Another Chapter of the Right Versus Left Story: Is Primary Tumor Location a Prognostic Feature in RAS Mutant Metastatic Colorectal Cancer?

Fotios Loupakis; Marta Schirripa; Rossana Intini; Francesca Bergamo; Roberta Bertorelle; Matteo Fassan; Vincenzo Dadduzio; Stefano Merigliano; Pierluigi Pilati; Emanuele Luca Damiano Urso; Umberto Cillo; Massimo Rugge; Sara Lonardi; Vittorina Zagonel

doi:10.1634/theoncologist.2018-0180

Another Chapter of the Right Versus Left Story: Is Primary Tumor Location a Prognostic Feature in RAS Mutant Metastatic Colorectal Cancer?

Oncologist. 2019 Feb;24(2):e77-e79. doi: 10.1634/theoncologist.2018-0180. Epub 2018 Aug 17.

Affiliations

¹ Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Istituto Oncologico Veneto, IRCCS, Padua, Italy fotios.loupakis@iov.veneto.it.
² Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Istituto Oncologico Veneto, IRCCS, Padua, Italy.
³ Unit of Immunology and Oncological Molecular Diagnostics, Department of Clinical and Experimental Oncology, Istituto Oncologico Veneto, IRCCS, Padua, Italy.
⁴ Surgical Pathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy.
⁵ UOC Clinica Chirurgica, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy.
⁶ Chirurgia ULSS 16 Unità Locale Socio Sanitaria Padova, Ospedale Sant' Antonio, Padua, Italy.
⁷ Clinica Chirurgica I, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy.
⁸ Hepatobiliary Surgery and Liver Transplant Center, Department of Surgery, University of Padua, Padua, Italy.

Abstract

Background: The prognostic value of primary tumor location (PTL) in patients with metastatic colorectal cancer (mCRC) was reported by recent analyses in RAS wild-type patients. Here, we investigated the prognostic value of PTL in RAS mutated mCRC patients.

Materials and methods: PTL was defined as left or right if distal or proximal to the splenic flexure. Primary endpoint was overall survival (OS) according to PTL. Subgroup analyses were conducted according to time to metastases and RAS mutation subtypes.

Results: Five hundred sixty-four patients were included. Left- and right-sided cases were 65% and 35%, respectively. No difference in OS was detected according to PTL (hazard ratio [HR] = 0.99, p = .964). No difference in OS was observed in right versus left when looking at synchronous (HR 0.92, p = .557) or metachronous (HR 1.07, p = .807) patients.

Conclusion: No OS difference was detected in RAS mutated mCRC. Molecular and clinical features able to improve prognosis and treatment strategies in this setting are needed.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Colorectal Neoplasms / pathology*
Female
Humans
Male
Middle Aged
Mutation
Prognosis
Young Adult