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KMID : 1035920220250020053
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Journal of Minimally Invasive Surgery
2022 Volume.25 No. 2 p.53 ~ p.62
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Oncological impact of vascular invasion in colon cancer might differ depending on tumor sidedness
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Shalkamy Moamen Shalkamy Abdelgawaad
Bae Jung-Hoon
Lee Chul-Seung
Han Seung-Rim
Kim Ji-Hoon
Kye Bong-Hyeon
Lee In-Kyu
Lee Yoon-Suk
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Abstract
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Purpose: Vascular invasion is a well-known independent prognostic factor in colon cancer and tumor sidedness is also being considered a prognostic factor. The aim of this study was to compare the oncological impact of vascular invasion depending on the tumor location in stages I to III colon cancer.
Methods: A retrospective analysis was performed using data from patients who underwent curative resection between 2004 and 2015. Patients were divided into right-sided colon cancer (RCC) and left-sided colon cancer (LCC) groups according to the tumor location. Disease-free survival (DFS) and overall survival (OS) were compared between the RCC and LCC groups, depending on the presence of vascular invasion.
Results: A total of 793 patients were included, of which 304 (38.3%) had RCC and 489 (61.7%) had LCC. DFS and OS did not differ significantly between the RCC and LCC groups. Vascular invasion was a poor prognostic factor for DFS in both RCC (hazard ratio [HR], 2.291; 95% confidence interval [CI], 1.186?4.425; p = 0.010) and LCC (HR, 1.848; 95% CI, 1.139?2.998; p = 0.011). Additionally, it was associated with significantly worse OS in the RCC (HR, 3.503; 95% CI, 1.681?7.300; p < 0.001), but not in the LCC group (HR, 1.676; 95% CI, 0.885?3.175; p = 0.109). Multivariate analysis revealed that vascular invasion was independently poor prognostic factor for OS in the RCC (HR, 3.186; 95% CI, 1.391?7.300; p = 0.006).
Conclusion: This study demonstrated that RCC with vascular invasion had worse OS than LCC with vascular invasion.
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KEYWORD
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Colonic neoplasms, Vascular invasion, Survival, Tumor sidedness
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