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手术切除的右侧和左侧结直肠癌的临床和预后差异。

Clinical and prognostic differences between surgically resected right-sided and left-sided colorectal cancer.

机构信息

Department of Gastrointestinal Surgery, Japanese Red Cross Nagoya First Hospital, Nakamura-ku Michishita 3-35, Nagoya, Aichi, Japan.

出版信息

Surg Today. 2020 Mar;50(3):267-274. doi: 10.1007/s00595-019-01889-4. Epub 2019 Oct 14.

Abstract

PURPOSE

A growing body of evidence suggests that right-sided colorectal cancer (RCRC) differs from left-sided colorectal cancer (LCRC) in certain clinicopathological features. Therefore, we investigated the difference between RCRC and LCRC in a series of 899 patients.

METHODS

We reviewed data retrospectively, from 899 patients who underwent R0-resection for stage II and III CRC and compared the clinicopathological factors between patients with RCRC and LCRC.

RESULTS

The patients with RCRC tended to be older, more likely female, with a larger tumor, higher pathological T stage, and a greater proportion of their tumors were poorly differentiated adenocarcinoma, mucinous adenocarcinoma, or signet ring cell carcinoma than the patients with LCRC,. Recurrence-free survival (RFS) of the patients with RCRC tended to be higher than that of the patients with LCRC and was significantly better among patients with stage II cancer. The overall survival (OS) was similar for patients with RCRC and LCRC, irrespective of cancer stage.

CONCLUSION

Compared with the patients with LCRC, those with RCRC had several oncologically unfavorable factors, with better RFS in stage II and similar OS in stages II and III. These results suggest that the biological aggressiveness of RCRC is lower than that of LCRC in stage II; however, it can increase after relapse.

摘要

目的

越来越多的证据表明,右半结直肠癌(RCRC)在某些临床病理特征上与左半结直肠癌(LCRC)不同。因此,我们在一系列 899 例患者中研究了 RCRC 和 LCRC 之间的差异。

方法

我们回顾性地分析了 899 例接受 R0 切除的 II 期和 III 期 CRC 患者的数据,并比较了 RCRC 和 LCRC 患者的临床病理因素。

结果

与 LCRC 患者相比,RCRC 患者年龄更大,女性更多,肿瘤更大,病理 T 分期更高,且肿瘤分化程度较低的腺癌、黏液腺癌或印戒细胞癌比例更高。RCRC 患者的无复发生存率(RFS)高于 LCRC 患者,且 II 期患者的 RFS 明显更好。无论癌症分期如何,RCRC 患者的总生存率(OS)与 LCRC 患者相似。

结论

与 LCRC 患者相比,RCRC 患者具有一些肿瘤学上不利的因素,在 II 期时 RFS 更好,而在 II 期和 III 期时 OS 相似。这些结果表明,在 II 期,RCRC 的生物学侵袭性低于 LCRC;但在复发后可能会增加。

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