Impact of Primary Tumor Location on Demographics, Resectability, Outcomes, and Quality of Life in Finnish Metastatic Colorectal Cancer Patients (Subgroup Analysis of the RAXO Study)

被引：0

作者：

Aho, Sonja ^{[1
,2
,3
,4
]}

Osterlund, Emerik ^{[5
,6
]}

Ristimaki, Ari ^{[7
,8
]}

Nieminen, Lasse ^{[9
,10
]}

Sundstrom, Jari ^{[11
,12
]}

Makinen, Markus J. ^{[13
,14
,15
]}

Kuopio, Teijo ^{[16
,17
]}

Kytola, Soili ^{[18
,19
]}

Algars, Annika ^{[20
]}

Ristamaki, Raija ^{[20
]}

Heerva, Eetu ^{[20
]}

Kallio, Raija ^{[21
,22
]}

Halonen, Paivi ^{[23
,24
]}

Soveri, Leena-Maija ^{[24
,25
]}

Nordin, Arno ^{[6
,26
]}

Uutela, Aki ^{[6
,26
]}

Salminen, Tapio ^{[1
,2
]}

Stedt, Hanna ^{[27
,28
]}

Lamminmaki, Annamarja ^{[27
,28
]}

Muhonen, Timo ^{[24
,29
]}

Kononen, Juha ^{[30
,31
]}

Glimelius, Bengt ^{[5
]}

Isoniemi, Helena ^{[6
,26
]}

Lehto, Juho T. ^{[3
,4
]}

Lehtomaki, Kaisa ^{[1
,2
]}

Osterlund, Pia ^{[1
,2
,23
,24
,32
,33
]}

机构：

[1] Tampere Univ Hosp, Tays Canc Ctr, Dept Oncol, Elamanaukio 2, Tampere 33520, Finland

[2] Tampere Univ, Fac Med & Hlth Technol, Arvo Ylpon Katu 23, Tampere 33520, Finland

[3] Tampere Univ, Fac Med & Hlth Technol, TUNI Palliat Care Res Grp, Arvo Ylpon Katu 23, Tampere 33520, Finland

[4] Tampere Univ Hosp, Palliat Care Ctr, Elamanaukio 2, Tampere 33520, Finland

[5] Uppsala Univ, Dept Immunol Genet & Pathol, S-75185 Uppsala, Sweden

[6] Helsinki Univ Hosp, Dept Transplantat & Liver Surg, Haartmaninkatu 4, Helsinki 00290, Finland

[7] Helsinki Univ Hosp, Dept Pathol, HUS Diagnost Ctr, HUSLAB, Haartmaninkatu 3, Helsinki 00290, Finland

[8] Univ Helsinki, Fac Med, Res Programs Unit, Appl Tumor Genom Res Program, Haartmaninkatu 8, Helsinki 00290, Finland

[9] Tampere Univ Hosp, Dept Obstet & Gynecol, Elamanaukio 2, Tampere 33520, Finland

[10] Univ Tampere, Dept Pathol, Arvo Ylpon Katu 23, Tampere 33520, Finland

[11] Turku Univ Hosp, Dept Pathol, Kiinanmyllynkatu 4-8, Turku 20520, Finland

[12] Univ Turku, Inst Biomed, Kiinanmyllynkatu 10, Turku 20520, Finland

[13] Oulu Univ Hosp, Dept Pathol, Kajaanintie 50, Oulu 90220, Finland

[14] Univ Oulu, Dept Pathol, Translat Med Res Unit, Pentti Kaiteran Katu 1, Oulu 90570, Finland

[15] Med Res Ctr Oulu, Pentti Kaiteran Katu 1, Oulu 90570, Finland

[16] Hosp Nova, Dept Pathol, Hoitajantie 3, Jyvaskyla 40620, Finland

[17] Univ Jyvaskyla, Dept Biol & Environm Sci, Seminaarinkatu 15, Jyvaskyla 40014, Finland

[18] Helsinki Univ Hosp, HUS Diagnost Ctr, Dept Genet, HUSLAB, Haartmaninkatu 3, Helsinki 00290, Finland

