Difference in Time to Locoregional Recurrence Between Patients With Right-Sided and Left-Sided Colon Cancers
Difference in Time to Locoregional Recurrence Between Patients With Right-Sided and Left-Sided Colon Cancers
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DOI：
10.1097/dcr.0000000000000426
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发表时间：
2015-09-01
影响因子：
3.9
通讯作者：
Oh, Jae Hwan
中科院分区：
文献类型：
--
作者：
Park, Jung Hun;Kim, Min Jung;Oh, Jae Hwan
背景：结肠癌根治性切除后的局部复发率差异很大。确定与局部复发相关的因素可能有助于患者的治疗。目的：本研究的目的是根据原发部位比较结肠癌根治术后局部复发时间和局部复发分布，探讨结肠癌局部复发的危险因素。设计：这是一项回顾性观察性研究。设置：本研究在单一机构进行。患者：本研究分析了2001年1月至2009年12月在韩国国立癌症中心接受根治性切除术的1632例无远处转移的结肠腺癌患者。研究的主要终点是从手术到局部复发的时间。采用Kaplan-Meier法估计局部区域复发的累积发生率，采用log-rank检验检验患者亚组之间局部区域复发的时间差异。采用Cox比例风险模型探讨局部复发的危险因素。主要观察指标：比较右侧和左侧结肠癌患者从手术到局部复发的时间。结果：左右两侧结肠癌患者局部复发时间差异有统计学意义（右侧HR = 2.35, p < 0.001）。整体5年局部复发率为5.7%，右侧和左侧结肠癌患者的复发率分别为8.5%和4.1%。多变量分析显示，右侧位置、女性、T4病变、淋巴结转移、神经周围浸润是结肠癌局部复发的独立危险因素。局限性：这是一项回顾性的单机构研究。结论：右侧结肠癌患者局部复发的风险显著增加。右侧位置、女性、T4病变、淋巴结转移、神经周围浸润是结肠癌局部复发的独立危险因素。
BACKGROUND:Locoregional recurrence rates after curative resection for colon cancer vary widely. Identification of factors associated with locoregional recurrence may help in patient management.OBJECTIVE:The purpose of this study was to compare time to locoregional recurrence and distribution of locoregional recurrence after curative resection of colon cancer according to primary tumor location and to investigate risk factors for locoregional recurrence of colon cancer.DESIGN:This was a retrospective observational study.SETTINGS:This study was conducted at a single institution.PATIENTS:This study analyzed 1632 patients with colonic adenocarcinoma without distant metastasis who underwent curative resection at the National Cancer Center in Korea between January 2001 and December 2009. The primary end point of the study was time from surgery to locoregional recurrence. The Kaplan-Meier method was used to estimate the cumulative incidence of locoregional recurrence, and the log-rank test was used to test the difference in time to locoregional recurrence between patient subgroups. Cox proportional hazards models were used to investigate the risk factors for locoregional recurrence.MAIN OUTCOME MEASURES:The time from surgery to locoregional recurrence was compared between patients with right-sided and left-sided colon cancers.RESULTS:The time to locoregional recurrence was significantly different between patients with right-sided and left-sided colon cancers (HR = 2.35 for right-sided; p < 0.001). The overall 5-year locoregional recurrence rate was 5.7%, and that in patients with right-sided and left-sided colon cancers was 8.5% and 4.1%. Multivariable analysis demonstrated that right-sided location, female sex, T4 disease, lymph node metastasis, and perineural invasion were independent risk factors for locoregional recurrence of colon cancer.LIMITATIONS:This was a retrospective design and single-institution study.CONCLUSIONS:Patients with right-sided colon cancers presented with significantly increased risk of locoregional recurrence. Right-sided location, female sex, T4 disease, lymph node metastasis, and perineural invasion are independent risk factors for locoregional recurrence of colon cancer.