Abstract 5242
Background
Until now, we have managed all CRC patients (pts) in the same way, However, emergent data show that location of primary tumour can have a prognostic and predictive value in metastatic setting. In this study, we analized differences in sv for every stage between right (R) and left-sided (L) CRC.
Methods
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 tumours originated in cecum, ascending colon, hepatic flexure or transverse colon, and L in splenic flexure, descending and sigmoid colon or rectum.
Results
Data from 1742 pts were examined for sidedness, stage, and survival at 2 years. 509 (29.2%) had R and 1233 (70.8%) L-CRCs. Most of cases were non-metastatic (92.3%), and males (63.4%). At 2 years, 14.2% of R-CRCs and 15.8% of L-CRCs experienced a recurrence (p 0.408). Nevertheless, the survival analysis revealed a poorer outcome for R-CRCs, with less patients alive at 2 years: 86.6% (CI 95%:83.5 - 89.6) than L-CRCs: 92.4% (CI 95% 90.8 - 93.8); p < 0.001. The prognosis was significantly better for L-tumours in more advanced stages (III and IV), and in stage I as well. Patients with stage II seemed to have a very similar outcome, regardless their tumours were placed in right or left side. Only survival mean was slightly higher in R-CRCs, but percentage of survival at 2 years was the same for two both sides, without showing any statistical difference.Table:
594P Differences in survival between R-CRC and L-CRC in every stage
Stage | n(%) | Sv 2 years, % | p | |
---|---|---|---|---|
R-CRC | L-CRC | |||
I | 374 (21.5) | 92.2 | 97.6 | 0.049 |
II | 641 (36.8) | 93.8 | 93.7 | 1.0 |
III | 594 (34.1) | 83.4 | 91.2 | 0.009 |
IV | 133 (7.6) | 48.6 | 75.5 | 0.006 |
Conclusions
Overall, prognosis is better for L-tumours in every stage, most notably in advances stages (III-IV). However, stage II behaves in a distinct manner and no differences in survival are found between R-CRC and L-CRCs in these pts.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
REDISSEC.
Funding
REDISSEC (RD12/0001/0010), Fondo de Investigaciones Sanitarias (13/0013) and Fondo Europeo de Desarrollo Regional (FEDER).
Disclosure
All authors have declared no conflicts of interest.
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