{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T18:59:01Z","timestamp":1770577141777,"version":"3.49.0"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nuklearmedizin"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This retrospective study aimed to investigate whether the differing biology of right-sided primary tumors (RSP) and left-sided primary tumors (LSP) in metastatic colorectal cancer (mCRC) affects survival outcomes following selective internal radiation therapy (SIRT).<\/jats:p>\n                  <jats:p>A cohort of 140 mCRC patients with liver metastases treated with SIRT between 2009 and 2016 was analyzed. Patients were stratified by tumor localization (RSP: proximal colon; LSP: distal colon and rectum), clinical, histopathological, and molecular data, were collected. Survival outcomes (OS and PFS) were evaluated using Kaplan-Meier analysis. Cox regression analysis identified independent predictors of survival, and subgroup analyses examined differences between RSP and LSP patients.<\/jats:p>\n                  <jats:p>Of the patients, 80.7% had LSP, and 19.3% had RSP. RSP patients demonstrated more aggressive tumor biology, with a higher frequency of poorly differentiated tumors (G3), extrahepatic metastases and K-RAS mutations. Median OS was significantly longer for LSP patients (7.0 months) compared to RSP patients (4.0 months, p&lt;0.005). Similarly, PFS was longer for LSP patients (3.0 months) than for RSP patients (1.6 months, p&lt;0.032). Multivariable Cox regression analysis revealed that K-RAS mutation (HR 3.345, p=0.017), N2 lymph node involvement (HR 2.458, p=0.015), and RSP localization (HR 0.338, p=0.001) were independently associated with poor survival.<\/jats:p>\n                  <jats:p>This study demonstrates that right-sided tumor localization, K-RAS mutation, and N2 lymph node involvement are key predictors of poor survival following SIRT in mCRC patients. RSP tumors, with distinct molecular and clinical profiles, exhibit shorter median OS and PFS after SIRT compared to LSP tumors.<\/jats:p>","DOI":"10.1055\/a-2738-2390","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T23:54:08Z","timestamp":1764892448000},"page":"13-21","source":"Crossref","is-referenced-by-count":0,"title":["Primary Tumor Localization is Associated with Progression-free Survival and Overall Survival after Selective-Internal-Radio-Therapy of Liver Metastases in Metastatic Colorectal Cancer"],"prefix":"10.1055","volume":"65","author":[{"given":"Lucia","family":"Lutat","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, University Hospital Bonn, Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Kreppel","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, University Hospital Bonn, Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milka","family":"Marinova","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, University Hospital Bonn, Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingo G. H.","family":"Schmidt-Wolf","sequence":"additional","affiliation":[{"name":"Center for Integrated Oncology, University Hospital Bonn, Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carsten","family":"Meyer","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Essler","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, University Hospital Bonn, Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"15065","DOI":"10.1038\/nrdp.2015.65.","article-title":"Colorectal cancer. Nature reviews","volume":"1","author":"EJ Kuipers","year":"2015","journal-title":"Disease primers"},{"issue":"01","key":"ref2","doi-asserted-by":"publisher","first-page":"e24","DOI":"10.3747\/co.26.4217","article-title":"Efficacy of second-line chemotherapy after a first-line triplet in patients with metastatic colorectal cancer","volume":"26","author":"S Bazarbashi","year":"2019","journal-title":"Current oncology (Toronto, Ont.)"},{"issue":"07","key":"ref3","doi-asserted-by":"publisher","first-page":"659","DOI":"10.7150\/ijms.24453.","article-title":"New Trends in the Therapeutic Approach to Metastatic Colorectal Cancer","volume":"15","author":"J S\u00e1nchez-Gund\u00edn","year":"2018","journal-title":"International journal of medical sciences"},{"issue":"23","key":"ref4","doi-asserted-by":"publisher","first-page":"2392","DOI":"10.1001\/jama.2017.7105.","article-title":"Effect of First-Line Chemotherapy Combined With Cetuximab or Bevacizumab on Overall Survival in Patients With KRAS Wild-Type Advanced or Metastatic Colorectal Cancer: A Randomized Clinical Trial","volume":"317","author":"AP Venook","year":"2017","journal-title":"JAMA"},{"issue":"06","key":"ref5","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1097\/01.sla.0000128305.90650.71.","article-title":"Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection\/ablation for colorectal liver metastases","volume":"239","author":"EK Abdalla","year":"2004","journal-title":"Annals of surgery"},{"issue":"06","key":"ref6","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1002\/bjs.10834.","article-title":"Biomarkers in colorectal