Document Detail

Prognostic impact of tumor location in stage iv colon cancer: a propensity score analysis in a multicenter study.
MedLine Citation:
PMID:  25091400     Owner:  NLM     Status:  Publisher    
BACKGROUND: Right-sided colon cancer is considered to be biologically different from left-sided colon cancer; however, conflicting results have been reported regarding differences in prognosis. We aimed to clarify the prognostic impact of tumor location in stage IV colon cancer.
METHODS: Stage IV colon cancer treated from January 1997 to December 2007 (n = 2,208) were retrospectively studied. Clinical and pathological features were compared between right-sided colon cancer (cecum, ascending, and transverse colon) and left-sided colon cancer (descending, sigmoid, and rectosigmoid colon). The impact of tumor location on cancer-specific survival (CSS) was analyzed in a multivariate analysis and propensity score analysis to mitigate the differences in background features.
RESULTS: Right-sided colon cancer was associated with older age, female sex, larger tumor size, poorly differentiated adenocarcinoma, mucinous adenocarcinoma, and signet-ring cell carcinoma, a more advanced state within stage IV disease, and a worse CSS. In the cohort matched by propensity scores for background clinicopathological features, tumor location in the right-sided colon was associated with a significantly worse CSS (hazard ratio 1.2, 95% confidence interval 1.1-1.4, p = 0.008) in patients treated with palliative primary tumor resection, but not in those treated with R0 resection or no resection.
CONCLUSION: Right-sided colon cancer were diagnosed at a more advanced state within stage IV disease and showed a significantly worse prognosis than left-sided colon cancer, suggesting that stage IV right-sided colon cancer is oncologically more aggressive than left-sided colon cancer.
Soichiro Ishihara; Takeshi Nishikawa; Toshiaki Tanaka; Junichiro Tanaka; Tomomichi Kiyomatsu; Kazushige Kawai; Keisuke Hata; Hioaki Nozawa; Takamitsu Kanazawa; Shinsuke Kazama; Hironori Yamaguchi; Eiji Sunami; Joji Kitayama; Yojiro Hashiguchi; Kenichi Sugihara; Toshiaki Watanabe
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-1
Journal Detail:
Title:  International journal of surgery (London, England)     Volume:  -     ISSN:  1743-9159     ISO Abbreviation:  Int J Surg     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101228232     Medline TA:  Int J Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014. Published by Elsevier Ltd.
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