Primary Tumor Location as a Prognostic and Predictive Marker in Metastatic Colorectal Cancer (mCRC)

Bahl, Ankur; Talwar, Vineet; Sirohi, Bhawna; Mehta, Priya; Arya, Devavrat; Shrivastava, Gunjan; Dahiya, Akhil; Pavithran, Keechilat

doi:10.3389/fonc.2020.00964

Cited by 12 publications

(6 citation statements)

References 25 publications

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“…Our study also found that in patients with simultaneous CRC BM, those with primary tumors located in the left colon had better prognosis than those with tumors located in the right colon. Similar to previous studies, metastatic colorectal cancer with primary tumors located in the right colon tends to have a poorer prognosis than those located in the left colon [ 25 , 26 , 27 , 28 ]. This may be due to biological differences between the two regions, such as differences in blood supply and genetic stability [ 25 , 29 ].…”

Section: Discussionsupporting

confidence: 83%

Primary Tumor Resection Plus Chemotherapy versus Chemotherapy Alone for Colorectal Cancer Patients with Synchronous Bone Metastasis

Cheng

Zhong

et al. 2023

Medicina

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Background and Objective: Colorectal cancer (CRC) bone metastasis (BM), particularly synchronous metastasis, is infrequent and has a poor prognosis. Radical surgery for CRC with BM is challenging, and chemotherapy is the standard treatment. However, it is unclear whether combining chemotherapy with primary tumor resection (PTR) yields greater survival benefits than chemotherapy alone, as no relevant reports exist. Material and Methods: The Surveillance, Epidemiology, and End Results (SEER) database provided data on 1662 CRC patients with bone metastasis between 2010 and 2018, who were divided into two groups: chemotherapy combined with PTR and chemotherapy alone. Survival distributions were compared using the log-rank test, and survival estimates were obtained using the Kaplan–Meier method. A Cox proportional multivariate regression analysis was conducted to estimate the survival benefit of chemotherapy combined with PTR while controlling for additional prognostic factors. Results: The chemotherapy only group consisted of 1277 patients (76.8%), while the chemotherapy combined with PTR group contained 385 patients (23.2%). Patients who received chemotherapy combined with PTR had a significantly higher 1-year survival rate (60.7%) and 2-year survival rate (32.7%) compared to those who only received chemotherapy (43.8% and 18.4%, respectively; p < 0.0001). Independent prognostic factors identified by Cox proportional analysis were age, location of the primary tumor, type of tumor, M stage, metastasectomy and PTR. Patients who received chemotherapy combined with PTR had a significantly improved prognosis (HR 0.586, 95% CI 0.497–0.691, p < 0.0001). All subgroups demonstrated a survival advantage for patients who received chemotherapy in combination with PTR. Conclusions: Our findings suggest that patients with BM from CRC may benefit from chemotherapy combined with PTR. Our analysis also identified age, location of the primary tumor, type of tumor, M stage, metastasectomy, and PTR as independent prognostic risk factors for CRC patients with synchronous BM.

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Section: Discussionsupporting

confidence: 83%

Primary Tumor Resection Plus Chemotherapy versus Chemotherapy Alone for Colorectal Cancer Patients with Synchronous Bone Metastasis

Cheng

Zhong

et al. 2023

Medicina

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“…mCRC patients with distal tumors respond better to anti-EGFR agents than those with proximal tumors [ 39 ], possibly due to the different embryologic origin of distal tumors, whether embryonic hindgut or embryonic midgut. Interestingly, differences in embryologic origin are associated to different phenotypes, with proximal tumors carrying RAS and BRAF mutations, whereas distal tumors carry KRAS , APC , PIK3CA , and TP53 mutations [ 58 ]. Similarly, therapy responses can be different among these two kinds of colorectal tumors: cancer patients with left-sided tumors may be responsive to anti-EGFR targeted therapy, while those with right-sided tumors do not have the same benefit from conventional treatments [ 59 ].…”

Section: Introductionmentioning

confidence: 99%

Artificial Intelligence Predictive Models of Response to Cytotoxic Chemotherapy Alone or Combined to Targeted Therapy for Metastatic Colorectal Cancer Patients: A Systematic Review and Meta-Analysis

