Primary Tumor Location and Survival in the General Population With Metastatic Colorectal Cancer

Molecular characterization of a large unselected cohort of metastatic colorectal cancers in relation to primary tumor location, rare metastatic sites and prognosis

“…In contrast to most recent studies in mCRC, this study could not substantiate worse survival for right-sided compared to left-sided tumors [27,28]. In this study and a Canadian population study [16], we find that about 40% of patients with mCRC have a right-sided tumor. The two mCRC subgroups with the worst prognosis, MSI-H and BRAFmutated tumors are all more common in right-sided tumors.…”

“…Several reports claim that right-sided tumors have a worse prognosis and require different treatment upfront, beyond the information provided by investigation of RAS, BRAF and microsatellite instability (MSI). However, most of this evidence has been obtained from trial patients and real-world evidence is limited [16].…”

Do we make progress in elderly patients with metastatic colorectal cancer?

“…In another article from Australia including almost 6000 patients from either a population-based register (SA) or from a treatment-related register (TRACC) [22], the proportion actively treated with chemotherapy (or surgery) clearly differs with 61% in SA, in line with what other populations registers have reported [8,14,15,25] and 78% in TRACC, in line with the 80% reported in the Danish study referred to above [21]. Patients with lung and liver metastases only did better than those with peritoneal metastases and particularly those with brain and skeletal metastases.…”

CA19-9 Concentration After First-line Chemotherapy Is Prognostic Predictor of Metastatic Colon Cancer

“…Analysis of the Cox proportional hazard model regarding differences in primary cancer site (right-side or left-side colon), which has recently become a topic of discussion (25)(26)(27), revealed a significant difference only in serum CA19-9 levels at four months after starting chemotherapy, and the serum CA19-9 levels had a higher hazard ratio than the difference between the primary cancer being in the left or the right colon. It has been reported that little effect can be expected from anti-epidermal growth factor receptor (EGFR) antibodies as a concomitant drug with chemotherapy in patients with primary cancer in the right-side colon (25)(26)(27). In the current study, there were more cases in which angiogenesis inhibitors were used as a concomitant drug with chemotherapy in patients with primary cancer in the rightside colon as compared to anti-EGFR antibodies.…”