Impact of tumor sidedness on survival and recurrence patterns in colon cancer patients

Jong Min Lee, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Namkyu Kim

Research output: Contribution to journalReview article

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.

Original languageEnglish
Pages (from-to)296-304
Number of pages9
JournalAnnals of Surgical Treatment and Research
Volume96
Issue number6
DOIs
Publication statusPublished - 2019 Jun 1

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Colonic Neoplasms
Recurrence
Survival
Neoplasms
Confidence Intervals
Regression Analysis
Patient Rights
Korea
Registries
Colorectal Neoplasms
Colon
Adenocarcinoma
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Lee, Jong Min ; Han, Yoon Dae ; Cho, Min Soo ; Hur, Hyuk ; Min, Byung Soh ; Lee, Kang Young ; Kim, Namkyu. / Impact of tumor sidedness on survival and recurrence patterns in colon cancer patients. In: Annals of Surgical Treatment and Research. 2019 ; Vol. 96, No. 6. pp. 296-304.
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title = "Impact of tumor sidedness on survival and recurrence patterns in colon cancer patients",
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.",
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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, Namkyu.

In: Annals of Surgical Treatment and Research, Vol. 96, No. 6, 01.06.2019, p. 296-304.

Research output: Contribution to journalReview article

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T1 - Impact of tumor sidedness on survival and recurrence patterns in colon cancer patients

AU - Lee, Jong Min

AU - Han, Yoon Dae

AU - Cho, Min Soo

AU - Hur, Hyuk

AU - Min, Byung Soh

AU - Lee, Kang Young

AU - Kim, Namkyu

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Y1 - 2019/6/1

N2 - 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.

AB - 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.

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