[19] Univ Helsinki, Dept Genet, Haartmaninkatu 8, Helsinki 00290, Finland

[20] Turku Univ Hosp, Dept Oncol, Hameentie 11, Turku 20520, Finland

[21] Oulu Univ Hosp, Dept Oncol, Kajaanintie 50, Oulu 90220, Finland

[22] Univ Oulu, Dept Oncol, Pentti Kaiteran Katu 1, Oulu 90570, Finland

[23] Helsinki Univ Hosp, Dept Oncol, Haartmaninkatu 4, Helsinki 00290, Finland

[24] Univ Helsinki, Dept Oncol, Haartmaninkatu 8, Helsinki 00290, Finland

[25] Joint Municipal Author Hlth Care & Social Serv Kes, Home Care, Sairaalakatu 1, Hyvinkaa 05850, Finland

[26] Univ Helsinki, Dept Surg, Haartmaninkatu 8, Helsinki 00290, Finland

[27] Kuopio Univ Hosp, Dept Oncol, Puijonlaaksontie 2, Kuopio 70210, Finland

[28] Univ Eastern Finland, Fac Hlth Sci, Yliopistonranta 1A, Kuopio 70210, Finland

[29] South Carel Cent Hosp, Dept Oncol, Valto Kakelan Katu 1, Lappeenranta 53130, Finland

[30] Docrates Hosp, Docrates Canc Ctr, Saukonpaadenranta 2, Helsinki 00180, Finland

[31] Hosp Nova, Dept Oncol, Hoitajankatu 3, Jyvaskyla 40620, Finland

[32] Karolinska Univ Sjukhuset, Dept Gastrointestinal Oncol, Eugeniavagen 3, S-17176 Solna, Sweden

[33] Karolinska Inst, Dept Oncol Pathol, Solnavagen 1, S-17177 Solna, Sweden

来源：

CANCERS | 2024年 / 16卷 / 05期

关键词：

metastatic colorectal cancer; primary tumor location; resectability; metastasectomy; quality of life; SIDED COLON-CANCER; RAS WILD-TYPE; SURVIVAL; 1ST-LINE; CHEMOTHERAPY; PANITUMUMAB; INSTRUMENT; QLQ-C30;

D O I：

10.3390/cancers16051052

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Simple Summary The location of the primary tumor in the right colon, left colon, or rectum affects the efficacy of biological drugs used in the treatment of metastatic colorectal cancer, but how? We examined how the primary tumor location affects disease characteristics, treatability, quality of life, and outcome in a real-life study population of 1080 Finnish patients in the RAXO study. The primary tumor location correlates with the location of metastases, the frequency of gene mutations, how often metastases can be operated upon, long-term survival after curative surgery or palliative chemotherapy, and the quality of life during the disease trajectory. The primary tumor location is a helpful surrogate for clinicians working with metastatic colorectal cancer patients in estimating the clinical course of the disease. This study cannot identify the reasons for the associations, i.e., whether it is the primary location per se, the different mutations, or other reasons.Abstract The primary tumor location (PTL) is associated with the phenotype, metastatic sites, mutations, and outcomes of metastatic colorectal cancer (mCRC) patients, but this has mostly been studied according to sidedness (right vs. left sided). We studied right colon vs. left colon vs. rectal PTL in a real-life study population (n = 1080). Health-related quality of life (HRQoL) was assessed multi-cross-sectionally with QLQ-C30, QLQ-CR29, EQ-5D, and 15D. A chi-square, Kaplan-Meier, and Cox regression were used to compare the groups. The PTL was in the right colon in 310 patients (29%), the left colon in 396 patients (37%), and the rectum in 375 patients (35%). The PTL was associated with distinct differences in metastatic sites during the disease trajectory. The resectability, conversion, and resection rates were lowest in the right colon, followed by the rectum, and were highest in the left colon. Overall survival was shortest for right colon compared with left colon or rectal PTL (median 21 vs. 35 vs. 36 months), with the same trends after metastasectomy or systemic therapy only. PTL also remained statistically significant in a multivariable model. The distribution of symptoms varied according to PTL, especially between the right colon (with general symptoms of metastases) and rectal PTL (with sexual- and bowel-related symptoms). mCRC, according to PTL, behaves differently regarding metastatic sites, resectability of the metastases, outcomes of treatment, and HRQoL.

引用

页数：22