Clinical characteristics and prognosis of different primary tumor location in colorectal cancer: a population-based cohort study
Clinical characteristics and prognosis of different primary tumor location in colorectal cancer: a population-based cohort study
复制标题
结直肠癌不同原发部位的临床特征及预后：基于人群的队列研究
DOI：
10.1007/s12094-019-02083-1
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发表时间：
2019-11-01
影响因子：
3.4
通讯作者：
Li, S.
中科院分区：
文献类型：
--
作者：
Zheng, C.;Jiang, F.;Li, S.
目的：新数据显示，在转移性结直肠癌方面，左侧癌症患者的生存率高于右侧癌症患者。然而，在局部结直肠癌中，现有的信息和发现仍然有限和矛盾。本研究旨在探讨结直肠癌原发肿瘤位置（PTL）的临床特点及预后。方法利用2006 - 2015年监测、流行病学和最终结果数据库对患者进行诊断。对原发肿瘤的部位、组织学和分期信息进行了进一步的分析。评估PTL与总生存期（OS）的相关性。结果与左侧肿瘤相比，右侧肿瘤更容易发展为T3癌（50.0% vs. 44.8%）、T4癌（15.8% vs. 12.3%）、粘液腺癌（10.8% vs. 5.0%）和印戒细胞癌（1.4% vs. 0.7%），P< 0.01。右侧肿瘤患者的OS较差（56.1%比60.2%），各分期的风险比为1.224 （95% CI, 1.208 ~ 1.241，P< 0.001）。分期Cox回归分析显示，右侧肿瘤患者各期OS均低于左侧肿瘤患者（P< 0.05）。结论本研究表明，无论分期如何，左侧肿瘤患者的预后均优于右侧肿瘤患者。PTL可作为结直肠癌的预后因素。我们鼓励开展临床和转化研究，以阐明PTL与预后之间的因果关系。
PurposeEmerging data have shown that patients with left-sided cancers have better survival than patients with right-sided cancers in terms of metastatic colorectal cancer. However, the available information and findings remain limited and contradictory in localized colorectal cancer. This study aimed to evaluate the clinical characteristics and prognosis of primary tumor location (PTL) in colorectal cancer.MethodsPatients’ diagnoses were identified using the Surveillance, Epidemiology, and End Result database between 2006 and 2015. The analyses were further stipulated to patients with primary cancer site, histology, and stage information. The correlations between PTL and overall survival (OS) were assessed.ResultsCompared with left-sided tumors, right-sided tumors were more likely to develop into T3 cancers (50.0% vs. 44.8%), T4 cancers (15.8% vs. 12.3%), mucinous or mucin-producing adenocarcinoma (10.8% vs. 5.0%), and signet ring cell carcinoma (1.4% vs. 0.7%),P< 0.01, respectively. Patients with right-sided tumors showed inferior OS (56.1% vs. 60.2%), and the hazard ratio was 1.224 (95% CI, 1.208–1.241,P< 0.001) in all stages. Stage-specific Cox regression analysis revealed that patients with right-sided tumors also showed inferior OS in every stage (respectively,P< 0.05) than left-sided tumors.ConclusionsThis study demonstrated that the prognoses of patients with left-sided cancers were better than those of patients with right-sided cancers regardless of stage. PTL can be a prognosis factor in colorectal cancer. We encourage developing clinical and translational studies to elucidate the causative relationship between PTL and prognosis.