SCOT: Tumor Sidedness and the Influence of Adjuvant Chemotherapy Duration on Disease Free Survival (DFS)

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical colorectal cancer Pub Date : 2023-06-01 DOI:10.1016/j.clcc.2023.02.005

Mark P. Saunders , Rohan Iype , Caroline Kelly , Jana Crosby , Rachel Kerr , Andrea Harkin , Karen Allan , John McQueen , Sarah R Pearson , James Cassidy , Louise C. Medley , Sherif Raouf , Mark Harrison , Alison Brewster , Charlotte Rees , Richard Ellis , Anne L. Thomas , Mark Churn , Timothy Iveson , Noori Maka

{"title":"SCOT: Tumor Sidedness and the Influence of Adjuvant Chemotherapy Duration on Disease Free Survival (DFS)","authors":"Mark P. Saunders , Rohan Iype , Caroline Kelly , Jana Crosby , Rachel Kerr , Andrea Harkin , Karen Allan , John McQueen , Sarah R Pearson , James Cassidy , Louise C. Medley , Sherif Raouf , Mark Harrison , Alison Brewster , Charlotte Rees , Richard Ellis , Anne L. Thomas , Mark Churn , Timothy Iveson , Noori Maka","doi":"10.1016/j.clcc.2023.02.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Aim</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>6088 patients with Stage III/high risk Stage II colorectal cancers were randomized between 27<sup>th</sup> March 2008 and 29<sup>th</sup> 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; <em>P</em> < .0001). Adjusting for T and N-stage reduced the HR to 1.230 (95% CI 1.066-1.420, <em>P</em> = .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, <em>P</em> = .571. Further sub-set analysis was limited due to cohort size.</p></div><div><h3>Conclusions</h3><p>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.</p></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"22 2","pages":"Pages 231-237"},"PeriodicalIF":3.3000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical colorectal cancer","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1533002823000087","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

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 27^th March 2008 and 29^th 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.

查看原文本刊更多论文

SCOT：肿瘤侧性和辅助化疗持续时间对无病生存（DFS）的影响

目的局部右侧结直肠肿瘤患者的总生存率（OS）较差。在SCOT研究中，我们研究了患有右侧和左侧肿瘤的结直肠患者在无病生存率（DFS）方面的差异。方法SCOT研究表明，对于癌症III期和II期高危患者，含奥沙利铂的辅助化疗（OxFp）3个月不劣于6个月。我们将队列分为左侧和右侧肿瘤患者，并评估对DFS的影响和原则3个月与6个月的分析。结果2008年3月27日至2013年11月29日期间，来自244个国际中心的6088名III期/高危II期结直肠癌患者被随机分组。2017年2月（3年FU），3309名患者（1238名R侧，2071名L侧）获得了侧性信息。右侧肿瘤患者的DFS明显较差（3年DFS右侧：73.3%（se=1.3%），左：80.2%（se=0.9%）HR 1.423（95%CI 1.237-1.637；P<；.0001）。调整T期和N期将HR降低到1.230（95%CI 1.066-1.420，P=.005）。数据不表明侧性影响化疗持续时间对3年DFS的影响（R:HR 1.024[0.831-1.261]，L:HR 0.944[0.783-1.339]）。异质性检验，P=.571。由于队列规模的原因，进一步的子集分析受到限制。结论这是第一项表明未经选择的右侧肿瘤患者的DFS比左侧肿瘤更差的研究。肿瘤侧性对SCOT中3个月与6个月的比较没有影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical colorectal cancer 医学-肿瘤学

CiteScore

5.50

自引率

2.90%

发文量

审稿时长

27 days

期刊介绍： Clinical Colorectal Cancer is a peer-reviewed, quarterly journal that publishes original articles describing various aspects of clinical and translational research of gastrointestinal cancers. Clinical Colorectal Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of colorectal, pancreatic, liver, and other gastrointestinal cancers. The main emphasis is on recent scientific developments in all areas related to gastrointestinal cancers. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.