liver metastases","volume":"105","author":"S Yamashita","year":"2018","journal-title":"The British journal of surgery"},{"issue":"09","key":"ref7","doi-asserted-by":"publisher","first-page":"1278","DOI":"10.1002\/bjs.8845.","article-title":"Repeat hepatic resection for colorectal liver metastases","volume":"99","author":"RA Adair","year":"2012","journal-title":"The British journal of surgery"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1312","DOI":"10.1007\/s11605-013-2190-5","article-title":"A systematic review of repeat hepatectomy for recurrent colorectal liver metastases","volume":"17","author":"VWT Lam","year":"2013","journal-title":"J Gastrointest Surg"},{"issue":"03","key":"ref9","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1002\/hep.24451.","article-title":"Survival after yttrium-90 resin microsphere radioembolization of hepatocellular carcinoma across Barcelona clinic liver cancer stages: a European evaluation","volume":"54","author":"B Sangro","year":"2011","journal-title":"Hepatology (Baltimore, Md.)"},{"issue":"03","key":"ref10","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1002\/hep.24451.","article-title":"Survival after yttrium-90 resin microsphere radioembolization of hepatocellular carcinoma across Barcelona clinic liver cancer stages: a European evaluation","volume":"54","author":"B Sangro","year":"2011","journal-title":"Hepatology (Baltimore, Md.)"},{"issue":"15","key":"ref11","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1200\/JCO.2015.66.1181.","article-title":"SIRFLOX: Randomized Phase III Trial Comparing First-Line mFOLFOX6 (Plus or Minus Bevacizumab) Versus mFOLFOX6 (Plus or Minus Bevacizumab) Plus Selective Internal Radiation Therapy in Patients With Metastatic Colorectal Cancer","volume":"34","author":"GA Hazel","year":"2016","journal-title":"Journal of clinical oncology : official journal of the American Society of Clinical Oncology"},{"issue":"03","key":"ref12","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1038\/bjc.2016.191.","article-title":"Yttrium-90 radioembolization for unresectable\/recurrent intrahepatic cholangiocarcinoma: a survival, efficacy and safety study","volume":"115","author":"C Mosconi","year":"2016","journal-title":"British journal of cancer"},{"issue":"09","key":"ref13","doi-asserted-by":"publisher","first-page":"1404","DOI":"10.2967\/jnumed.113.135855","article-title":"The efficacy of hepatic 90Y resin radioembolization for metastatic neuroendocrine tumors: a meta-analysis","volume":"55","author":"Z Devcic","year":"2014","journal-title":"Journal of nuclear medicine: official publication, Society of Nuclear Medicine"},{"issue":"04","key":"ref14","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.1245\/s10434-013-3436-1.","article-title":"Yttrium-90 radioembolization for unresectable, chemoresistant breast cancer liver metastases: a large single-center experience of 40 patients","volume":"21","author":"A Saxena","year":"2014","journal-title":"Annals of surgical oncology"},{"issue":"04","key":"ref15","doi-asserted-by":"publisher","first-page":"e617","DOI":"10.1016\/j.clcc.2018.06.001.","article-title":"Effect of Primary Tumor Side on Survival Outcomes in Untreated Patients With Metastatic Colorectal Cancer When Selective Internal Radiation Therapy Is Added to Chemotherapy: Combined Analysis of Two Randomized Controlled Studies","volume":"17","author":"P Gibbs","year":"2018","journal-title":"Clinical colorectal cancer"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.clcc.2019.09.003.","article-title":"High Concordance and Negative Prognostic Impact of RAS\/BRAF\/PIK3CA Mutations in Multiple Resected Colorectal Liver Metastases","author":"TH Brunsell","year":"2019","journal-title":"Clinical colorectal cancer"},{"issue":"01","key":"ref17","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1080\/1120009X.2019.1692282","article-title":"Impact of KRAS mutation status on outcomes of metastatic colorectal cancer treated with anti-angiogenic agents: a meta-analysis","volume":"32","author":"X Liang","year":"2020","journal-title":"Journal of chemotherapy (Florence, Italy)"},{"issue":"07","key":"ref18","doi-asserted-by":"publisher","first-page":"e180996","DOI":"10.1001\/jamasurg.2018.0996.","article-title":"Association of BRAF Mutations With Survival and Recurrence in Surgically Treated Patients With Metastatic Colorectal Liver Cancer","volume":"153","author":"GA Margonis","year":"2018","journal-title":"JAMA surgery"},{"issue":"10","key":"ref19","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1080\/14737140.2018.1502664.","article-title":"Targeted therapy for metastatic colorectal cancer","volume":"18","author":"TJ Price","year":"2018","journal-title":"Expert review of anticancer therapy"},{"issue":"02","key":"ref20","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1007\/s00261-016-0875-8.","article-title":"Connecting cancer biology and clinical outcomes to imaging in KRAS mutant and wild-type colorectal cancer liver tumors following selective internal radiation therapy with