Prognostic impact of primary tumor location in colorectal liver metastases - right-sided colon versus left-sided colon versus rectum: a single-center retrospective study

Abstract Purpose Currently, right colon cancer (RCC), left colon cancer (LCC), and rectal cancer (REC) are typically considered as different tumor entities when discussed. The curative effect and different prognoses of patients with colorectal liver metastases (CRLM) whom underwent simultaneous radical surgery are studied based on the site of the primary tumor. Methods This study analyzed 215 patients with CRLM at the First Affiliated Hospital of Sun Yat-sen University and were treated with radical surgery from 2008 to 2021. All data were analyzed by SPSS. Results Ratio of right colon liver metastasis (RCLM) of longitudinal diameter of primary tumor ≥ 5cm was more than left colon liver metastasis (LCLM) and rectal cancer liver metastasis (ReCLM) (61.0% versus 34.3% versus 33.3%, p = 0.001), and similarly for Percentage circumference of intestinal wall involved=1 (74.6% versus 57.8% versus 50.0%, p = 0.021).The three-year overall survival (OS) of RCLM group was significantly less than LCLM group and ReCLM group (37.5% versus 64.7% versus 62.5%, p = 0.016). The univariate and Multivariate analysis showed Percentage circumference of intestinal wall involved, lymph node metastasis and CA199 were the independent risk factors for OS of RCLM, and Percentage circumference of intestinal wall involved and CA199 were the independent risk factors for DFS of CRLM. Conclusion Primary tumors should be considered when analyzing the outcomes of CRLM.