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

SCOT: Tumor sidedness and the influence of chemotherapy duration on DFS

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  • Medientyp: E-Artikel
  • Titel: SCOT: Tumor sidedness and the influence of chemotherapy duration on DFS
  • Beteiligte: Saunders, Mark P.; Paul, James; Crosby, Jana; Brown, Gordon; Iveson, Timothy; Kerr, Rachel; Harkin, Andrea; Allan, Karen; McQueen, John; Pearson, Sarah R; Cassidy, James; Medley, Louise C.; Raouf, Sherif; Harrison, Mark; Brewster, Alison; Rees, Charlotte; Ellis, Richard; Thomas, Anne L.; Churn, Mark; Maka, Noori
  • Erschienen: American Society of Clinical Oncology (ASCO), 2018
  • Erschienen in: Journal of Clinical Oncology
  • Sprache: Englisch
  • DOI: 10.1200/jco.2018.36.4_suppl.558
  • ISSN: 0732-183X; 1527-7755
  • Schlagwörter: Cancer Research ; Oncology
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:p> 558 </jats:p><jats:p> Background: Patients with R-sided tumours who develop metastatic disease have a worse prognosis compared to patients with L-sided tumours. The latter may also have a greater benefit from treatment with EGFR inhibitors. In general, registry studies and meta-analyses have shown that patients with loco-regional R-sided tumours have a worse overall survival (OS). This has recently been confirmed by the PETACC8 study but only after they had relapsed. There was not a significant difference in disease free survival (DFS). Methods: The SCOT study showed that 3-months of oxaliplatin-containing adjuvant chemotherapy (OxFp) was non-inferior to 6-months for patients with stage III and high-risk stage II colorectal cancer. Here we divide the population into left and right-sided tumours to see whether sidedness had an impact on DFS. We also evaluated whether sidedness impacted on the 3 vs. 6-months comparison in SCOT. Results: 6088 patients with Stage III/high risk Stage II cancers or the colon or rectum were randomised between March 27, 2008 and November 29, 2013 from 244 centres (164 UK, 32 Australia, 19 Spain, 14 Sweden, 10 Denmark and 5 New Zealand). In February 2017 (3-years FU) information on sidedness was available for 3219 patients (1207 R-sided, 2012 L-sided). Characteristics: Right: median age: 65, Male: 53%, T4 41%, Stage II: 17%; Left: median age: 65, Male: 66%, T4 24%, Stage II: 21%). Patients with R-sided tumours had a significantly worse DFS (3-year DFS right: 73% (se=1%), left: 80% (se=1%). HR 1.401 (95% CI 1.216-1.615; p=0.000004). Adjusting for T and N-stage reduced the HR to 1.215 (95% ci 1.051-1.404, p=0.009). The data did not suggest that sidedness affected the impact of chemotherapy duration on 3-year DFS (R: HR (3 month/6 month) 1.049 (0.849 -1.296) L: 0.910 (0.753-1.099). Test for homogeneity, p=0.327). Further sub-set analysis was limited due to cohort size. Conclusions: This is the first study to show that unselected patients with R-sided tumours had a worse DFS compared to L-sided tumours. This implies that prognosis is influenced primarily by greater recurrence rather than the contributing factors that influence OS. Tumour sidedness did not impact on the 3-months vs. 6-months comparison in SCOT. Clinical trial information: ISRCTN59757862. </jats:p>
  • Zugangsstatus: Freier Zugang