SCOT: tumour sidedness and the influence of adjuvant chemotherapy duration on disease free survival (DFS)

Saunders, M. P. et al. (2023) SCOT: tumour sidedness and the influence of adjuvant chemotherapy duration on disease free survival (DFS). Clinical Colorectal Cancer, 22(2), pp. 231-237. (doi: 10.1016/j.clcc.2023.02.005) (PMID:36967267)

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Aim: Patients with loco-regional right-sided colorectal tumours have a worse overall survival (OS). Here we investigate the difference in DFS between colorectal patients with right and left sided tumours 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 tumours, and evaluated the effect on DFS and the principle 3 vs 6-months analysis. Results: 6088 patients with Stage III/high risk Stage II colorectal cancers were randomised between 27th March 2008 and 29th November 2013 from 244 centres 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 tumours 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 < 0.0001). Adjusting for T and N-stage reduced the HR to 1.230 (95% CI 1.066 – 1.420, p = 0.005). 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 = 0.571. Further sub-set analysis was limited due to cohort size. Conclusions: This is the first study to show that unselected patients with right-sided tumours had a worse DFS compared to left-sided tumours. Tumour sidedness did not impact upon the 3-months v 6-months comparison in SCOT.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Cassidy, Professor James and Allan, Ms Karen and Crosby, Dr Jana and Mcqueen, Mr John and Kelly, Mrs Caroline and Harkin, Mrs Andrea
Authors: Saunders, M. P., Iype, R., Kelly, C., Crosby, J., Kerr, R., Harkin, A., Allan, K., McQueen, J., Pearson, S. R., Cassidy, J., Medley, L. C., Raouf, S., Harrison, M., Brewster, A., Rees, C., Ellis, R., Thomas, A. L., Churn, M., Iveson, T., and Maka, N.
College/School:College of Medical Veterinary and Life Sciences > School of Cancer Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Clinical Colorectal Cancer
ISSN (Online):1938-0674
Published Online:22 February 2023
Copyright Holders:Copyright © 2023 Elsevier Inc.
First Published:First published in Clinical Colorectal Cancer 22(2): 231-237
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
173116Extension of Follow-Up for High Risk Stage II Patients (additional 3 years) and Stage III Patients (up to year 3 follow-up) in the SCOT study.James PaulNational Institute for Health Research (NIHR)14/140/84CS - Clinical Trials UInit Gartnavel
166187tranSCOT - sample collection for translational studies in colorectal cancer.James PaulCancer Research UK (CRUK)C6716/A13941CS - Clinical Trials UInit Gartnavel
160740CRUK Clinical Trials Unit Glasgow - Quinquennial reviewJames PaulCancer Research UK (CRUK)C973/A9894CS - Clinical Trials UInit Gartnavel