文章：

原发肿瘤部位对芬兰转移性结直肠癌患者人口统计学特征、可切除性、治疗结局及生活质量的影响（RAXO研究亚组分析）

Impact of Primary Tumor Location on Demographics, Resectability, Outcomes, and Quality of Life in Finnish Metastatic Colorectal Cancer Patients (Subgroup Analysis of the RAXO Study)

原文发布日期：5 March 2024

DOI: 10.3390/cancers16051052

类型: Article

开放获取: 是

英文摘要：

The primary tumor location (PTL) is associated with the phenotype, metastatic sites, mutations, and outcomes of metastatic colorectal cancer (mCRC) patients, but this has mostly been studied according to sidedness (right vs. left sided). We studied right colon vs. left colon vs. rectal PTL in a real-life study population (n= 1080). Health-related quality of life (HRQoL) was assessed multi-cross-sectionally with QLQ-C30, QLQ-CR29, EQ-5D, and 15D. A chi-square, Kaplan–Meier, and Cox regression were used to compare the groups. The PTL was in the right colon in 310 patients (29%), the left colon in 396 patients (37%), and the rectum in 375 patients (35%). The PTL was associated with distinct differences in metastatic sites during the disease trajectory. The resectability, conversion, and resection rates were lowest in the right colon, followed by the rectum, and were highest in the left colon. Overall survival was shortest for right colon compared with left colon or rectal PTL (median 21 vs. 35 vs. 36 months), with the same trends after metastasectomy or systemic therapy only. PTL also remained statistically significant in a multivariable model. The distribution of symptoms varied according to PTL, especially between the right colon (with general symptoms of metastases) and rectal PTL (with sexual- and bowel-related symptoms). mCRC, according to PTL, behaves differently regarding metastatic sites, resectability of the metastases, outcomes of treatment, and HRQoL.

摘要翻译： 

原发肿瘤部位（PTL）与转移性结直肠癌（mCRC）患者的表型、转移部位、基因突变及预后相关，但既往研究多基于肿瘤侧性（右侧与左侧）进行探讨。本研究在真实世界研究人群（n=1080）中，比较了右半结肠、左半结肠及直肠原发肿瘤的差异。采用QLQ-C30、QLQ-CR29、EQ-5D及15D量表对健康相关生活质量（HRQoL）进行多时点横断面评估。组间比较采用卡方检验、Kaplan-Meier法和Cox回归分析。结果显示，310例（29%）患者原发肿瘤位于右半结肠，396例（37%）位于左半结肠，375例（35%）位于直肠。在疾病进程中，原发肿瘤部位与转移灶分布特征存在显著差异。右半结肠原发肿瘤的转移灶可切除率、转化率及切除率最低，直肠次之，左半结肠最高。与左半结肠或直肠原发肿瘤相比，右半结肠原发患者的总生存期最短（中位生存期分别为21个月 vs. 35个月 vs. 36个月），这一趋势在仅接受转移灶切除术或全身系统治疗的患者中保持一致。多变量模型中，原发肿瘤部位仍具有统计学显著性。症状分布因原发部位而异，右半结肠肿瘤主要表现为转移相关全身症状，而直肠肿瘤则以性功能及肠道相关症状为特征。研究表明，不同原发部位的转移性结直肠癌在转移模式、转移灶可切除性、治疗结局及健康相关生活质量方面均存在显著差异。

原文链接：

Impact of Primary Tumor Location on Demographics, Resectability, Outcomes, and Quality of Life in Finnish Metastatic Colorectal Cancer Patients (Subgroup Analysis of the RAXO Study)