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Primary tumor location in stage III colon cancer has prognostic impact on subsequent liver metastasis
Author(s) -
Liao ChunKai,
Chiang JyMing,
Tsai WenSy,
You JengFu,
Hsieh PaoShiu,
Hung HsinYuan,
Chen HongHwa,
Tang ReiPing,
Chen JinnShiun,
Yeh ChienYuh
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25270
Subject(s) - medicine , colorectal cancer , cancer , metastasis , malignancy , gastroenterology , oncology , stage (stratigraphy) , primary tumor , multivariate analysis , transverse colon , survival analysis , survival rate , paleontology , biology
Background and Objectives We aim to investigate whether a difference exists between right‐sided and left‐sided colon cancer at the same disease stage and subsequent liver metastasis and identify whether tumor location can independently influence survival. Methods Right‐sided colon cancer was defined as malignancy arising from the cecum to the transverse colon; left‐sided colon cancer was defined as malignancy arising from the splenic flexure to the sigmoid colon. Clinicopathological features and survival data were collected for analysis. Results Overall, 1442 patients were included for analysis. The median follow‐up time was 58.2 months. Patients with left‐sided colon cancer had better 5‐year overall survival (75.2% vs 61.7%, P = 0.005), 5‐year cancer‐specific survival (81.6% vs 73.4%, P = 0.001), and 5‐year recurrence‐free survival (70.9% vs 66.5%, P = 0.033) compared with patients having right‐sided colon cancer. After the presentation of subsequent liver metastasis, patients with primary left‐sided colon cancer had better 3‐year cancer‐specific survival ( P < 0.001). In the multivariate analysis, cancer location was an independent prognostic factor for cancer‐specific survival (right vs left, HR: 1.276, 95% CI: 1.002‐1.625). Conclusions The primary tumor location can serve as a prognostic factor for treatment outcomes either in primary stage III colon cancer or subsequent liver metastasis.