Impact of primary tumor location on survival after recurrence in colon cancer
Sofia Dahlberg, Gaelle Cortas, Fredrik Jörgren, Pamela BuchwaldAbstract
Introduction
Primary tumor location has been proposed as prognostic factor in colon cancer, yet its impact on metastatic patterns and survival after recurrence remains unclear. This study examined the association between tumor laterality, metastatic patterns, and post-recurrence survival in patients with colon cancer.
Methods
This retrospective population-based cohort study utilized data from the Swedish Colorectal Cancer Registry (SCRCR) and medical records. Patients undergoing elective curative resection for stage I-III colon cancer in Region Skåne (2010–2016) who subsequently developed recurrence were included.
Results
Of 2834 patients undergoing curative resection, 275 (9.7 per cent) developed recurrence. Metastatic site and time to recurrence did not differ between right-sided and left-sided tumors. However, patients with left-sided tumors were more likely to receive curative-intent treatment for their first metastasis (45.0 per cent versus 22.9 per cent, P = 0.002). Overall survival was shorter for right-sided tumors (median 39 versus 61 months, P < 0.001). In multivariable analysis, right-sided location remained independently associated with worse 5-year survival (OR 2, 14, 95 per cent c.i. 1.08 to 4.25; P = 0.030), alongside primary tumor stage (OR 2.17, 95 per cent c.i. 1.03 to 4.59; P = 0.042) and palliative treatment intent at first metastasis (OR 11.02, per cent c.i. 5.6 to 21.6, P < 0.001).
Discussion
Although metastatic patterns and time to recurrence were similar, right-sided colon cancer was associated with worse survival after recurrence. Tumor laterality may represent an important prognostic factor even in the recurrent disease setting.