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Does Side Really Matter? Survival Analysis among Patients with Right- Versus Left-Sided Colon Cancer: A Propensity Score-Adjusted Analysis

Annals of Surgical Oncology volume 28, pages 2768–2778 (2021)Cite this article

Abstract

Background

Right- and left-sided colon cancer are increasingly regarded as two independent disease entities based on different gene expression profiles as well as underlying genetic mutations. Data regarding prognosis and survival are heterogeneous and more favorable in cases of left-sided colon cancer.

Objective

The purpose of this study was to evaluate the long-term oncological outcome for patients with left-sided versus right-sided stage I–III colon cancer.

Methods

Overall, 318 consecutive patients who underwent surgery for right- or left-sided sided colon cancer between 2001 and 2014 were analyzed. Analysis was performed applying a prospectively maintained database with respect to overall, disease-specific, and relative survival, using Cox regression and propensity score analyses.

Results

A total of 155 patients (48.7%) presented with right-sided colon cancer and 163 patients (51.3%) presented with left-sided colon cancer. In risk-adjusted Cox regression analysis, tumor location had no significant impact on overall survival (hazard ratio [HR] 1.53, 95% confidence interval [CI] 0.80–2.92; p = 0.197), disease-specific survival (HR 1.36, 95% CI 0.76–2.44; p = 0.301), and relative survival (HR 1.70, 95% CI 0.89–3.27; p = 0.107). After propensity score matching, the results from risk-adjusted Cox regression analysis were confirmed. Stratified by American Joint Committee on Cancer stage, patients with right-sided stage II colon cancer had a statistically significant superior relative survival compared with patents with left-sided colon cancer.

Conclusions

No significant negative impact on overall, disease-specific, or relative survival could be observed in patients with right- versus left-sided colon cancer after risk adjustment, using multivariable Cox regression and propensity score analyses.

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Funding

This trial was funded by a grant from the Heidelberg Foundation of Surgery.

Author information

Affiliations

  1. Department of Visceral, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany

    Johannes Klose MD

  2. Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany

    Johannes Klose MD, Pia Antony MD, Lukas F. Liesenfeld MD, Markus W. Büchler MD, Martin Schneider MD & Ignazio Tarantino MD

  3. Department of Applied Tumor Biology, Institute of Pathology, University of Heidelberg, Heidelberg, Germany

    Matthias Kloor MD

  4. Department of General, Visceral, Endocrine and Transplantation Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland

    René Warschkow MD & Ignazio Tarantino MD

Authors
  1. Johannes Klose MD
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  2. Matthias Kloor MD
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  3. René Warschkow MD
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  4. Pia Antony MD
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  5. Lukas F. Liesenfeld MD
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  6. Markus W. Büchler MD
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  7. Martin Schneider MD
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  8. Ignazio Tarantino MD
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Contributions

The final version of the manuscript was read and approved by all authors. JK and IT designed the study; JK, MK, and LFL participated in data collection; JK, MK, RW, PA, MWB, MS, and IT analyzed and interpreted the data; JK and IT wrote the paper; and JK and IT drafted the paper.

Corresponding author

Correspondence to Johannes Klose MD.

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Disclosures

Johannes Klose, Matthias Kloor, René Warschkow, Pia Antony, Lukas F. Liesenfeld, Markus W. Büchler, Martin Schneider, and Ignazio Tarantino have no disclosures to declare.

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Klose, J., Kloor, M., Warschkow, R. et al. Does Side Really Matter? Survival Analysis among Patients with Right- Versus Left-Sided Colon Cancer: A Propensity Score-Adjusted Analysis. Ann Surg Oncol 28, 2768–2778 (2021). https://doi.org/10.1245/s10434-020-09116-y

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  • DOI: https://doi.org/10.1245/s10434-020-09116-y

Keywords

  • Colon cancer
  • Left-sided
  • Right-sided
  • Survival
  • Microsatellite status
  • Propensity score analysis