Department of Anesthesiology, First Hospital of Jilin University, Changchun, 130021, Jilin, China.
Sci Rep. 2020 Oct 21;10(1):17900. doi: 10.1038/s41598-020-74926-9.
This study aimed to explore the association of tumor sidedness with the prognosis of patients with colon signet ring cell carcinoma (SRCC). Eligible patients were retrieved from the Surveillance, Epidemiology, and End Results database between 2004 and 2015. Cancer-specific survival (CSS) and overall survival (OS) were compared between patients with left-sided colon SRCC and those with right-sided lesions. A total of 2660 patients were included, among them, 1983 (74.5%) had right-sided colon SRCC. Compared to patients with left-sided colon SRCC, those who had the right-sided colon SRCC showed higher proportion of white race, female, aged ≥ 65 years, receiving total colectomy and ≥ 4 regional lymph node dissection; while had lower proportion of advanced AJCC stage. Besides, right-sided patients exhibited superior 5-year CSS (32.74% vs. 25.89%, P = 0.001) and OS (27.38% vs. 23.02%, P = 0.024) rates compared with left-sided ones. Multivariate analysis revealed that tumor sidedness was an independent prognostic factor. To be specific, patients with right-sided colon SRCC showed better CSS (HR: 0.873; 95% CI 0.777-0.981; P = 0.023) and OS (HR: 0.838; 95% CI 0.753-0.965; P = 0.002). Moreover, subgroup analysis demonstrated superior CSS and OS for right-sided patients in most subgroups. Tumor sidedness was an independent prognostic indicator for colon SRCC. Besides, patients with right-sided colon SRCC have superior prognosis than those with left-sided lesions.
本研究旨在探讨肿瘤侧别与结肠癌印戒细胞癌（SRCC）患者预后的关系。从 2004 年至 2015 年，从监测、流行病学和最终结果数据库中检索符合条件的患者。比较左半结肠癌 SRCC 患者和右半结肠癌患者的癌症特异性生存率（CSS）和总生存率（OS）。共纳入 2660 例患者，其中 1983 例（74.5%）为右半结肠癌 SRCC。与左半结肠癌 SRCC 患者相比，右半结肠癌 SRCC 患者中白人、女性、年龄≥65 岁、接受全结肠切除术和≥4 个区域淋巴结清扫术的比例较高；而 AJCC 分期较晚的比例较低。此外，右半结肠癌患者的 5 年 CSS（32.74%比 25.89%，P=0.001）和 OS（27.38%比 23.02%，P=0.024）率均优于左半结肠癌患者。多因素分析显示肿瘤侧别是独立的预后因素。具体来说，右半结肠癌患者的 CSS（HR：0.873；95%CI 0.777-0.981；P=0.023）和 OS（HR：0.838；95%CI 0.753-0.965；P=0.002）均较好。此外，亚组分析显示大多数亚组中右半结肠癌患者的 CSS 和 OS 均较好。肿瘤侧别是结肠癌 SRCC 的独立预后指标。此外，右半结肠癌患者的预后优于左半结肠癌患者。
