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Kamphues C, Lefevre JH, Wang J, Amini N, Beaugerie L, Kuehn F, Park SH, Andreatos N, Lauscher JC, Enea D, Lehmann KS, Peru N, Weixler B, Kirchgesner J, Degro CE, Pozios I, van Beekum CJ, Schölch S, Zambonin D, Schineis C, Loch FN, Geka D, Theoxari M, Wu B, Wang PP, Antoniou E, Pikoulis E, Moussata D, Theodoropoulos G, Ouaissi M, Seeliger H, Inaba Y, Scaringi S, Reißfelder C, Vilz TO, Lin C, Yang SK, Beyer K, Renz BW, Sasaki K, Margonis GA, Svrcek M, Kreis ME. Prognostic value of primary tumor sidedness in patients with non-metastatic IBD related CRC - Is it the exception to the rule? Surg Oncol 2022; 45:101874. [PMID: 36257179 PMCID: PMC10266238 DOI: 10.1016/j.suronc.2022.101874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 09/22/2022] [Accepted: 10/04/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Although primary tumor sidedness (PTS) has a known prognostic role in sporadic colorectal cancer (CRC), its role in Inflammatory Bowel Disease related CRC (IBD-CRC) is largely unknown. Thus, we aimed to evaluate the prognostic role of PTS in patients with IBD-CRC. METHODS All eligible patients with surgically treated, non-metastatic IBD-CRC were retrospectively identified from institutional databases at ten European and Asian academic centers. Long term endpoints included recurrence-free (RFS) and overall survival (OS). Multivariable Cox proportional hazard regression as well as propensity score analyses were performed to evaluate whether PTS was significantly associated with RFS and OS. RESULTS A total of 213 patients were included in the analysis, of which 32.4% had right-sided (RS) tumors and 67.6% had left-sided (LS) tumors. PTS was not associated with OS and RFS even on univariable analysis (5-year OS for RS vs LS tumors was 68.0% vs 77.3%, respectively, p = 0.31; 5-year RFS for RS vs LS tumors was 62.8% vs 65.4%, respectively, p = 0.51). Similarly, PTS was not associated with OS and RFS on propensity score matched analysis (5-year OS for RS vs LS tumors was 82.9% vs 91.3%, p = 0.79; 5-year RFS for RS vs LS tumors was 85.1% vs 81.5%, p = 0.69). These results were maintained when OS and RFS were calculated in patients with RS vs LS tumors after excluding patients with rectal tumors (5-year OS for RS vs LS tumors was 68.0% vs 77.2%, respectively, p = 0.38; 5-year RFS for RS vs LS tumors was 62.8% vs 59.2%, respectively, p = 0.98). CONCLUSIONS In contrast to sporadic CRC, PTS does not appear to have a prognostic role in IBD-CRC.
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Affiliation(s)
- Carsten Kamphues
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of General and Visceral Surgery, Campus Benjamin Franklin, Berlin, Germany
| | - Jeremie H Lefevre
- Sorbonne Université, Department of Digestive Surgery, Assistance Publique des Hôpitaux de Paris AP-HP, Hôpital Saint Antoine, Paris, France
| | - Jane Wang
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Neda Amini
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Laurent Beaugerie
- Department of Gastroenterology, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Florian Kuehn
- Department of General, Visceral and Transplantation Surgery, Hospital of the University of Munich, Munich, Germany
| | - Sang Hyoung Park
- Department of Gastroenterology and Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Nikolaos Andreatos
- Department of Surgery and Department of Internal Medicine and Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Johannes C Lauscher
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of General and Visceral Surgery, Campus Benjamin Franklin, Berlin, Germany
| | - Diana Enea
- Sorbonne Université, Assistance Publique des Hôpitaux de Paris AP-HP, Department of Pathology, Saint-Antoine Hospital, Paris, France
| | - Kai S Lehmann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of General and Visceral Surgery, Campus Benjamin Franklin, Berlin, Germany
| | - Nicolas Peru
- Sorbonne Université, Department of Digestive Surgery, Assistance Publique des Hôpitaux de Paris AP-HP, Hôpital Saint Antoine, Paris, France
| | - Benjamin Weixler
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of General and Visceral Surgery, Campus Benjamin Franklin, Berlin, Germany
| | - Julien Kirchgesner
- Department of Gastroenterology, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Claudius E Degro
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of General and Visceral Surgery, Campus Benjamin Franklin, Berlin, Germany
| | - Ioannis Pozios
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of General and Visceral Surgery, Campus Benjamin Franklin, Berlin, Germany
| | | | - Sebastian Schölch
- Department of Surgery, University Medical Centre Mannheim and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Daniela Zambonin
- Department of Experimental and Clinical Medicine, IBD Unit, Careggi University Hospital, Florence, Italy
| | - Christian Schineis
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of General and Visceral Surgery, Campus Benjamin Franklin, Berlin, Germany
| | - Florian N Loch
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of General and Visceral Surgery, Campus Benjamin Franklin, Berlin, Germany
| | - Despoina Geka
- First Department of Propaedeutic Surgery, Hippokration General Hospital of Athens, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Theoxari
- First Department of Propaedeutic Surgery, Hippokration General Hospital of Athens, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Bin Wu
- Department of General Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Pei-Pei Wang
