Impact of primary tumor site on the prognosis in different stage colorectal cancer patients after radical resection
10.3760/cma.j.issn.0529-5815.2018.01.015
- VernacularTitle: 肿瘤部位对根治性切除术后不同分期结直肠癌患者预后的影响
- Author:
Jing HAN
1
;
Xue ZHANG
;
Andu ZHANG
;
Xinliang ZHOU
;
Li FENG
;
Junyan WANG
;
Guiying WANG
Author Information
1. Department of Medical Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
- Publication Type:Journal Article
- Keywords:
Colonic neoplasms;
Rectal neoplasms;
Prognosis
- From:
Chinese Journal of Surgery
2018;56(1):68-73
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the effect to the prognosis of tumor site on the patients of colorectal cancer after curative resection with different stage.
Methods:Clinicopathological and follow-up data of 2 097 colorectal carcinoma cases undergoing resection at Fourth Hospital of Hebei Medical University from January 2008 to March 2015 were retrospectively analyzed. There were 421 patients in left-sided colorectal cancer (LCC) group (including carcinoma in cecum, ascending colon , hepatic flexure, and transvers colon) , 386 in right-sided colorectal cancer (RCC) group (including carcinoma in splenic flexure, descending colon and sigmoid colon) and 1 290 in rectal cancer (RECC) group. Clinicopathologic features in patients with different tumor location were compared. 5-year overall survival rate were compared among the 3 groups. Patients were stratified by different stage to analyze the effect of tumor location on the prognosis. χ2test and Kruskal-Wallis rank-sum test were used to compare the clinicopathological features among the 3 groups, Kaplan-Meier curve and Log-rank test were used to analyze prognosis, respectively.
Results:No significant differences were identified between the three groups in age, family history, N stage and intestinal obstruction. Significant difference were found in gender among LCC, RCC and RECC group (male were 62.5% vs. 54.9% vs.56.3%, χ2=6.040, P=0.049) . Compared with LCC group and RCC group, RECC group had more well and moderately differentiated adenocarcinoma patients (89.7% vs. 86.0% vs. 82.4%, χ2=10.712 and 17.385, P=0.013 and 0.001) , more stage Ⅰ patients (17.1% vs. 6.9% vs. 6.5%, χ2=37.459 and 37.208, P=0.000 and 0.000) , and less likely to be stage T4 (44.7% vs. 76.7% vs.78.5%, χ2=128.015 and 133.704, P=0.000 and 0.000), metastasis (2.6% vs. 5.7% vs. 3.6%, χ2=1 417.167 and 1 424.217, P=0.000 and 0.000) and intestinal obstruction (11.3% vs. 21.1% vs. 24.4%, χ2=25.846 and 41.141, P=0.000 and 0.000). Five-year survival rate reduced in turn in the patients with RECC, LCC and RCC(70.9%, 59.8%, 58.9%, χ2=11.577, P=0.009). In the subgroup of stage Ⅲ, patients with different tumor location had different overall survival (χ2=9.878, P=0.007). Compared to right-sided colon cancer patients, rectal ones had significantly better overall survival (χ2=9.271, P=0.002); but in the subgroup of stage Ⅰ, Ⅱ and stage Ⅳ, patients with different tumor location had similar overall survival (P were 0.124, 0.888, 0.263, respectively).
Conclusions:Colorectal cancer patients with tumor location had different clinicopathologic features. Patients with rectal cancer had better five-year survival rate than those with left located and right located colon cancer. Tumor location had different effects on the prognosis according to the different TNM stage-subgroups.
