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KMID : 0371420190960060296
Annals of Surgical Treatment and Research
2019 Volume.96 No. 6 p.296 ~ p.304
Impact of tumor sidedness on survival and recurrence patterns in colon cancer patients
Lee Jong-Min

Han Yoon-Dae
Cho Min-Soo
Hur Hyuk
Min Byung-Soh
Lee Kang-Young
Kim Nam-Kyu
Abstract
Purpose: Previous studies have reported conflicting results regarding the prognostic value of tumor sidedness in colon cancer. We investigated the oncologic impact of tumor location and examined whether recurrence patterns were related to tumor sidedness in colon cancer patients.

Methods: We identified stage I?III colon adenocarcinoma patients from a prospective colorectal cancer registry at Severance Hospital, Seoul, Korea, who underwent complete mesocolic excision between 2005 and 2012. Adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for predictors of cancer-specific survival (CSS), recurrence-free survival (RFS), and cumulative recurrence at specific anatomic sites were examined using Cox proportional hazard regression analysis.

Results: Overall, 1,912 patients, 1,077 (56.3%) with left-sided colon cancer (LCC), and 835 (43.7%) with right-sided colon cancer (RCC), at a median follow-up of 59 months, were eligible and included in the study. In univariate analysis, similar 5-year CSS and RFS were observed for LCC and RCC in the total patient population, and when stratified by stage for stage I and II patients. For stage III patients, an adjusted Cox regression analysis indicated that RCC patients had a higher risk of cancer-specific mortality (HR, 1.75; 95% CI, 1.07?2.86; P = 0.024) and recurrence (HR, 1.78; 95% CI, 1.22?2.60; P = 0.003). Furthermore, RCC was an independent predictor of peritoneal recurrence (HR, 1.86; 95% CI, 1.05?3.29; P = 0.031) in stage III patients.

Conclusion: RCC correlated with worse CSS and RFS than LCC. In stage III patients, RCC correlated with increased risk of peritoneal recurrence. The reasons for these differences remain to be investigated.
KEYWORD
Colonic neoplasm, Right, Left, Neoplasm recurrence, local, Survival, Treatment outcome
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