右侧 II 期结肠癌比左侧 II 期结肠癌的生存率更高：基于 SEER 数据库的倾向评分匹配分析。
Better survival of right-sided than left-sided stage II colon cancer: a propensity scores matching analysis based on SEER database.
机构信息
Department of Gastrointestinal surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.
出版信息
Turk J Gastroenterol. 2020 Nov;31(11):805-813. doi: 10.5152/tjg.2020.19531.
BACKGROUND/AIMS: Most studies have found that right-sided colon cancer (RCC) has worse prognosis than left-sided colon cancer (LCC), especially in stage III, but the reported prognosis of stage II colon cancer is variable. This study aimed to evaluate the impact of tumor location on survival outcomes in stage II colon cancer.
MATERIALS AND METHODS
Patients with stage II colon cancer were identified in the Surveillance, Epidemiology, and End Results database from 2004 to 2009. The effect of tumor location on overall survival and cancer-specific survival was analyzed using Cox proportional hazards regression models and propensity score matching.
RESULTS
Of 16,519 patients, 69.6% had RCC and30.4% had LCC. In unadjusted analyses, RCC had a 13% increased overall mortality risk (hazards ratio [HR], 1.13; 95% confidence interval [CI], 1.07-1.19; p<0.001) but an18% reduction in cancer-specific mortality risk compared with LCC (HR, 0.82; 95% CI, 0.76-0.89; p<0.001). After propensity scores matching analyses, RCC had a 21% reduced overall mortality risk (HR, 0.79; 95% CI, 0.72-0.87; p<0.001) and a 49% reduction in cancer-specific mortality risk compared with LCC (HR, 0.51; 95% CI, 0.44-0.60; p<0.001).
CONCLUSION
When adjusted for multiple clinicopathological features, stage II RCC showed better prognosis than stage II LCC.
背景/目的：大多数研究发现，右侧结肠癌（RCC）的预后比左侧结肠癌（LCC）差，尤其是在 III 期，但 II 期结肠癌的报告预后存在差异。本研究旨在评估肿瘤位置对 II 期结肠癌生存结局的影响。
材料与方法
从 2004 年至 2009 年，在监测、流行病学和最终结果数据库中确定了 II 期结肠癌患者。使用 Cox 比例风险回归模型和倾向评分匹配分析肿瘤位置对总生存和癌症特异性生存的影响。
结果
在 16519 例患者中，69.6%为 RCC，30.4%为 LCC。在未调整分析中，RCC 的总死亡率风险增加了 13%（风险比 [HR]，1.13；95%置信区间 [CI]，1.07-1.19；p<0.001），但与 LCC 相比，癌症特异性死亡率风险降低了 18%（HR，0.82；95%CI，0.76-0.89；p<0.001）。经过倾向评分匹配分析后，RCC 的总死亡率风险降低了 21%（HR，0.79；95%CI，0.72-0.87；p<0.001），癌症特异性死亡率风险降低了 49%（HR，0.51；95%CI，0.44-0.60；p<0.001）。
结论
在调整了多个临床病理特征后，II 期 RCC 的预后优于 II 期 LCC。
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