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右半结肠癌和左半结肠癌根治性切除术后的结局。

Outcomes of right-sided and left-sided colon cancer after curative resection.

机构信息

Department of Surgery, Taipei Medical University Shuang-Ho Hospital, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, 235, Taiwan.

Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Shuang-Ho Hospital, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, 235, Taiwan.

出版信息

Sci Rep. 2022 Jul 5;12(1):11323. doi: 10.1038/s41598-022-15571-2.

DOI:10.1038/s41598-022-15571-2
PMID:35790871
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9256690/
Abstract

The right and left side of the colon derived from the midgut and hindgut, respectively. Previous studies have reported different characteristics of right-sided colon cancer (RCC) and left-sided colon cancer (LCC), but oncological outcomes remain unclear. This study compared the outcomes of RCC and LCC. This retrospective study included 1017 patients who received curative colectomy for stage I-III colon cancer at a single institute between August 2008 and December 2019. Overall survival (OS) and time to recurrence (TTR) were analyzed as outcome measurements. No significant difference in the OS or TTR of patients with RCC and LCC were observed. In subgroup analysis, RCC was associated with shorter TTR than LCC in stage II colon cancer (HR 2.36, 95% confidence interval 1.24-4.48, p < 0.01). Multivariate analysis demonstrated that right sidedness, R1 resection, low body mass index (BMI) and adjuvant chemotherapy were independent factors for poor prognosis for stage II colon cancer. Low BMI, perineural invasion, higher T stage and N2 stage were independent factors for poor prognosis for stage III colon cancer. The results were confirmed by multivariate analysis after propensity score matching. Our study revealed that RCC was an independent risk factor for recurrence in stage II colon cancer.

摘要

结肠的左右两侧分别起源于中肠和后肠。先前的研究报告了右半结肠癌（RCC）和左半结肠癌（LCC）的不同特征，但肿瘤学结果仍不清楚。本研究比较了 RCC 和 LCC 的结果。本回顾性研究纳入了 2008 年 8 月至 2019 年 12 月在一家机构接受 I-III 期结肠癌根治性结肠切除术的 1017 例患者。将总生存（OS）和复发时间（TTR）作为观察结果进行分析。RCC 和 LCC 患者的 OS 或 TTR 无显著差异。亚组分析显示，在 II 期结肠癌中，RCC 的 TTR 短于 LCC（HR 2.36，95%置信区间 1.24-4.48，p<0.01）。多变量分析表明，右半结肠癌、R1 切除、低体重指数（BMI）和辅助化疗是 II 期结肠癌预后不良的独立因素。低 BMI、神经周围侵犯、较高 T 分期和 N2 分期是 III 期结肠癌预后不良的独立因素。倾向评分匹配后的多变量分析证实了这一结果。本研究表明，RCC 是 II 期结肠癌复发的独立危险因素。

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