Yaqi Li1, Yang Feng2, Weixing Dai1, Qingguo Li1, Sanjun Cai1, Junjie Peng3. 1. Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. 2. Department of Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China. 3. Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. Electronic address: pengjj67@hotmail.com.
Abstract
BACKGROUND: The prognostic value of tumor sidedness in metastatic colorectal cancer (CRC) has been established, but its impact on nonmetastatic disease remains unclear. Our study aimed to explore the prognostic effect of tumor sidedness by subgroup survival analyses, according to histology and tumor grade in stage I-IV CRCs. METHODS: A retrospective population-based study was conducted based on Surveillance, Epidemiology and End Results (SEER) data. Population data in the SEER 9 registry (1975-2014) were used to determine survival trends of CRCs, and associated population data in the SEER 18 registry (2000 to 2014) were used to assess the prognostic impact of tumor sidedness on CRCs. RESULTS: The 5-year cause-specific survival for all subgroups of CRCs improved from 1975 to 2014. Of 238,826 patients, 44.2% had right-sided cancer. Patients with right-sided cancer were more likely to be older, to be women, to have disease of mucinous or signet-ring cell histology, to have more poorly differentiated tumors, and to be diagnosed with a more advanced disease stage. Multivariate Cox regression showed stage I-II right-sided cancers had better cause-specific survival than the left-sided cancers (left colon: hazard ratio [HR] = 1.091, 95% confidence interval [CI], 1.052-1.132; rectum: HR = 1.363; 95% CI, 1.304-1.425; P < .001), while stage III and IV right-sided cancers had worse cause-specific survival. In subgroup analyses by histology and tumor grade within stage III CRCs, right-sided poorly differentiated mucinous adenocarcinoma showed significantly better survival (left colon: HR = 1.352; 95% CI, 1.145-1.596; rectum: HR = 1.125; 95% CI, 0.916-1.381; P = .002). CONCLUSION: The relationship between sidedness and prognosis in CRCs depends on stage and histopathologic characteristics, especially for stage III disease.
BACKGROUND: The prognostic value of tumor sidedness in metastatic colorectal cancer (CRC) has been established, but its impact on nonmetastatic disease remains unclear. Our study aimed to explore the prognostic effect of tumor sidedness by subgroup survival analyses, according to histology and tumor grade in stage I-IV CRCs. METHODS: A retrospective population-based study was conducted based on Surveillance, Epidemiology and End Results (SEER) data. Population data in the SEER 9 registry (1975-2014) were used to determine survival trends of CRCs, and associated population data in the SEER 18 registry (2000 to 2014) were used to assess the prognostic impact of tumor sidedness on CRCs. RESULTS: The 5-year cause-specific survival for all subgroups of CRCs improved from 1975 to 2014. Of 238,826 patients, 44.2% had right-sided cancer. Patients with right-sided cancer were more likely to be older, to be women, to have disease of mucinous or signet-ring cell histology, to have more poorly differentiated tumors, and to be diagnosed with a more advanced disease stage. Multivariate Cox regression showed stage I-II right-sided cancers had better cause-specific survival than the left-sided cancers (left colon: hazard ratio [HR] = 1.091, 95% confidence interval [CI], 1.052-1.132; rectum: HR = 1.363; 95% CI, 1.304-1.425; P < .001), while stage III and IV right-sided cancers had worse cause-specific survival. In subgroup analyses by histology and tumor grade within stage III CRCs, right-sided poorly differentiated mucinous adenocarcinoma showed significantly better survival (left colon: HR = 1.352; 95% CI, 1.145-1.596; rectum: HR = 1.125; 95% CI, 0.916-1.381; P = .002). CONCLUSION: The relationship between sidedness and prognosis in CRCs depends on stage and histopathologic characteristics, especially for stage III disease.
Authors: Luigi Ricciardiello; Clarissa Ferrari; Michela Cameletti; Federica Gaianill; Francesco Buttitta; Franco Bazzoli; Gian Luigi de'Angelis; Alberto Malesci; Luigi Laghi Journal: Clin Gastroenterol Hepatol Date: 2020-09-06 Impact factor: 11.382
Authors: Jessica Alonso-Molero; Antonio J Molina; Jose Juan Jiménez-Moleón; Beatriz Pérez-Gómez; Vicente Martin; Victor Moreno; Pilar Amiano; Eva Ardanaz; Silvia de Sanjose; Inmaculada Salcedo; Guillermo Fernandez-Tardon; Juan Alguacil; Dolores Salas; Rafael Marcos-Gragera; Maria Dolores Chirlaque; Nuria Aragonés; Gemma Castaño-Vinyals; Marina Pollán; Manolis Kogevinas; Javier Llorca Journal: BMJ Open Date: 2019-11-21 Impact factor: 2.692