Prognostic factors of patients with stagesI - III left-sided versus rightsided colon cancer receiving radical surgery / 肿瘤

ABSTRACT

Objective: To investigate the prognostic factors of patients with stages I-III left-sided colon cancer (LCC) versus right-sided colon cancer (RCC) receiving radical surgery. Methods: A retrospective analysis of clinical data from 332 patients with stages I-III colorectal cancer (CRC) who underwent radical surgery in Anhui Provincial Hospital, Anhui Medical University between February 2008 and February 2012 was conducted. The differences in clinicopathological characteristics by tumor location (RCC vs LCC) were examined by using χ2 test. The comparisons of overall 5-year survival rate between RCC and LCC within each stage and for all stages were done by using Kaplan-Meier method. The univariate analysis of prognosis was performed by using log-rank test, and the multivariate analysis was performed by using COX regression model. Results: The overall 5-year survival rate of all patients was 69.9%. The LCC patients had significantly higher overall 5-year survival rate than RCC patients (72.6% vs 66.9%, P = 0.020). The stage III LCC patients had significantly higher overall 5-year survival rate than the stage III RCC patients (62.5% vs 52.2%, P = 0.018), but no significant difference in overall 5-year survival rate was found between stage I or II RCC and LCC patients (P > 0.05). There were significant differences in T stage, histologic type, degree of differentiation, tumor size, hemoglobin, albumin, fibrinogen and carcinoembryonic antigen (CEA) between RCC and LCC patients (all P < 0.05). The univariate analysis showed that tumor location, T stage, N stage, histologic type, degree of differentiation, tumor size, hemoglobin, albumin, fibrinogen and CEA were significantly correlated with overall 5-year survival rate of CRC patients (all P < 0.05). Multivatiate analysis showed that N stage, histologic type, degree of differentiation, hemoglobin, albumin, fibrinogen and CEA were independent prognostic factors of CRC (all P < 0.05). Conclusion: For patients with stages I-III CRC treated with radical surgery, the factors of higher tumor N stage, mucinous adenocarcinoma/signet ring cell carcinoma, poorly differentiated carcinoma, anemia, hypoproteinemia, fibrinogen level more than 4 g/L and CEA level more than 10 ng/mL indicate a poor prognosis. The significant differences in clinicopathological characteristics and prognosis are found between RCC and LCC, but the tumor location is not an independent prognostic factor.