Is There a Difference in Survival Between Right- Versus Left-Sided Colon Cancers?
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The incidence of right-sided colon cancers has been increasing in recent years. It is unclear whether patient prognosis varies by tumor location. In this study, we have compared the survival of right-and left-sided colon cancers in a longitudinal population-based database.
A retrospective survival analysis was performed using the Surveillance, Epidemiology, and End Results Program (SEER) database between 1988 and 2003 on subjects who underwent surgical resection for the a primary diagnosis of pathologically confirmed invasive colon adenocarcinoma. Cox proportional hazard regression analysis was used to assess long-term survival outcomes comparing right-sided (cecum to transverse colon, excluding appendix) versus left-sided (splenic flexure to sigmoid, excluding rectum) colon cancers.
A total of 77,978 subjects were identified with adenocarcinoma of the colon. Overall median survival was 83 months. Median survival for right-sided cancers was 78 vs. 89 months for left-sided cancers (P < .001). By Cox proportional hazard regression analysis, controlling for statistically significant confounders, including age, sex, race, marital status, tumor stage, tumor size, histologic grade, number of lymph nodes examined, and year of diagnosis, right-sided colon cancers were associated with a 5% increased mortality risk compared with left-sided colon cancers (hazard ratio, 1.04; 95% confidence interval, 1.02–1.07). These findings were consistent across subsets of subjects.
On the basis of analysis of information from the SEER database, we found that right-sided colon cancers have a worse prognosis than left-sided colon cancers. The reason for this remains unclear but may be due to biological and/or environmental factors and may have particular bearing, given the rising incidence of right-sided colon cancers.
- Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008. CA Cancer J Clin 2008; 58:71–96
- Obrand, DI, Gordon, PH (1998) Continued change in the distribution of colorectal carcinoma. Br J Surg 85: pp. 246-8 CrossRef
- Levi, F, Randimbison, L, La Vecchia, C (1993) Trends in subsite distribution of colorectal cancers and polyps from the Vaud Cancer Registry. Cancer 72: pp. 46-50 CrossRef
- Jass, JR (1991) Subsite distribution and incidence of colorectal cancer in New Zealand, 1974–1983. Dis Colon Rectum 34: pp. 56-9 CrossRef
- Iacopetta, B (2002) Are there two sides to colorectal cancer?. Int J Cancer 101: pp. 403-8 CrossRef
- Distler, P, Holt, PR (1997) Are right-and left-sided colon neoplasms distinct tumors?. Dig Dis 15: pp. 302-11 CrossRef
- Glebov, OK, Rodriguez, LM, Nakahara, K (2003) Distinguishing right from left colon by the pattern of gene expression. Cancer Epidemiol Biomarkers Prev 12: pp. 62-755
- Birkenkamp-Demtroder, K, Olesen, SH, Sorensen, FB (2005) Differential gene expression in colon cancer of the caecum versus the sigmoid and rectosigmoid. Gut 54: pp. 374-84 CrossRef
- Reifferscheid M, Fass J, Hartung R, et al. [Special aspects of right colon cancer]. Langenbecks Arch Chir 1987; 371:193–200
- Surveillance, Epidemiology, and End Results Program (SEER). Public-Use Data (1973–2002) released April 2005, based on November 2004 submission. Available at: http://seer.cancer.gov/data/. Accessed 29 August 2006
- Zippin, C, Lum, D, Hankey, BF (1995) Completeness of hospital cancer case reporting from the SEER Program of the National Cancer Institute. Cancer 76: pp. 2343-50 CrossRef
- Langman, J (1981) Medical Embryology. Williams & Wilkins, Baltimore
- Gervaz, P, Bucher, P, Morel, P (2004) Two colons—two cancers: paradigm shift and clinical implications. J Surg Oncol 88: pp. 261-6 CrossRef
- Popat, S, Hubner, R, Houlston, RS (2005) Systematic review of microsatellite instability and colorectal cancer prognosis. J Clin Oncol 23: pp. 609-18 CrossRef
- Malesci, A, Laghi, L, Bianchi, P (2007) Reduced likelihood of metastases in patients with microsatellite-unstable colorectal cancer. Clin Cancer Res 13: pp. 3831-9 CrossRef
- Is There a Difference in Survival Between Right- Versus Left-Sided Colon Cancers?
Annals of Surgical Oncology
Volume 15, Issue 9 , pp 2388-2394
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- Colon cancer
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- Author Affiliations
- 1. Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- 2. Department of Surgery, Georgetown University Hospital, Washington, DC, USA
- 3. Cameron Division of Surgical Oncology, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- 4. 1650 Orleans St, CRB-I Room 342, Baltimore, MD, 21231, USA