Instituto Nacional de Cancerologia, Ciudad de México, México.
Instituto Nacional de Cancerologia, Ciudad de México, México.
Arch Med Res. 2019 Feb;50(2):63-70. doi: 10.1016/j.arcmed.2019.05.011. Epub 2019 Jun 14.
Right-colon cancer (RCC) presents differences with Left-colon cancer (LCC) in terms of Overall survival (OS), but certain reports provide conflicting findings. Our objective is to define differences regarding prognostic factors in RCC and LCC by multivariate analysis.
Retrospective cohort including patients treated from 1992-2016. The Kaplan-Meier and Cox models were used to define prognostic factors.
871 patients had RCC and 748 LCC; mean age was 58.1. Location was associated with socioeconomic status, body mass, blood hemoglobin, serum albumin, lymphocyte count and Prognostic nutritional index (PNI). Distribution of TNM stages was similar between groups, as well as gender, age, surgical morbidity/mortality; 72.3% of RCC and 83.2% of LCC were well/moderately differentiated (p <0.0001). Mean surgical lymph-node retrieval was 19.3 (SD14.6) for RCC and 15.7 (SD13.1) for LCC (p <0.0001). Median OS was 5.2 (95% CI 3.9-6.5) for RCC, and 3.2 years (95% CI 2.1-4.4) for LCC (p = 0.426). OS was different between RCC and LCC by stratified analyses within PNI, TNM, differentiation and R classification. RCC presents different OS in stages IIIC, and IVB than LCC.
Differences between RCC and LCC were mainly by immunonutritional variables. Differences in OS were found after stratified analysis of PNI, TNM stages, differentiation degree, and R classification. Location of the neoplasm in the colon should be considered in the design of clinical trials in patients with colon cancer.
右半结肠癌（RCC）在总生存期（OS）方面与左半结肠癌（LCC）存在差异，但某些报告提供了相互矛盾的结果。我们的目的是通过多变量分析来确定 RCC 和 LCC 中与预后因素相关的差异。
这是一项回顾性队列研究，纳入了 1992 年至 2016 年期间接受治疗的患者。使用 Kaplan-Meier 和 Cox 模型来确定预后因素。
871 例患者患有 RCC，748 例患有 LCC；平均年龄为 58.1 岁。肿瘤位置与社会经济地位、体重、血红细胞、血清白蛋白、淋巴细胞计数和预后营养指数（PNI）有关。两组的 TNM 分期分布相似，性别、年龄、手术发病率/死亡率也相似；RCC 和 LCC 的分化程度分别为 72.3%和 83.2%（p<0.0001）。RCC 的平均手术淋巴结检出数为 19.3（SD14.6），LCC 为 15.7（SD13.1）（p<0.0001）。RCC 的中位 OS 为 5.2（95%CI 3.9-6.5）年，LCC 为 3.2 年（95%CI 2.1-4.4）年（p=0.426）。在 PNI、TNM、分化和 R 分类的分层分析中，RCC 和 LCC 的 OS 不同。RCC 在 IIIC 和 IVB 期的 OS 与 LCC 不同。
RCC 和 LCC 之间的差异主要与免疫营养变量有关。在 PNI、TNM 分期、分化程度和 R 分类的分层分析后，发现 OS 存在差异。在设计结肠癌患者的临床试验时，应考虑肿瘤在结肠中的位置。
