Impact of Primary Tumor Location on Postoperative Recurrence and Subsequent Prognosis in Nonmetastatic Colon Cancers

Ishihara, Soichiro; Murono, Koji; Sasaki, Kazuhito; Yasuda, Koji; Otani, Kensuke; Nishikawa, Takeshi; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Kawai, Kazushige; Hata, Keisuke; Nozawa, H; Sugihara, Kenichi; Watanabe, Toshiaki

doi:10.1097/sla.0000000000002206

Cited by 40 publications

(54 citation statements)

References 31 publications

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“…Regarding the histology subtype, most colon cancers were adenocarcinoma, but more mucinous adenocarcinoma was observed in RCC patients. In our study, 9.6% of RCC was mucinous adenocarcinoma, which was consistent with other studies . Histological grade showed a significant proportion of poor differentiation in RCC, and this was also frequently observed in previous studies …”

Section: Discussionsupporting

confidence: 93%

“…Previous studies have revealed a more advanced stage at diagnosis and a more mucinous component of RCC compared with LCC . In the current study, the excised tumor size was larger in RCC than in LCC with a mean difference of about 1 cm in either width or length.…”

Section: Discussionmentioning

confidence: 42%

“…Bufill et al found distinct genetic characteristics among colon cancers between the proximal and distal regions of the large intestine; proximal colon cancer is genetically more stable than distal colon cancer, which indicates that two different entities of colon cancer, according to primary tumor location, may exist . Numerous studies have shown that RCC is predominately found in women and older patients; this contrasts with LCC, which predominantly occurs in men . RCC is relatively less symptomatic and typically presents as a larger and more advanced tumor upon diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Because of the differences in tumor behavior, RCC usually presents with nonspecific symptoms and is diagnosed at a more advanced stage compared with left‐sided colon cancer (LCC) . Besides adenocarcinoma, more mucinous components were found to be present in RCC . A molecular‐based investigation revealed more microsatellite instability, as well as KRAS and BRAF mutations in RCC .…”

Section: Introductionmentioning

confidence: 99%

“…For the reasons, many authors have indicated RCC as a disease distinct from LCC. Most studies have shown that survival with RCC is poorer than that with LCC for either primary lesions or cancer with metastasis . However, these previous studies mainly analyzed patients with primary colon cancer undergoing resection or patients with metastatic colorectal cancer.…”

Section: Introductionmentioning

confidence: 99%

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Primary tumor location in stage III colon cancer has prognostic impact on subsequent liver metastasis

Liao

Chiang

Tsai

et al. 2018

Journal of Surgical Oncology

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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.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 42%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Primary tumor location in stage III colon cancer has prognostic impact on subsequent liver metastasis

Liao

Chiang

Tsai

et al. 2018

Journal of Surgical Oncology

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Colorectal cancer treated by resection and extended lymphadenectomy: patterns of spread in left- and right-sided tumours

Kataoka

Beppu

Shiozawa

et al. 2020

British Journal of Surgery

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Background Whether tumour side affects the anatomical extent and distribution of lymph node metastasis in colon cancer is unknown. The impact of tumour side on the anatomical pattern of lymphatic spread in colon cancer was assessed. Methods Patients with stage III colon cancer from a Japanese multi‐institutional database who underwent extensive (D3) lymphadenectomy, which is similar in concept to complete mesocolic excision with central venous ligation, were divided into groups with right‐ and left‐sided tumours. Based on location, mesenteric lymph nodes were categorized as paracolic (L1), intermediate (L2) or central (L3). The Kaplan–Meier method was used to evaluate disease‐free survival (DFS) and overall survival (OS), and multivariable Cox models were used to evaluate the association between anatomical lymph node level, metastatic pattern and outcome. Results A total of 4034 patients with stage III colon cancer (right 1618, left 2416) were included. Unadjusted OS was worse in patients with right colon cancer (hazard ratio 1·23, 95 per cent c.i. 1·08 to 1·40; P = 0·002), but DFS was similar. Right‐sided tumours more frequently invaded L3 nodes than left‐sided lesions (8·5 versus 3·7 per cent; P < 0·001). The proportion of patients with a skipped pattern of lymphatic spread was higher in right than in left colon cancer (13·7 versus 9·0 per cent; P < 0·001). In multivariable analysis, invasion of L3 nodes was associated with worse OS in left but not in right colon cancer. The presence of skipped metastasis was associated with worse DFS in left, but not right, colon cancer. Conclusion There are significant differences in the pattern of lymph node invasion between right‐ and left‐sided stage III colon cancer, and in their prognostic significance, suggesting that tumour side may dictate the operative approach.

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Current treatment and surveillance modalities are not sufficient for advanced stage III colon cancer: Result from a multicenter cohort analysis

Xie

Huang

et al. 2021

Cancer Medicine

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Objective:We conducted this multicenter cohort study to evaluate the current tumor-node-metastasis staging system and treatment modality by analyzing the survival outcomes of patient groups with stage III and IV colon cancer. Patients and Methods:Stage III and IV colon cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database (SEER cohort) and prospectively maintained Sun Yat-sen University (SYSU) cohort were included in this study. Kaplan-Meier method was used to estimate the cumulative rate of overall survival (OS) between patient groups, and the inverse probability weighting method was used to calculated age and sex-adjusted survival curves. The Cox regression model was used to identify the risk factors for OS.Results: A total of 17,911 and 1135 stage III-IV cases were included in the SEER and SYSU cohorts, respectively. Among them, 1448 and 124 resectable stage IV cases underwent curative-intent treatment in the SEER and SYSU cohorts, respectively. The T4N2b group showed a significantly worse survival outcome compared with the M1a subset receiving curative-intent treatment (HR, 1.46; p < 0.001). This finding was validated in the SYSU cohort, in which the T4N2 group had a worse outcome than that of the M1 group receiving curative-intent treatment (HR, 2.44; p < 0.001). These findings were confirmed in the adjusted survival analysis. In the multivariate analysis, the right-side tumor, poor-undifferentiated tumor, and age over 60 years were identified as independent risk factors for T4N2b patients.

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Impact of Primary Tumor Location on Postoperative Recurrence and Subsequent Prognosis in Nonmetastatic Colon Cancers

Abstract: The primary tumor location of nonmetastatic colon cancer might have different prognostic implications for the rates of recurrence after curative resection and cancer-specific mortality after recurrence.

Cited by 40 publications

References 31 publications

Primary tumor location in stage III colon cancer has prognostic impact on subsequent liver metastasis

Primary tumor location in stage III colon cancer has prognostic impact on subsequent liver metastasis

Colorectal cancer treated by resection and extended lymphadenectomy: patterns of spread in left- and right-sided tumours

Current treatment and surveillance modalities are not sufficient for advanced stage III colon cancer: Result from a multicenter cohort analysis

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