The effects of primary tumour location on patients with all stages of colorectal cancer

Öz

Abstract:

Purpose:The aim of this study was to examine the effects of tumor localization in early and advanced stage colon cancer patients.

Materials and Methods :This retrospective study enrolled  249 primary colorectal cancer (CRC) patients at medical oncology department of Adnan Menderes University between 2013-2017.

Results:In early stage, left sided tumors were significantly more common in males(p=0.027). In right sided tumours recurrence developed earlier in female patients(p=0.043) and female sex,young age were unfavorable prognostic factors for the relapse time.  Positive and unknown PANRAS mutation status were found to be unfavorable prognostic factors for both side. In metastatic stage, patients with PANRAS mutant left sided tumors lived longer than PANRAS negative patients(49.0 vs 25.5 months respectively, p <0.001). OS was 11 months and PFS was 1.8 months longer with anti-EGFR agents than anti-VEGFR agents, in right sided tumors.In left sided tumors, there was no difference, only PFS was longer with anti-VEGFR agents(13 months vs 6.3 months). In PANRAS positive patients, OS and PFS were longer with anti-VEGFR treatment in the left side tumors(OS 49.0 months vs 30.6 months PFS, 13.2 months vs 7.2 months, p=0.784).

Conclusions: In our study, the efficacy results of the treatment which was given according to the primary tumor location were not compatible with the literature. Primer tumor location is a transition period for understanding of molecular subtypes at the colon cancer. The on-going studies of genomic differences between right and left sided tumors will able to better clarifying of the biologic explanation of the observed difference.

Anahtar Kelimeler

• Colorectal cancer,tumour location,early stage,metastatic stage

Kolorektal kanserde primer tümör lokalizasyonunun tüm evrelerdeki etkileri

Öz

Amaç: Bu çalışmanın amacı erken ve ileri evre kolon kanseri hastalarında tümör lokalizasyonunun etkilerini incelemektir.

Gereç ve Yöntem: 2013-2017 arasında Adnan Menderes Üniversitesi'nin tıbbi onkoloji bölümüne başvuran  primer kolorektal kanser tanılı hastaları retrospektif olarak taradık ve 249 hastayı çalışmaya dahil ettik.

Bulgular: Erken evrede, sol taraftaki kolorektal kanserler  erkeklerde anlamlı olarak daha yaygındı (p = 0.027). Sağ taraftaki tümörlerde nüks  kadın hastalarda daha erken gelişti (p = 0.043) ve kadın cinsiyet, genç yaş nüks süresi için bağımsız prognostik faktörlerdi. PANRAS pozitif ve bilinmeyen mutasyon durumunun her iki taraftaki tümörler için olumsuz prognostik faktörler olduğu bulundu.

Metastatik evrede, sol taraftaki tümörlerde PANRAS mutant olan hastalar daha uzun süre yaşadılar (sırasıyla 49.0'a 25.5 ay, p <0.001). Birinci basamak tedavide anti-EGFR ajanları alan sağ kolon kanseri hastalarında anti-VEGFR ajanları alanlara göre ortalama yaşam süresi(OS) 11 ay, progresyona kadar geçen süre(PFS) 1.8 ay daha uzundu. Sol kolon  tümörlerinde, ilk basamak tedavide fark yoktu yalnızca PFS anti-VEGFR ajanlarıyla daha uzundu (13 ay vs 6.3 ay ). PANRAS pozitif antiVEGFR tedavisi alan hastalar içinde sol kolon yerleşimli tümörlerde OS ve PFS daha uzundu (OS 49.0 ay - 30.6 ay PFS, 13.2 ay ve 7.2 ay, p = 0.784).

Sonuç: Çalışmamızda primer tümör lokasyonuna göre verilen tedavinin etkinlik sonuçları literatürle uyumlu değildi. Primer tümörün yeri, kolon kanserinde moleküler alt tiplerin anlaşılması için bir geçiş dönemidir. Sağ ve sol taraftaki tümörler arasında genomik farklılıkları araştıran çalışmalar, gözlenen farkın biyolojik açıklamasının daha iyi anlaşılmasını mümkün kılacaktır.

Anahtar Kelimeler

• kolorektal kanser,tümör lokalizasyonu,erken evre,metastatik evre

Kaynakça

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