- Department of General Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Efstathios Antoniou
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Emmanouil Pikoulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - George Theodoropoulos
- First Department of Propaedeutic Surgery, Hippokration General Hospital of Athens, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Mehdi Ouaissi
- Department of Digestive, Oncological, Endocrine, Hepato-Biliary and Pancreatic Surgery, Liver Transplantation, Colorectal Surgery Unit, Trousseau Hospital, Tours, France
| | - Hendrik Seeliger
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of General and Visceral Surgery, Campus Benjamin Franklin, Berlin, Germany
| | - Yosuke Inaba
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Stefano Scaringi
- Department of Experimental and Clinical Medicine, IBD Unit, Careggi University Hospital, Florence, Italy
| | - Christoph Reißfelder
- Department of Surgery, University Medical Centre Mannheim and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Tim O Vilz
- Department of Surgery, University Hospital of Bonn, Bonn, Germany
| | - Chen Lin
- Department of General Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Suk-Kyun Yang
- Department of Gastroenterology and Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Katharina Beyer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of General and Visceral Surgery, Campus Benjamin Franklin, Berlin, Germany
| | - Bernhard W Renz
- Department of General, Visceral and Transplantation Surgery, Hospital of the University of Munich, Munich, Germany
| | - Kazunari Sasaki
- Department of Surgery and Department of Internal Medicine and Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Georgios Antonios Margonis
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of General and Visceral Surgery, Campus Benjamin Franklin, Berlin, Germany; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Magali Svrcek
- Sorbonne Université, Assistance Publique des Hôpitaux de Paris AP-HP, Department of Pathology, Saint-Antoine Hospital, Paris, France
| | - Martin E Kreis
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of General and Visceral Surgery, Campus Benjamin Franklin, Berlin, Germany
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Belias M, Sasaki K, Wang J, Andreatos N, Kamphues C, Kyriakos G, Seeliger H, Beyer K, Kreis ME, Margonis GA. Is Laterality Prognostic in Resected KRAS-Mutated Colorectal Liver Metastases? A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:799. [PMID: 35159066 PMCID: PMC8833748 DOI: 10.3390/cancers14030799] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND It is debated whether primary tumor laterality (PTL) is prognostic in all patients with colorectal liver metastases (CRLM) or only those with KRAS wild-type or KRAS-mutated tumors; Methods: We systematically reviewed PubMed for studies reporting on resected CRLM originating from left-sided (LS) versus right-sided (RS) colon cancer stratified by KRAS status. Individual participant data (IPD) were used if available. Given that there are two definitions of PTL, we performed two meta-analyses for KRAS-mutated and two for wild-type patients. To assess if an interaction underlies the possible difference between the effects of PTL in KRAS-mutated vs. wild-type CRLM, we similarly performed two meta-analyses of interaction terms; Results: The meta-analyses included eight studies and 7475 patients. PTL had a prognostic association with OS in patients with wild-type tumors (HR for LS: 0.71 [0.60-0.84]), but not in those with KRAS-mutated tumors (HR: 0.99 [0.82-1.19]). This difference stemmed from a truly variable effect of PTL for each KRAS status (mutated vs. wild-type) as the meta-analysis of interaction terms showed a significant interaction between them (HR:1.38 [1.24-1.53]). Similar results were obtained when the second definition of PTL (LS to not include the rectum) was used; Conclusions: KRAS status modifies the association of tumor site with survival. Right-sided tumors are associated with worse OS only in patients with wild-type CRLM.
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Affiliation(s)
- Michail Belias
- Health Evidence, Radboud University Medical Center, Mailbox 133, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands;
| | - Kazunari Sasaki
- Department of General Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (K.S.); (N.A.)
| | - Jane Wang
- Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA;
| | - Nikolaos Andreatos
- Department of General Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (K.S.); (N.A.)
| | - Carsten Kamphues
- Department of General and Visceral Surgery, Charité Campus Benjamin Franklin, 12200 Berlin, Germany; (C.K.); (H.S.); (K.B.); (M.E.K.)
| | - Georgios Kyriakos
- Division of Endocrinology and Nutrition, Hospital General Universitario Santa Lucia, 30202 Cartagena, Spain;
| | - Hendrik Seeliger
- Department of General and Visceral Surgery, Charité Campus Benjamin Franklin, 12200 Berlin, Germany; (C.K.); (H.S.); (K.B.); (M.E.K.)
| | - Katharina Beyer
- Department of General and Visceral Surgery, Charité Campus Benjamin Franklin, 12200 Berlin, Germany; (C.K.); (H.S.); (K.B.); (M.E.K.)
| | - Martin E. Kreis
- Department of General and Visceral Surgery, Charité Campus Benjamin Franklin, 12200 Berlin, Germany; (C.K.); (H.S.); (K.B.); (M.E.K.)
| | - Georgios Antonios Margonis
- Department of General and Visceral Surgery, Charité Campus Benjamin Franklin, 12200 Berlin, Germany; (C.K.); (H.S.); (K.B.); (M.E.K.)
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
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