 250; 26.7%). They were compared to tumours located from the splenic flexure to the rectum categorised as left-sided (n = 687; 73.3%).

Results

In right-sided carcinomas, we observed significantly more female patients (50.8 vs 36.2%; p < 0.001), more unfavourable histological types (24.0 vs 8.6%; p < 0.001), more M1c carcinomas (metastases to the peritoneum ± others; 32.0 vs 14.4%; p < 0.001) and more emergencies (11.6 vs 7.1%; p = 0.029), while multimodal treatment was utilised in fewer patients (51.6 vs 63.8%; p = 0.001) and curative resections were less frequently (24.1 vs 35.4%; p = 0.002). Prognosis was significantly worse in patients with right-sided carcinomas (2-year-survival 27.2 vs 44.6%, p < 0.01). This difference was more pronounced after R2 resection (15.3 vs 29.7%; p < 0.001), than after macroscopic curative resection (2-year-survival 63.9 vs 71.9%; p = 0.106). In multivariate Cox regression analysis, tumour site was found to be an independent prognostic factor for overall survival (HR 1.2; 95% CI 1.0–1.5; p = 0.012). During the three 10-year periods, the prognosis improved equally in patients with right- and left-sided carcinomas, while the differences in survival remained identical.

Conclusions

In a surgical patient cohort undergoing primary tumour resection, significant differences in prognosis were observed between patients with metastatic right- and left-sided colorectal carcinomas.

Keywords

Colorectal carcinoma Stage IV Tumour site Survival Distant metastases 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryFriedrich-Alexander-Universität Erlangen-NürnbergErlangenGermany
  2. 2.Department of SurgeryUniversity Hospital ErlangenErlangenGermany
  3. 3.Department of Medicine 1Friedrich-Alexander-Universität Erlangen-NürnbergErlangenGermany
  4. 4.Department of Radiation OncologyFriedrich-Alexander-Universität Erlangen-NürnbergErlangenGermany
  5. 5.Institute of PathologyFriedrich-Alexander-Universität Erlangen-NürnbergErlangenGermany

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