Prognostic Effect of Tumor Sidedness in Colorectal Cancer: A SEER-Based Analysis
Prognostic Effect of Tumor Sidedness in Colorectal Cancer: A SEER-Based Analysis
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DOI：
10.1016/j.clcc.2018.10.005
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发表时间：
2019-03-01
影响因子：
3.4
通讯作者：
Peng, Junjie
中科院分区：
文献类型：
--
作者：
Li, Yaqi;Feng, Yang;Peng, Junjie
基于SEER数据库，根据结直肠癌（CRC）组织学亚型和分化进行了一项回顾性人群研究。与腺癌（AC）不同，III期右侧低分化粘液和印戒细胞AC的生存率明显高于左侧疾病。结合组织学亚型和sidedness可能有助于更准确地预测预后，并有助于指导个性化治疗的患者CRC.Background：转移性结直肠癌（CRC）的肿瘤sidedness的预后价值已被确立，但其对非转移性疾病的影响仍不清楚。我们的研究旨在通过亚组生存分析，根据I-IV期CRC的组织学和肿瘤分级，探讨肿瘤偏侧的预后影响。方法：根据监测、流行病学和最终结果（SEER）数据进行回顾性人群研究。SEER 9登记研究（1975-2014）中的人群数据用于确定CRC的生存趋势，SEER 18登记研究（2000 - 2014）中的相关人群数据用于评估肿瘤侧性对CRC的预后影响。结果：从1975年到2014年，所有CRC亚组的5年病因特异性生存率都有所改善。在238，826名患者中，44.2%患有右侧癌症。右侧癌症患者更有可能是老年人，女性，患有粘液性或印戒细胞组织学疾病，具有更低分化的肿瘤，并且被诊断为更晚期的疾病阶段。多变量考克斯回归分析显示，I-II期右侧结肠癌的病因特异性生存率高于左侧结肠癌（左结肠：风险比[HR] = 1.091，95%置信区间[CI]，1.052-1.132;直肠：HR = 1.363; 95% CI，1.304-1.425; P
A retrospective population-based study was conducted based on the SEER database stratified by colorectal cancer (CRC) histologic subtype and differentiation. Unlike adenocarcinoma (AC), stage III right-sided poorly differentiated mucinous and signet-ring cell AC showed significantly better survival than left-sided disease. Combining histologic subtype and sidedness may help to more precisely predict prognosis and help guide personalized treatment for patients with CRC.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