Skin Disorders and Primary Tumor Location as Prognostic Factors in Patients with Metastatic Colorectal Cancer Treated with Cetuximab and Chemotherapy

摘要

Background: Cetuximab-induced skin disorder is common in colorectal cancer (CRC), and is known to affectprolonged overall survival (OS). Patients with left-sided CRC survive longer than those with right-sided CRC, amongthose treated with combination cetuximab and chemotherapy. However, no study has evaluated patient prognosisin terms of OS and progression-free survival (PFS) in relation to both tumor location and skin disorder. This studyaimed to determine the incidence of skin disorder according to tumor location and analyze the relationship of tumorlocation and skin disorder with OS. Methods: Patients with metastatic colorectal cancer (mCRC) treated with standardchemotherapy and cetuximab as first-line therapy were included. Differences in the incidence of skin disorders due tothe location of the primary tumors were compared in the same patient. The OS and PFS in relation to the location ofthe primary tumors and presence or absence of skin disorder were also compared. Results: Total frequency of eachskin disorder as rash acneiform, paronychia, and dry skin in patients with left- and right-sided mCRC was 70%, 70%,and 43% and 27%, 36%, and 27%, respectively. The median OS was 8.9 months for mCRC on the left-sided withoutskin disorder and 56.3 months for mCRC on the left-sided with skin disorder. In comparison, the median OS was 10.4months for mCRC on the right-sided without skin disorder and 11.3 months for mCRC on the right-sided with skindisease (left-sided with skin disorder versus other three group; P0.001). Conclusions: Primary tumor location andthe presence of skin disorder are important factors in patients with mCRC who receive cetuximab. In particular, ourresults show the new fact that the left-sided and right-sided mCRC survival time were comparable if there is no skindisorder caused by cetuximab.