yttrium-90","volume":"42","author":"MJ Magnetta","year":"2017","journal-title":"Abdom Radiol (NY)"},{"issue":"08","key":"ref21","doi-asserted-by":"publisher","first-page":"1386","DOI":"10.1093\/annonc\/mdw235.","article-title":"ESMO consensus guidelines for the management of patients with metastatic colorectal cancer","volume":"27","author":"E Cutsem","year":"2016","journal-title":"Annals of oncology : official journal of the European Society for Medical Oncology"},{"issue":"06","key":"ref22","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/s11864-018-0543-z.","article-title":"Promising New Agents for Colorectal Cancer","volume":"19","author":"S Das","year":"2018","journal-title":"Current treatment options in oncology"},{"issue":"08","key":"ref23","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1007\/s40265-018-0921-7.","article-title":"Colorectal Cancer: Why Does Side Matter?","volume":"78","author":"C Gallois","year":"2018","journal-title":"Drugs"},{"issue":"03","key":"ref24","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1016\/j.tranon. 2018.12.003","article-title":"Oncologic Outcomes in Metastatic Colorectal Cancer with Regorafenib with FOLFIRI as a Third- or Fourth-Line Setting","volume":"12","author":"C-J Ma","year":"2019","journal-title":"Translational oncology"},{"issue":"10","key":"ref25","doi-asserted-by":"publisher","first-page":"1995","DOI":"10.1093\/annonc\/mdu275.","article-title":"Distal and proximal colon cancers differ in terms of molecular, pathological, and clinical features","volume":"25","author":"E Missiaglia","year":"2014","journal-title":"Annals of oncology : official journal of the European Society for Medical Oncology"},{"issue":"21","key":"ref26","doi-asserted-by":"publisher","first-page":"6470","DOI":"10.3748\/wjg.v21.i21.6470.","article-title":"Different treatment strategies and molecular features between right-sided and left-sided colon cancers","volume":"21","author":"H Shen","year":"2015","journal-title":"World journal of gastroenterology"},{"issue":"23","key":"ref27","doi-asserted-by":"publisher","first-page":"7303","DOI":"10.1158\/1078-0432.CCR-11-1570.","article-title":"Gene expression differences between colon and rectum tumors","volume":"17","author":"R Sanz-Pamplona","year":"2011","journal-title":"Clinical cancer research: an official journal of the American Association for Cancer Research"},{"issue":"08","key":"ref28","doi-asserted-by":"publisher","DOI":"10.3390\/cancers11081042.","article-title":"Circulating Tumor Cells in Right- and Left-Sided Colorectal Cancer","volume":"11","author":"C Nicolazzo","year":"2019","journal-title":"Cancers"},{"issue":"10","key":"ref29","doi-asserted-by":"publisher","first-page":"1518","DOI":"10.1038\/s41416-020-0812-z.","article-title":"Immune phenotype and histopathological growth pattern in patients with colorectal liver metastases","volume":"122","author":"S Stremitzer","year":"2020","journal-title":"British journal of cancer"},{"issue":"04","key":"ref30","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1016\/j.clcc.2022.09.002","article-title":"CIRT Principal Investigators. Prognostic factors for effectiveness outcomes after transarterial radioembolization in metastatic colorectal cancer: results from the multicentre observational study CIRT","volume":"21","author":"N Schaefer","year":"2022","journal-title":"Clin Colorectal Cancer"},{"issue":"08","key":"ref31","doi-asserted-by":"publisher","first-page":"1102","DOI":"10.1016\/j.jvir.2015.05.032.","article-title":"KRAS status as an independent prognostic factor for survival after yttrium-90 radioembolization therapy for unresectable colorectal cancer liver metastases","volume":"26","author":"SJ Lahti","year":"2015","journal-title":"J Vasc Interv Radiol"},{"issue":"04","key":"ref32","doi-asserted-by":"publisher","first-page":"264","DOI":"10.14740\/gr1062w.","article-title":"Difference between left-sided and right-sided colorectal cancer: a focused review of literature","volume":"11","author":"B Baran","year":"2018","journal-title":"Gastroenterol Res"},{"issue":"01","key":"ref33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4132\/KoreanJPathol.2013.47.1.1.","article-title":"Radiotherapy response in microsatellite instability related rectal cancer","volume":"47","author":"JS Shin","year":"2013","journal-title":"Korean J Pathol"}],"container-title":["Nuklearmedizin - NuclearMedicine"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2738-2390.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T23:30:24Z","timestamp":1770420624000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2738-2390"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,4]]},"references-count":33,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2026,2,6]]},"published-print":{"date-parts":[[2026,2]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2738-2390","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0029-5566","2567-6407"],"issn-type":[{"value":"0029-5566","type":"print"},{"value":"2567-6407","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,4]]}}}