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- Aho, Sonja, et al.
(author)
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Impact of Primary Tumor Location on Demographics, Resectability, Outcomes, and Quality of Life in Finnish Metastatic Colorectal Cancer Patients (Subgroup Analysis of the RAXO Study)
- 2024
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In: Cancers. - : MDPI. - 2072-6694. ; 16:5
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Journal article (peer-reviewed)abstract
- Simple Summary The location of the primary tumor in the right colon, left colon, or rectum affects the efficacy of biological drugs used in the treatment of metastatic colorectal cancer, but how? We examined how the primary tumor location affects disease characteristics, treatability, quality of life, and outcome in a real-life study population of 1080 Finnish patients in the RAXO study. The primary tumor location correlates with the location of metastases, the frequency of gene mutations, how often metastases can be operated upon, long-term survival after curative surgery or palliative chemotherapy, and the quality of life during the disease trajectory. The primary tumor location is a helpful surrogate for clinicians working with metastatic colorectal cancer patients in estimating the clinical course of the disease. This study cannot identify the reasons for the associations, i.e., whether it is the primary location per se, the different mutations, or other reasons.Abstract The primary tumor location (PTL) is associated with the phenotype, metastatic sites, mutations, and outcomes of metastatic colorectal cancer (mCRC) patients, but this has mostly been studied according to sidedness (right vs. left sided). We studied right colon vs. left colon vs. rectal PTL in a real-life study population (n = 1080). Health-related quality of life (HRQoL) was assessed multi-cross-sectionally with QLQ-C30, QLQ-CR29, EQ-5D, and 15D. A chi-square, Kaplan-Meier, and Cox regression were used to compare the groups. The PTL was in the right colon in 310 patients (29%), the left colon in 396 patients (37%), and the rectum in 375 patients (35%). The PTL was associated with distinct differences in metastatic sites during the disease trajectory. The resectability, conversion, and resection rates were lowest in the right colon, followed by the rectum, and were highest in the left colon. Overall survival was shortest for right colon compared with left colon or rectal PTL (median 21 vs. 35 vs. 36 months), with the same trends after metastasectomy or systemic therapy only. PTL also remained statistically significant in a multivariable model. The distribution of symptoms varied according to PTL, especially between the right colon (with general symptoms of metastases) and rectal PTL (with sexual- and bowel-related symptoms). mCRC, according to PTL, behaves differently regarding metastatic sites, resectability of the metastases, outcomes of treatment, and HRQoL.
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| 2. |
- Jönsson, S., et al.
(author)
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Social climate and job control as mediators between empowering leadership and learning from a cross-cultural perspective
- 2015
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In: International Journal of Cross Cultural Management. - : SAGE Publications. - 1470-5958 .- 1741-2838. ; 15:2, s. 135-149
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Journal article (peer-reviewed)abstract
- The purpose of this article is to examine the direct effects of empowering leadership on learning and the indirect or mediating role of social climate and job control from a cross-cultural perspective. Questionnaires were distributed to two furniture retail stores in Sweden and two stores in China belonging to the same company. The final sample consisted of 483 participants from the Chinese and 254 participants from the Swedish stores. The results of the structural equation modeling showed that there was a direct relationship between empowering leadership and learning (both in the Chinese and the Swedish sample). The study also showed that social climate had a mediating effect of empowering leadership and learning (both in the Chinese and the Swedish sample). In addition, the result indicated that job control had a mediating effect (Swedish sample). The model explained 38% of the variance in learning among the Chinese sample and 62% in the Swedish. This indicates that the tested factors are highly relevant in the context of learning. Despite some methodological limitations such as the cross-sectional design and problems with acquiescence in responses, the results indicate the complexity of the role of culture in organizational behavior. Managers working in increasingly globalized contexts need to take into consideration that some organizational behaviors gradually become more universal, whereas others remain culturally contingent. This article illustrates the complex relationship between leadership behavior, social climate, job control, and learning in the same corporate culture but in different cultural settings. © SAGE Publications.
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