Russo¹,

Lallo²,

Munnia³

et al. 2022

Cancers

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Tailored treatments for metastatic colorectal cancer (mCRC) have not yet completely evolved due to the variety in response to drugs. Therefore, artificial intelligence has been recently used to develop prognostic and predictive models of treatment response (either activity/efficacy or toxicity) to aid in clinical decision making. In this systematic review, we have examined the ability of learning methods to predict response to chemotherapy alone or combined with targeted therapy in mCRC patients by targeting specific narrative publications in Medline up to April 2022 to identify appropriate original scientific articles. After the literature search, 26 original articles met inclusion and exclusion criteria and were included in the study. Our results show that all investigations conducted on this field have provided generally promising results in predicting the response to therapy or toxic side-effects. By a meta-analytic approach we found that the overall weighted means of the area under the receiver operating characteristic (ROC) curve (AUC) were 0.90, 95% C.I. 0.80–0.95 and 0.83, 95% C.I. 0.74–0.89 in training and validation sets, respectively, indicating a good classification performance in discriminating response vs. non-response. The calculation of overall HR indicates that learning models have strong ability to predict improved survival. Lastly, the delta-radiomics and the 74 gene signatures were able to discriminate response vs. non-response by correctly identifying up to 99% of mCRC patients who were responders and up to 100% of patients who were non-responders. Specifically, when we evaluated the predictive models with tests reaching 80% sensitivity (SE) and 90% specificity (SP), the delta radiomics showed an SE of 99% and an SP of 94% in the training set and an SE of 85% and SP of 92 in the test set, whereas for the 74 gene signatures the SE was 97.6% and the SP 100% in the training set.

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“…In 2020, new data demonstrated that there was no consensus with respect to the implications of tumor sidedness in second and subsequent lines of treatment, and the concept of tumor sidedness may not be true in this setting. There is certainly a need for a consensus statement in this space 25 .…”

Section: Discussionmentioning

confidence: 99%

The effect of mutation status, pathological features and tumor location on prognosis ın patients with colorectal cancer

Babat¹,

Polat²,

Gürsu

et al. 2021

Rev. Assoc. Med. Bras.

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OBJECTIVE: Colorectal cancer is the most common malignancy of the gastrointestinal tract. It is the third most common tumor in both genders and the second reason of cancer-related deaths. In recent years, tumor location has gained importance as a prognostic indicator.In this study, we aimed to analyze if there was a prognostic effect of tumor location, the pathological features, and the mutation status of patients on survival.METHODS: Two-hundred and ten colorectal cancer patients aged 18 years and older were included into the study. One-hundred and forty-two patients had left-sided tumor and 68 patients had right-sided tumor. Patients who had other malignancies rather than squamous cell skin cancer and in situ cervical cancer were excluded. All statistical tests were carried out using two-sided process, and a p≤0.05 was considered statistically significant.RESULTS: There were 140 men and 70 women in the study. The median age of the patients was 62 years old. There was no statistically significant difference according to tumor location and survival of patients. The overall survival of patients with right-sided tumors was 60.5 months and 47.2 months for left-sided tumors. Disease-free survival of patients was 63.7 months for right-sided tumors and 46 months for left-sided ones. Perineural invasion, grade and stage were crucial prognostic parameters. Disease-free survival was longer for female colorectal cancer patients. CONCLUSION:According to our study, survival of patients was similar regardless of tumor location. This can be explained by the different sequencing of treatment strategies and divergent population genetics.

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Primary Tumor Location as a Prognostic and Predictive Marker in Metastatic Colorectal Cancer (mCRC)

Cited by 12 publications

References 25 publications

Primary Tumor Resection Plus Chemotherapy versus Chemotherapy Alone for Colorectal Cancer Patients with Synchronous Bone Metastasis

Primary Tumor Resection Plus Chemotherapy versus Chemotherapy Alone for Colorectal Cancer Patients with Synchronous Bone Metastasis

Artificial Intelligence Predictive Models of Response to Cytotoxic Chemotherapy Alone or Combined to Targeted Therapy for Metastatic Colorectal Cancer Patients: A Systematic Review and Meta-Analysis

The effect of mutation status, pathological features and tumor location on prognosis ın patients with colorectal cancer

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