Comparison of 627 patients with right‐ and left‐sided colon cancer in China: Differences in clinicopathology, recurrence, and survival

Chronic Diseases and Translational Medicine - Tập 3 - Trang 51-59 - 2017
Qiong Qin1, Lin Yang2, Yong-Kun Sun2, Jian-Ming Ying3, Yan Song2, Wen Zhang2, Jin-Wan Wang2, Ai-Ping Zhou3
1Department of Medical Oncology, Tianjin Medical University General Hospital, Tianjin, 300052, China
2Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
3Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China

Tóm tắt

AbstractObjectiveRecent 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).MethodsWe 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.ResultsOf 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 (P < 0.05). Right‐sided colon cancer had a higher recurrence incidence compared with left‐sided cancer (30.6% vs. 23.2%, P = 0.037), particularly with multiple metastatic sites in the first recurrence (17.5% vs. 5.6%, P = 0.020). Kaplan–Meier 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%, P = 0.043). However, there was no significant difference in the 5‐year OS rate between the two groups (73.8% vs. 79.0%, P = 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%, P = 0.002; 69.5% vs. 53.5%, P = 0.006, respectively); there were no significant differences in the 5‐year DFS and OS rates at stage II (85.2% vs. 85.9%, P = 0.819; 89.8% vs. 88.5%, P = 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) = 1.203, 95% confidence interval (CI): 0.605–2.391, P = 0.598; HR = 0.980, 95% CI: 0.542–1.774, P = 0.948, respectively] or all stages combined (HR = 0.867, 95% CI: 0.613–1.227, P = 0.421; HR = 0.832, 95% CI: 0.606–1.142, P = 0.255, respectively). However, stage III left‐sided cancer had higher 5‐year OS and DFS rates (HR = 0.626, 95% CI: 0.414–0.948, P = 0.027; HR = 0.630, 95% CI: 0.428–0.926, P = 0.019, respectively).ConclusionWe 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.

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Chronic Diseases and Translational Medicine

Tập 3

51-59

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