Better survival in right-sided versus left-sided stage I - III colon cancer patients

被引：150

作者：

Warschkow, Rene ^{[1
,2
]}

Sulz, Michael C. ^{[3
]}

Marti, Lukas ^{[1
]}

Tarantino, Ignazio ^{[4
]}

Schmied, Bruno M. ^{[1
]}

Cerny, Thomas ^{[5
]}

Gueller, Ulrich ^{[4
,5
,6
]}

机构：

[1] Kantonsspital St Gallen, Dept Surg, CH-9007 St Gallen, Switzerland

[2] Heidelberg Univ, Inst Med Biometry & Informat, D-69120 Heidelberg, Germany

[3] Kantonsspital St Gallen, Div Gastroenterol & Hepatol, CH-9007 St Gallen, Switzerland

[4] Heidelberg Univ, Dept Gen Abdominal & Transplant Surg, D-69120 Heidelberg, Germany

[5] Kantonsspital St Gallen, Div Med Oncol & Hematol, CH-9007 St Gallen, Switzerland

[6] Univ Hosp Berne, Univ Clin Visceral Surg & Med, CH-3010 Bern, Switzerland

来源：

BMC CANCER | 2016年 / 16卷

关键词：

Colon cancer; Right-sided; Left-sided; Survival; SEER; MICROSATELLITE INSTABILITY; EPIDEMIOLOGY; SURVEILLANCE; SHIFT; AGE;

D O I：

10.1186/s12885-016-2412-0

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: The distinction between right-sided and left-sided colon cancer has recently received considerable attention due to differences regarding underlying genetic mutations. There is an ongoing debate if right-versus left-sided tumor location itself represents an independent prognostic factor. We aimed to investigate this question by using propensity score matching. Methods: Patients with resected, stage I - III colon cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) database (2004-2012). Both univariable and multivariable Cox regression as well as propensity score matching were used. Results: Overall, 91,416 patients (51,937 [56.8 %] with right-sided, 39,479 [43.2 %] with left-sided colon cancer; median follow-up 38 months) were eligible. In univariable analysis, patients with right-sided cancer had worse overall (hazard ratio [HR] = 1.32, 95 % CI: 1.29-1.36, P < 0.001) and cancer-specific survival (HR = 1.26, 95 % CI: 1.21-1.30, P < 0.001) compared to patients with left-sided cancer. After propensity score matching, the prognosis of right-sided carcinomas was better regarding overall (HR = 0.92, 95 % CI: 0.89 - 0.94, P < 0.001) and cancer-specific survival (HR = 0.90, 95 % CI: 0. 87 - 0.93, P < 0.001). In stage I and II, the prognosis of right-sided cancer was better for overall (HR = 0.89, 95 % CI: 0.84-0. 94 and HR = 0.85, 95 % CI: 0.81-0.89) and cancer-specific survival (HR = 0.71, 95 % CI: 0.64 - 0.79 and HR = 0.75, 95 % CI: 0. 70-0.80). Right-and left-sided colon cancer had a similar prognosis for stage III (overall: HR = 0.99, 95 % CI: 0.95-1.03 and cancer-specific: HR = 1.04, 95 % CI: 0.99-1.09). Conclusions: This population-based analysis on stage I - III colon cancer provides evidence that the prognosis of localized right-sided colon cancer is better compared to left-sided colon cancer. This questions the paradigm from previous research claiming a worse survival in right-sided colon cancer patients.

引用

页数：14

共 33 条

[1]

[Anonymous], 2018, ANTI-CANCER DRUG, DOI [DOI 10.3322/caac.20115, DOI 10.1097/CAD.0000000000000617]

[2] Increasing Disparities in the Age-Related Incidences of Colon and Rectal Cancers in the United States, 1975-2010 [J].