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.
Original language | English |
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Article number | 251 |
Number of pages | 9 |
Journal | BMC Cancer |
Volume | 17 |
DOIs | |
Publication status | Published - 2017 |
Open Access - Access Right Statement
© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Keywords
- cancer
- colon (anatomy)