Article Abstract

Comparison of clinicopathologic features and survival between patients with right-sided and left-sided stage III colon cancer

Authors: Min-Er Zhong, Bin Wu, Lai Xu, Yi Xiao, Guo-Le Lin, Hui-Zhong Qiu


Background: Previous studies have described diversities in biology and prognosis for colon cancer based on whether the primary is right-sided or left-sided. Recently, there is an ongoing debate as to whether tumor location itself represents an independent prognostic factor. We aimed to evaluate the clinicopathologic features and survival between right-sided (RCC) and left-sided (LCC) primary stage III colon cancer.
Methods: We performed a retrospective analysis of 175 Chinese patients with histologically proven TNM stage III colon cancer undergoing curative resection at our institute from 2005 to 2012. The objective was to analyze if there were any diversities in patients’ clinicopathologic features and survival based on whether the tumor was RCC (cecum to transverse colon, excluding the appendix) or LCC (splenic flexure to the sigmoid, excluding the rectum).
Results: A total of 175 patients were analyzed. RCC was found to be poorly differentiated (P=0.01), and was also more likely to develop carcinoma nodules (P=0.03). Mucinous adenocarcinoma (MAC) occurred more frequently in RCC. A higher lymph node ratio (LNR) was observed in patient with RCC. The mean overall survival (OS) time for the entire group regarding RCC and LCC was 89.55±5.02 and 100.32±4.93 months, respectively (P=0.02; 95% CI, 79.72–99.38 and 90.66–109.97); the mean disease-free survival (DFS) time for the entire group concerning RCC and LCC was 76.19±5.41 and 92.58±5.83 months, respectively (P=0.04; 95% CI, 65.59–86.79 and 81.18–104.01). Multivariate analysis confirmed tumor location and the LNR as independent prognostic factors.
Conclusions: A right-sided tumor location and an increasing positive LNR predict significantly worse survival.