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Does Tumor Location Impact Response to Adjuvant Therapy in Patients With Colon Cancer?

By: Joseph Fanelli
Posted: Monday, April 15, 2019

For Italian patients with stages II and III colon cancer receiving adjuvant therapy, primary tumor location may be associated with a different prognostic impact, according to findings from a GISCAD analysis of three randomized trials, presented in the European Journal of Cancer. The effect of the location is limited to overall survival in stage III cancer, with less of an impact in stage II cancer, concluded Stefano Cascinu, MD, of the Modena Cancer Center at the Universita` di Modena e Reggio Emilia, Italy, and colleagues.

“Our data suggest that it is not essential to stratify for primary tumor location in stage III disease if the trial endpoint is [disease-free survival], and in stage II tumors, it should be considered neither for [disease-free survival] nor for [overall survival],” the authors concluded.

The researchers analyzed clinical outcomes based on the primary tumor location in 5,239 patients with colon cancer from 3 Italian trials. The locations were the left side (55%), the right side (29%), and transverse (16%).

At the multivariate analysis, disease-free survival findings comparing right- and left-sided tumors were not statistically associated with clinical outcomes in the overall population. Of note, overall survival findings in right- and left-sided tumors were significantly associated with outcomes (hazard ratio = 1.20).  In patients with stage II tumors, there appeared to be no difference in disease-free or overall survival among the tumor locations, whereas in those with stage III patients, left-sided tumors displayed an improved prognosis for overall survival (hazard ratio = 1.36).

“These findings, indirectly, confirm the undisputable advances made in the treatment of metastatic colorectal cancer during the years,” Dr. Cascinu and colleagues concluded.

Disclosure: The study authors reported no conflicts of interest.

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