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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Cancer 1/2017

Sidedness is prognostic in locoregional colon cancer: an analysis of 9509 Australian patients

Zeitschrift:
BMC Cancer > Ausgabe 1/2017
Autoren:
Daniel Brungs, Morteza Aghmesheh, Paul de Souza, Weng Ng, Wei Chua, Martin Carolan, Philip Clingan, Emma Healey, June Rose, Tameika Tubaro, Marie Ranson
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12885-017-3255-z) contains supplementary material, which is available to authorized users.

Abstract

Background/Aim

Right sided colon cancer (RsCC) is proposed to be a distinct disease entity to left sided colon cancer (LsCC). We seek to confirm primary tumour location as an independent prognostic factor in locoregional colorectal cancer.

Methods

All patients with stage I – III primary adenocarcinoma of colon were identified from the New South Wales (NSW) clinical cancer registry (2006–2013). Primary tumour location (RsCC vs LsCC) survival analyses were conducted using the Kaplan-Meier method, and adjusted hazard ratios for 5-year all-cause mortality (OS) and 5-year cancer specific mortality (CSS) were obtained using Cox proportional hazards regression.

Results

We identified 9509 patients including 5051 patients with RsCC and 4458 with LsCC. Patients with RsCC were more likely to be older, female, have a higher Charlson comorbidity index, and have worse tumour prognostic factors. In univariate analysis of all stages combined, those patients with RsCC had a worse overall survival (OS, HR 1.20 95% CI 1.11–1.29, p < 0.0001), although this was not significant in the multivariate analysis (HR 0.96 95% CI 0.89–1.04, p = 0.35). Stage I patients with RsCC had a trend to improved OS (multivariate HR 0.84 95% CI 0.69–1.01, p = 0.07) and a significantly improved CSS (multivariate HR 0.51 95% CI 0.35–0.75, p = 0.0006). In stage II patients with RsCC there was a significantly improved OS (multivariate HR 0.85 95% CI 0.75–0.98, p = 0.02) and CSS (multivariate HR 0.59 95% CI 0.45–0.78, p = 0.0002) compared to LsCC. In stage III patients, those with RsCC had a worse OS (multivariate HR 1.13 95% CI 1.01–1.26, p = 0.032) and a trend to worse CSS (multivariate HR 1.12 95% CI 0.94–1.33, p = 0.22).

Conclusions

Primary tumour location is an important prognostic factor in locoregional colon cancer with an effect that varies by stage. RsCC is associated with lower all-cause mortality in stage II, and higher all-cause mortality in stage III.
Zusatzmaterial
Additional file 1: Figure S1. Effect of adjuvant chemotherapy on overall survival in patients with right sided colon cancer. Description: Overall survival in patients with right sided colon cancer by receipt of adjuvant chemotherapy (n = 2076). (TIFF 40 kb)
12885_2017_3255_MOESM1_ESM.tif
Additional file 2: Figure S2. Effect of adjuvant chemotherapy on overall survival in patients with left sided colon cancer. Description: Overall survival in patients with left sided colon cancer by receipt of adjuvant chemotherapy (n = 2030). (TIFF 40 kb)
12885_2017_3255_MOESM2_ESM.tif
Literatur
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