Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Jeonbuk, South Korea.
Ann Surg Oncol. 2019 May;26(5):1366-1375. doi: 10.1245/s10434-019-07164-7. Epub 2019 Feb 25.
Previous studies comparing the oncologic outcomes of primary tumor-sidedness for patients with colon cancer have reported a worse prognosis for those with right-sided tumors. However, most of these studies evaluated patients with metastatic disease.
PubMed, EMBASE, and the Cochrane Library were searched for studies that assessed the effects of primary tumor-sidedness on survival outcomes for patients with stages 1, 2, and 3 colon cancer. The hazard ratio (HR) for primary tumor location was estimated for overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS).
The inclusion criteria were met by 37 studies involving 581,542 patients. The patients with a right-sided tumor had better CSS (HR, 0.67; 95% confidence interval [CI], 0.56-0.80; p < 0.0001) among those with stage 1 cancer as well as better OS (HR, 0.89; 95% CI 0.86-0.92; I = 19%) and CSS (HR, 0.78; 95% CI 0.70-0.86; I = 78%) among those with stage 2 cancer. In contrast, among the patients with stage 3 cancer, those with a right-sided tumor had worse OS (HR, 1.12; 95% CI 1.04-1.20; p = 0.002), CSS (HR, 1.05; 95% CI 1.01-1.10; p = 0.02), and DFS (HR, 1.32; 95% CI 1.07-1.63; p = 0.008).
Primary tumor location may be a prognostic factor for patients with non-metastatic colon cancer. The prognosis for patients with right-sided tumor may be better for those with stage 1 or 2 cancer, but worse for those with stage 3 cancer.
先前比较结肠癌患者原发肿瘤侧别肿瘤的肿瘤学结局的研究报告称，右侧肿瘤患者的预后较差。然而，这些研究大多评估了转移性疾病患者的情况。
在 PubMed、EMBASE 和 Cochrane Library 中搜索评估原发肿瘤侧别对 1 期、2 期和 3 期结肠癌患者生存结局影响的研究。使用风险比（HR）评估原发肿瘤位置对总生存（OS）、癌症特异性生存（CSS）和无病生存（DFS）的影响。
37 项研究纳入了 581542 例患者，符合纳入标准。在 1 期癌症患者中，右侧肿瘤患者的 CSS 更好（HR，0.67；95%置信区间 [CI]，0.56-0.80；p<0.0001），在 2 期癌症患者中，OS（HR，0.89；95% CI，0.86-0.92；I=19%）和 CSS（HR，0.78；95% CI，0.70-0.86；I=78%）更好。相比之下，在 3 期癌症患者中，右侧肿瘤患者的 OS（HR，1.12；95% CI，1.04-1.20；p=0.002）、CSS（HR，1.05；95% CI，1.01-1.10；p=0.02）和 DFS（HR，1.32；95% CI，1.07-1.63；p=0.008）更差。
原发肿瘤位置可能是无转移性结肠癌患者的预后因素。对于 1 期或 2 期癌症患者，右侧肿瘤患者的预后可能更好，但对于 3 期癌症患者，预后可能更差。
