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

• Published in: The oncologist (Dayton, Ohio) Ohio), 2019-02, Vol.24 (2), p.e77-e79
• Main Authors: Loupakis, Fotios, Schirripa, Marta, Intini, Rossana, Bergamo, Francesca, Bertorelle, Roberta, Fassan, Matteo, Dadduzio, Vincenzo, Merigliano, Stefano, Pilati, Pierluigi, Urso, Emanuele Luca Damiano, Cillo, Umberto, Rugge, Massimo, Lonardi, Sara, Zagonel, Vittorina
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Brief Communications; Colorectal Neoplasms - pathology; Female; Humans; Male; Middle Aged; Mutation; Prognosis; Young Adult
• ISSN: 1083-7159; 1549-490X
• DOI: 10.1634/theoncologist.2018-0180

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. 摘要 背景。近期针对 RAS 野生型患者的分析报告了原发肿瘤部位 (PTL) 对转移性结直肠癌 (mCRC) 患者的预后价值。在此，我们研究了 PTL 对 RAS 突变 mCRC 患者的预后价值。 材料和方法。PTL 定义为左或右，代表脾曲远端或近端。根据 PTL，主要终点指标为总生存期 (OS)。根据转移时间和RAS 突变亚型进行了亚组分析。 结果。研究中包含564名患者。左右两侧病例分别为 65% 和 35%。根据 PTL [风险比(HR)= 0.99，p= 0.964]发现 OS 没有差异。观察同时性 (HR 0.92, p = 0.557) 和异时性 (HR 1.07, p = 0.807) 患者时，左右两组 OS 无差异。 结论。RAS突变的 mCRC 中未发现 OS 差异。此设定下需要能够改善预后和治疗策略的分子及临床特征。 Emerging data has led to the identification of right‐sided and left‐sided colorectal cancer (CRC) as two distinct clinical, pathological, and molecular diseases. This article is an analysis of the prognostic impact of primary tumor location in a population of patients with RAS mutated metastatic colorectal cancer.