Ann Coloproctol.  2019 Feb;35(1):15-23. 10.3393/ac.2018.07.25.

Does the Different Locations of Colon Cancer Affect the Oncologic Outcome? A Propensity-Score Matched Analysis

Affiliations
  • 1Department of General Surgery, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, Korea.
  • 2Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. ipark@amc.seoul.kr
  • 3Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  • 4Asan Life Science, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Abstract

PURPOSE
We evaluate the prognostic value of primary tumor location for oncologic outcomes in patients with colon cancer (CC).
METHODS
CC patients treated with curative surgery between 2009 and 2012 were classified into 2 groups: right-sided colon cancer (RCC) and left-sided colon cancer (LCC). Recurrence-free survival (RFS) and overall survival (OS) were examined based on tumor stage. Propensity scores were created using eight variables (age, sex, T stage, N stage, histologic grade, presence of lymphovascular invasion/perineural invasion, and microsatellite instability status).
RESULTS
Overall, 2,329 patients were identified. The 5-year RFSs for RCC and LCC patients were 89.7% and 88.4% (P = 0.328), respectively, and their 5-year OSs were 90.9% and 93.4% (P = 0.062). Multivariate survival analyses were carried out by using the Cox regression proportional hazard model. In the unadjusted analysis, a marginal increase in overall mortality was seen in RCC patients (hazard ratio [HR], 1.297; 95% confidence interval [CI], 0.987-1.704, P = 0.062); however, after multivariable adjustment, similar OSs were observed in those patients (HR, 1.219; 95% CI, 0.91-1.633; P = 0.183). After propensity-score matching with a total of 1,560 patients, no significant difference was identified (P = 0.183). A slightly worse OS was seen for stage III RCC patients (HR, 1.561; 95% CI, 0.967-2.522; P = 0.068) than for stage III LCC patients. The 5-year OSs for patients with stage III RCC and stage III LCC were 85.5% and 90.5%, respectively (P = 0.133).
CONCLUSION
Although the results are inconclusive, tumor location tended to be associated with OS in CC patients with lymph node metastasis, but it was not related to oncologic outcome.

Keyword

Colonic neoplasms; Treatment outcome; Survival

MeSH Terms

Colon*
Colonic Neoplasms*
Humans
Lymph Nodes
Microsatellite Instability
Mortality
Neoplasm Metastasis
Propensity Score
Proportional Hazards Models
Treatment Outcome
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