Comparison of 627 patients with right- and left-sided colon cancer in China: Differences in clinicopathology, recurrence, and survival
Objective: Recent studies have reported increased mortality for right-sided colon cancers; however, the results are conflicting for different stage tumors. We examined the differences in clinicopathology between right- and left-sided colon cancers and the relationships between colon cancer location...
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| Autores principales: | , , , , , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
KeAi Communications Co., Ltd.
2017
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/982f8063c64f443ea7229180d9533734 |
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| Sumario: | Objective: Recent studies have reported increased mortality for right-sided colon cancers; however, the results are conflicting for different stage tumors. We examined the differences in clinicopathology between right- and left-sided colon cancers and the relationships between colon cancer location (right- and left-side) and 5-year disease-free survival (DFS) and overall survival (OS). Methods: We identified patients from 2005 to 2008 with stage II/III colon cancer who underwent surgery for curative intent. We explored the impact of the tumor location on the postoperative DFS and OS using univariate and multivariate analyses. Results: Of 627 patients, 50.6% (317/627) had right-sided colon cancer. These patients were more likely to have weight loss, second primary tumor, elevated preoperative carbohydrate antigen 19-9 (CA19-9), increased incidence of non-adenocarcinoma, more poorly differentiated tumors, vascular invasion, defective mismatch repair, and a lighter smoking history (PÂ <Â 0.05). Right-sided colon cancer had a higher recurrence incidence compared with left-sided cancer (30.6% vs. 23.2%, PÂ =Â 0.037), particularly with multiple metastatic sites in the first recurrence (17.5% vs. 5.6%, PÂ =Â 0.020). KaplanâMeier survival curves demonstrated a significant difference in the 5-year DFS rate between right- and left-sided cancers across all stages (68.1% vs. 75.2%, PÂ =Â 0.043). However, there was no significant difference in the 5-year OS rate between the two groups (73.8% vs. 79.0%, PÂ =Â 0.103). Subgroup analysis demonstrated that patients with left-sided colon cancer had a significantly better 5-year DFS and OS rates compared with those with right-sided disease at stage III (64.3% vs. 46.8%, PÂ =Â 0.002; 69.5% vs. 53.5%, PÂ =Â 0.006, respectively); there were no significant differences in the 5-year DFS and OS rates at stage II (85.2% vs. 85.9%, PÂ =Â 0.819; 89.8% vs. 88.5%, PÂ =Â 0.803, respectively). Adjusted Cox regression analysis showed no significant differences in the 5-year OS and DFS rates for stage II [hazard ratio (HR)Â =Â 1.203, 95% confidence interval (CI): 0.605â2.391, PÂ =Â 0.598; HRÂ =Â 0.980, 95% CI:Â 0.542â1.774, PÂ =Â 0.948, respectively] or all stages combined (HR = 0.867, 95% CI: 0.613â1.227, P = 0.421; HR = 0.832, 95% CI: 0.606â1.142, P = 0.255, respectively). However, stage III left-sided cancer had higher 5-year OS and DFS rates (HRÂ =Â 0.626, 95% CI: 0.414â0.948, PÂ =Â 0.027; HRÂ =Â 0.630, 95% CI: 0.428â0.926, PÂ =Â 0.019, respectively). Conclusion: We found that right- and left-sided colon cancers had significantly different clinicopathological characteristics. Right-sided colon cancer had a higher incidence of recurrence than left-sided disease. Patients with stage III right-sided colon cancer had a worse prognosis compared with those with stage III left-sided colon cancer. Keywords: Colon cancer, Location, Recurrence, Survival |
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