Colon carcinoma - Classification into right and left sided cancer or according to colonic subsite? - Analysis of 29 568 patients
Colon carcinoma - Classification into right and left sided cancer or according to colonic subsite? - Analysis of 29 568 patients
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DOI：
10.1016/j.ejso.2010.12.004
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发表时间：
2011-02-01
期刊：
影响因子：
3.8
通讯作者：
Kube, R.
中科院分区：
文献类型：
--
作者：
Benedix, F.;Schmidt, U.;Kube, R.
背景：区分左右结肠癌（RCC和LCC）是常见的。但是，鲜为人知的是，它的确切位置上的肿瘤的阶段和特性的影响时，考虑在右或左colon.Methods的结肠亚位点：在一个为期五年的时间内，29 568例连续的患者进行了评估，从德国多中心观察性研究“结肠/直肠癌”的数据。将患者分为7组，每组代表一个结肠亚部位。他们进行了比较人口因素，肿瘤分期，转移扩散和组织病理学特征。结果：肿瘤分化和组织学亚型的分析显示，回盲瓣的线性相关性，支持右侧和左侧的分类模型。然而，RCC盲肠产生的癌症（52.3%）和LCC的脾曲（51.0%）显示出最高比例的ICC III/IV期肿瘤和淋巴管浸润，而RCC的升结肠（46.5%）和LCC的下降（44.7%）显示最低，这支持了一个更复杂的分类系统，将右侧和左侧分为结肠亚位点。年龄、肿瘤分级和组织学亚型支持右侧和左侧分类模型。然而，性别、UICC分期、转移扩散、T和N状态以及淋巴管浸润与特定的结肠亚部位相关，而与侧无关。RCC或LCC的分类提供了对肿瘤的一般理解，但结肠亚位点的鉴定提供了额外的预后信息。这项研究表明，标准的右侧和左侧分类模型可能是不够的。(C)2010爱思唯尔有限公司保留所有权利。
Background: It is common to distinguish between right and left colon cancer (RCC and LCC). But, little is known about the influence of its exact location on the tumor stage and characteristics when considering the colonic subsite within the right or left colon.Methods: During a five-year period, 29 568 consecutive patients were evaluated by data from the German multi-centered observational study "Colon/Rectal Carcinoma". Patients were split into 7 groups, each group representing a colonic subsite. They were compared regarding demographic factors, tumor stage, metastatic spread and histopathological characteristics.Results: Analysis of tumor differentiation and histological subtype revealed a linear correlation to the ileocecal valve, supporting the right and left side classification model. However, cancers arising from the RCC's cecum (52.3%) and LCC's splenic flexure (51.0%) showed the highest proportion of UICC stage III/IV tumors and lymphatic invasion, whereas the RCC's ascending colon (46.5%) and LCC's descending (44.7%) showed the lowest, which supports a more complex classification system, breaking down the right and left sides into colonic subsites.Conclusions: Age, tumor grade and histological subtype support the right and left side classification model. However, gender, UICC stage, metastatic spread, T and N status, and lymphatic invasion correlated with a specific colonic subsite, irrespective of the side. The classification of RCC or LCC provides a general understanding of the tumor, but identification of the colonic subsite provides additional prognostic information. This study shows that the standard right and left side classification model may be insufficient. (C) 2010 Elsevier Ltd. All rights reserved.