Highlights
- •The differences in DFS between left and right colorectal tumors were investigated in patients recruited to the SCOT study.
- •Right sided colorectal tumors have a worse DFS compared to left sided tumors.
- •Tumor sidedness did not impact upon outcomes for 3 months versus 6 months adjuvant oxaliplatin based chemotherapy.
Abstract
Aim
Patients with loco-regional right-sided colorectal tumors have a worse overall survival
(OS). Here we investigate the difference in disease free survival (DFS) between colorectal
patients with right and left sided tumors in the SCOT study.
Methods
The SCOT study showed 3-months of oxaliplatin-containing adjuvant chemotherapy (OxFp)
is non-inferior to 6-months for patients with stage III and high-risk stage II colorectal
cancer. We divided the cohort into patients with left and right sided tumors, and
evaluated the effect on DFS and the principle 3 versus 6-months analysis.
Results
6088 patients with Stage III/high risk Stage II colorectal cancers were randomized
between 27th March 2008 and 29th November 2013 from 244 centers internationally. In February 2017 (3-years FU) information
on sidedness was available for 3309 patients (1238 R-sided, 2071 L-sided). Patients
with right-sided tumors had a significantly worse DFS (3-year DFS right: 73.3% (se = 1.3%),
left: 80.2% (se = 0.9%) HR 1.423 (95% CI 1.237-1.637; P < .0001). Adjusting for T and N-stage reduced the HR to 1.230 (95% CI 1.066-1.420,
P = .005). The data did not suggest that sidedness affected the impact of chemotherapy
duration on 3-year DFS (R: HR 1.024 [0.831-1.261], L: HR 0.944 [0.783-1.139]). Test
for heterogeneity, P = .571. Further sub-set analysis was limited due to cohort size.
Conclusions
This is the first study to show that unselected patients with right-sided tumors had
a worse DFS compared to left-sided tumors. Tumor sidedness did not impact upon the
3-months versus 6-months comparison in SCOT.
Keywords
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Article info
Publication history
Published online: February 21, 2023
Accepted:
February 10,
2023
Received in revised form:
February 7,
2023
Received:
March 21,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Inc.
