Korean J Intern Med.
2019 Jan;34(1):165-177. 10.3904/kjim.2016.348.
The impact of primary tumor location in patients with metastatic colorectal cancer: a Korean Cancer Study Group CO12-04 study
- Affiliations
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- 1Department of Internal Medicine, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.
- 2Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
- 3Center for Colorectal Cancer, National Cancer Center, Goyang, Korea.
- 4Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
- 5Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
- 6Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea.
- 7Department of Hemato-Oncology, Inje University Haeundae Paik Hospital, Busan, Korea.
- 8Department of Internal Medicine, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.
- 9Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
- 10Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea.
- 11Division of OncologyHematology, Department of Medicine, Yeungnam University College of Medicine, Daegu, Korea.
- 12Department of Internal Medicine, Dankook University Hospital, Cheonan, Korea.
- 13Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
- 14Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea.
- 15Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
- 16Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
- 17Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
- 18Department of Internal Medicine, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea.
- 19Division of Oncology-Hematology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea.
- 20Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
- 21Division of Hematology-Oncology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
- 22Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. pys27hmo@skku.edu
- KMID: 2452500
- DOI: http://doi.org/10.3904/kjim.2016.348
Abstract
- BACKGROUND/AIMS
Colorectal cancer is associated with different anatomical, biological, and clinical characteristics. We determined the impact of the primary tumor location in patients with metastatic colorectal cancer (mCRC).
METHODS
Demographic data and clinical information were collected from 1,115 patients from the Republic of Korea, who presented with mCRC between January 2009 and December 2011, using web-based electronic case report forms. Associations between the primary tumor location and the patient's clinical characteristics were assessed, and factors inf luencing overall survival were analyzed using Cox proportional hazards regression models.
RESULTS
Of the 1,115 patients recruited to the study, 244 (21.9%) had right colon cancer, 483 (43.3%) had left colon cancer, and 388 (34.8%) had rectal cancer. Liver and lung metastases occurred more frequently in patients with left colon and rectal cancer (p = 0.005 and p = 0.006, respectively), while peritoneal and ovarian metastases occurred more frequently in patients with right and left colon cancer (p < 0.001 and p = 0.031, respectively). The median overall survival of patients with tumors originating in the right colon was significantly shorter than that of patients whose tumors had originated in the left colon or rectum (13.7 months [95% confidence interval (CI), 12.0 to 15.5] vs. 18.0 months [95% CI, 16.3 to 19.7] or 19.9 months [95% CI, 18.5 to 21.3], respectively; p = 0.003). Tumor resection, the number of metastatic sites, and primary tumor location correlated with overall survival in the univariate and multivariate analyses.
CONCLUSIONS
Primary tumor location influences the metastatic sites and prognosis of patients with mCRC.
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