Introduction: Uncertainty exists about a possible survival benefit of primary tumor resection (PTR) in synchronous metastatic colon cancer (mCC). Since sidedness of the primary tumor is regarded as an important prognostic factor, our objective was to study the interaction between PTR and sidedness in synchronous mCC. Methods: In this retrospective study, we used data from 2 first-line phase 3 randomized controlled trials (RCTs). A mixed Cox regression model was used to study the multiplicative interaction between PTR and sidedness. We adjusted for age, treatment arm, WHO performance status, number of affected organs by metastases, serum lactate dehydrogenase, and year of enrollment. Results: We found that PTR is associated with better survival in both right-sided (hazard ratio [HR] 0.59 [95% confidence interval 0.42–0.8 2]) and left-sided mCC (HR 0.70 [95% confidence interval 0.52–0.93]). The interaction between PTR and sidedness was not significant (p = 0.45). Conclusion: Our data suggest that the prognostic value of PTR is independent of sidedness. Validation of these results will be performed in ongoing RCTs.
Dig Surg

中文翻译：

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前期原发肿瘤切除和肿瘤侧向在同步转移性结肠癌患者生存中的作用

简介：关于原发性肿瘤切除术 (PTR) 在同步转移性结肠癌 (mCC) 中可能的生存获益存在不确定性。由于原发肿瘤的侧面被认为是一个重要的预后因素，我们的目标是研究同步 mCC 中 PTR 和侧面之间的相互作用。方法：在这项回顾性研究中，我们使用了 2 项一线 3 期随机对照试验 (RCT) 的数据。混合 Cox 回归模型用于研究 PTR 和边性之间的乘法相互作用。我们调整了年龄、治疗组、WHO 体能状态、受转移影响的器官数量、血清乳酸脱氢酶和入组年份。结果：我们发现 PTR 与右侧（风险比 [HR] 0.59 [95% 置信区间 0.42-0.8 2]）和左侧 mCC（HR 0.70 [95% 置信区间 0.52-0.93]）的更好生存率相关. PTR 和偏向性之间的相互作用不显着（p = 0.45）。结论：我们的数据表明，PTR 的预后价值与偏向性无关。这些结果的验证将在正在进行的 RCT 中进行。
挖掘外科