Primary tumor location and survival among metastatic colorectal cancer patients treated with systemic chemotherapy and biologic therapies: Retrospective analysis. (2022)

• Record Type: Journal Article
• Authors: Ramadan, Majed; Alfayea, Turki; Alsofyani, Abeer; Alyabsi, Mesnad; Alhusseini, Noara; Algarni, Alanood S.
• Is Part Of: Cancer treatment and research communications. Number 33(2023)
• Publication Date: 2022
• Subjects: Metastatic colorectal cancer (mCRC) -- Right-sided tumors -- Left-sided tumors survival -- Systemic chemotherapy -- Biological therapies
• DOI: 10.1016/j.ctarc.2022.100632
• Languages: English
• ISSNs: 2468-2942

Abstract

Highlights: The current study demonstrates a significant decrease in mortality for left-sided mCRC treated with systemic chemotherapy plus (SC) plus biological therapy (BT) compared to right-sided mCRC, which highlights the significant benefit of SC plus BT for mCRC left-sided patients. The current study confirms that this difference exists in a sample of Middle Eastern populations where multiple mCRC associated factors such as molecular biology of the tumor cells are different than other examined populations in the west. This study demonstrates that even those mCRC patients with unresectable metastases can have a survival benefit from left-sided SC plus BT treatment strategy. Abstract: Background: Metastatic colorectal cancer (mCRC) is a genetically heterogeneous disease and different ethnicities might result in different chemotherapy treatment responses. The aim of the study is to evaluate whether survival outcomes for mCRC patients treated with systemic chemotherapy (SC) and, with and without biologic therapies (BT) are different between left and right-sided tumors. Methods: A retrospective cohort study via the Ministry of National Guard- Health Affairs (MNG-HA) Cancer registry data was used to identify patients diagnosed with CRC between 2013 and 2016. Kaplan-Meier method and porosity score Cox proportional hazard models were used to assess survival for right and left-sided mCRC with and with BT. Results: There was a total of 549 CRC patients and 196 mCRC patients with mean age of 64 years and 57.65% were males. The median survival for the left-sided was higher than the right-sided mCRC tumors ( P 0.03). mCRC patients treated with SC+BT were associated with decreased mortality only among patients with left-sided mCRC compared to right-sided mCRC (HR, 0.21; 95% CI, 0.05–0.92; P 0.03). mCRC with no primary-tumor resection and CS+TB left-sided mCRC was significantly associated with decreased mortality compared to right-sided mCRC (HR, 0.15; 95% CI, 0.03–0.72; P 0.02). Conclusion: A significant decrease in mortality for the left-sided mCRC treated with SC + BT compared with the right-sided mCRC was observed. mCRC patients with unresectable metastases demonstrated survival benefits from left-sided SC + BT treatment. Randomized controlled trials are needed to determine the optimal treatment for mCRC patients.