Female Sex and Right-Sided Tumor Location Are Poor Prognostic Factors for Patients With Stage III Colon Cancer After a Curative Resection
Annals of Coloproctology 2018³â 34±Ç 6È£ p.286 ~ p.291
¹ÚÁ¤È£(Park Jung-Ho) - Hallym University Sacred Heart Hospital Department of Surgery
¹ÚÇüö(Park Hyoung-Chul) - Hallym University Sacred Heart Hospital Department of Surgery
¹Ú¼ºÂù(Park Sung-Chan) - National Cancer Center Center for Colorectal Cancer
¿ÀÀçȯ(Oh Jae-Hwan) - National Cancer Center Center for Colorectal Cancer
±è´ö¿ì(Kim Duck-Woo) - Seoul National University Bundang Hospital Department of Surgery
°¼º¹ü(Kang Sung-Bum) - Seoul National University Bundang Hospital Department of Surgery
Çã½Âö(Heo Seung-Chul) - Seoul Metropolitan Government-Seoul National University Boramae Medical Center Department of Surgery
Abstract
Purpose: Stage-IIIC colon cancer is an advanced disease; however, its oncologic outcomes and prognostic factors remain unclear. In this study, we aimed to determine the predictors of disease-free survival (DFS) in patients with stage-IIIC colon cancer.
Methods: From a multicenter database, we retrospectively enrolled 611 patients (355 men and 256 women) who had undergone a potentially curative resection for a stage-IIIC colon adenocarcinoma between 2003 and 2011. The primary end-point was the 5-year DFS.
Results: The median age was 62 years; 213 and 398 patients had right-sided colon cancer (RCC) and left-sided colon cancer (LCC), respectively. The 5-year DFS in all patients was 52.0%; median follow-up time was 35 months (range, 1?134 months). A multivariate Cox regression revealed that female sex (hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.19?1.90; P < 0.01), right-sided tumor location (HR, 1.65; 95% CI, 1.29?2.11; P < 0.01), lymphatic invasion (HR, 1.52; 95% CI, 1.08?2.15; P < 0.01) and a high (¡Ã0.4) metastatic lymph node ratio (HR, 3.72; 95% CI, 2.63?5.24; P < 0.01) were independent predictors of worse 5-year DFS. Female patients with RCC were 1.79 fold more likely to experience recurrence than male patients with LCC.
Conclusion: Female sex and right-sided tumor location are associated with higher tumor recurrence rates in patients with stage-IIIC colon cancers. Aggressive treatment and close surveillance should be planned for patients in these groups.
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Colonic neoplasms, Ascending colon, Descending colon, Prognosis, Recurrence
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À¯È¿¼º°á°ú(Recomendation)
stage-IIIC colon cancer produces poor oncologic outcomes when occurring in female patients, when it is right-sided, and when the LNR is high.