Unraveling the role of tumor sidedness in prognosis of stage II colon cancer  

作　　者：Yun Yang Xiaobao Yang Zhigang Bai Xiaozhe Gu Saloni Rameshchandra Shah Kenish Sirajbhai Salewala Mansi Pankajbhai Kevadiya Zhongtao Zhang 

机构地区：[1]Department of General Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing,P.R.China [2]State Key Lab of Digestive Health,Beijing Friendship Hospital,Beijing,P.R.China [3]National Clinical Research Center for Digestive Diseases,Beijing Friendship Hospital,Beijing,P.R.China [4]International School,Capital Medical University,Beijing,P.R.China

出　　处：《Gastroenterology Report》2024年第1期167-175,共9页胃肠病学报道(英文)

基　　金：supported by the National Key Technologies R&D Program[grant number 2017YFC0110904];the Beijing Natural Science Foundation[grant number L222149];the Beijing Municipal Administration of Hospitals’Youth Programme[grant number QML20230122];the Beijing Municipal Administration of Hospitals Incubating Program[grant number PX2022002].

摘　　要：Background:Stage II colon cancer has varying risks for metastasis,and treatment strategies depend on molecular and clinicopathological features.While tumor-sidedness is a well-accepted prognostic factor for stage III/IV colon cancer,its role in stage II is controversial.Understanding its effect in stage II is crucial for improving treatment strategies.Methods:We analyzed clinical and follow-up data of colon cancer from the Surveillance,Epidemiology,and End Results database(2004-2017).Patients were divided into a primary study cohort(2010-2017)and a validation cohort(2004-2009).The baseline characteristics between right-sided colon cancer(RCC)and left-sided colon cancer(LCC)groups were compared.Moreover,the effect of tumor size on cancer-specific survival(CSS)was evaluated using Kaplan-Meier analysis.Results:The study involved 87,355 patients in the study cohort and 65,858 in the validation cohort.Of the study cohort,52.3%were diagnosed with RCC.The median age was 64years old,with 48.5%females and 76.8%of white people.In addition,stage II RCC showed better CSS compared with LCC(5-year CSS 88.0%vs 85.5%,P<0.001),while stage III/IV RCC demonstrated poorer outcomes.Multivariate Cox regression analysis identified that the right-sidedness was a positive prognostic factor in stages I/II but negative in stages III(HR 1.10,P<0.001)and IV(HR 1.26,P<0.001).Chemotherapy rates decreased in RCC,particularly in stage II(RCC vs LCC:16.2%vs 28.5%,P<0.001).Subgroup analysis,stratified by T3/T4 stages and chemotherapy status,further highlighted better survival outcomes in RCC.Conclusions:RCC is associated with a significantly better prognosis in stage II.The importance of considering tumor-sidedness in clinical decision-making and the design of future clinical trials should be emphasized.

关 键 词：colonic neoplasms tumor-sidedness right-sided colon cancer stage II SURVIVAL 

分 类 号：R73[医药卫生—肿瘤]