The survival outcome differs between left-sided colon cancer and middle/low rectal cancer after colorectal hepatic metastasectomy

Jin-Han Yang ¹, Wen-Ling Lin ², Wei-Shone Chen ³

⁰Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract +

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May 23, 2024

View abstract on PubMed

Summary

Patients with left-sided colon cancer show better overall survival (OS) after colorectal hepatic metastasectomy than those with middle/low rectal cancer. This survival benefit was particularly noted in patients with RAS mutations, highlighting distinct prognostic implications.

Area Of Science

Oncology
Surgical Oncology
Gastroenterology

Background

Clinical outcomes differ between left-sided colon cancer and middle/low rectal cancer.
Colorectal hepatic metastasectomy is a treatment option for patients with metastatic disease.

Purpose Of The Study

To investigate the impact of primary tumor location (left-sided colon vs. middle/low rectum) on overall survival (OS).
To analyze survival outcomes in patients undergoing colorectal hepatic metastasectomy based on tumor origin.

Main Methods

Retrospective analysis of 365 patients who underwent colorectal hepatic metastasectomy.
Classification into left-sided colon cancer and middle/low rectal cancer groups.
Survival analysis using Kaplan-Meier method and Cox proportional hazards regression.

Main Results

Left-sided colon cancer patients demonstrated significantly better OS (median 48 months) compared to middle/low rectal cancer patients (median 38 months) (HR=0.725, P=.018).
In the RAS mutation subgroup, left-sided colon cancer showed a pronounced survival advantage (median 49 months vs. 26 months; HR=0.608, P=.034).

Conclusions

Middle/low rectal cancer is associated with poorer survival outcomes post-colorectal hepatic metastasectomy.
Patients with middle/low rectal cancer should be analyzed separately from left-sided colon cancer regarding OS.
Tumor location is a critical prognostic factor in patients undergoing hepatic metastasectomy.

Keywords:

Colorectal cancer Hepatic metastasectomy Overall survival RAS mutation