Until now, we have managed all CRC patients (pts) in the same way, However, emergent data show that location of primary tumor can have a prognostic and predictive value in metastatic setting. In this study, we analized differences in sv and cpc between right (R) and left-sided (L) CRC.
This prospective, multicentre observational study was conducted in coordination with 22 public-sector hospitals of Spain. Pts diagnosed with new CRC, stage I-IV and surgically treated, were included. We defined R-CRC as tumors originated in cecum, ascending colon, hepatic flexure or transverse colon, and L in splenic flexure, descending and sigmoid colon or rectum.
Of 2694 recruited pts, 807 (30%) had R and 1887 (70%) L-CRCs. Most of cases were non-metastatic (89.9%), and males (63.5%). Mortality risk was higher for R-CRC and independent of stage (localised vs metastatic), with HR 1.69; 95% IC 1.24-2.29. Pts with R-tumors were slightly older than L, with a higher Body Mass Index (BMI), a greater predominance of women, non-smokers and regular Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) users. At presentation, they stayed asymptomatic, had elevated CA 19.9 or interval CRCs (diagnosed after negative screening test), and needed urgent surgery more frequently. They also showed special histologies, high grade and vascular invasion more often than L. Although differences in N and M staging were not detected, we observed more T1-T2 in L and more T3- T4 in R-tumors.Table:
585P Differences in sv and cpc
|Sv 2 years (%, 95% IC)||87.110-T2||19.5||29.2|
R and L-CRCs are different, and prognosis is better for L-tumors, independently of stage.
Clinical trial identification
Legal entity responsible for the study
CARESS-CCR Study Group
REDISSEC (RD12/0001/0010), Fondo de Investigaciones Sanitarias (13/0013) and Fondo Europeo de Desarrollo Regional (FEDER).
All authors have declared no conflicts of interest.