eprintid: 21656
rev_number: 13
eprint_status: archive
userid: 1589
dir: disk0/00/02/16/56
datestamp: 2016-08-18 12:18:48
lastmod: 2024-05-08 22:56:10
status_changed: 2016-08-18 12:18:48
type: article
metadata_visibility: show
creators_name: Warschkow, Rene
creators_name: Sulz, Michael C.
creators_name: Marti, Lukas
creators_name: Tarantino, Ignazio
creators_name: Schmied, Bruno M.
creators_name: Cerny, Thomas
creators_name: Güller, Ulrich
title: Better survival in right-sided versus left-sided stage I - III colon cancer patients
subjects: ddc-610
divisions: i-910200
divisions: i-911800
abstract: Background: The distinction between right-sided and left-sided colon cancer has recently received considerable attention due to differences regarding underlying genetic mutations. There is an ongoing debate if right- versus left-sided tumor location itself represents an independent prognostic factor. We aimed to investigate this question by using propensity score matching.   Methods: Patients with resected, stage I - III colon cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) database (2004–2012). Both univariable and multivariable Cox regression as well as propensity score matching were used.   Results: Overall, 91,416 patients (51,937 [56.8%] with right-sided, 39,479 [43.2%] with left-sided colon cancer; median follow-up 38 months) were eligible. In univariable analysis, patients with right-sided cancer had worse overall (hazard ratio [HR] = 1.32, 95% CI:1.29–1.36, P < 0.001) and cancer-specific survival (HR = 1.26, 95% CI:1.21–1.30, P < 0.001) compared to patients with left-sided cancer. After propensity score matching, the prognosis of right-sided carcinomas was better regarding overall (HR = 0.92, 95% CI: 0.89 − 0.94, P < 0.001) and cancer-specific survival (HR = 0.90, 95% CI:0.87 − 0.93, P < 0.001). In stage I and II, the prognosis of right-sided cancer was better for overall (HR = 0.89, 95% CI:0.84–0.94 and HR = 0.85, 95% CI:0.81–0.89) and cancer-specific survival (HR = 0.71, 95% CI:0.64 − 0.79 and HR = 0.75, 95% CI:0.70–0.80). Right- and left-sided colon cancer had a similar prognosis for stage III (overall: HR = 0.99, 95% CI:0.95–1.03 and cancer-specific: HR = 1.04, 95% CI:0.99–1.09).   Conclusions: This population-based analysis on stage I - III colon cancer provides evidence that the prognosis of localized right-sided colon cancer is better compared to left-sided colon cancer. This questions the paradigm from previous research claiming a worse survival in right-sided colon cancer patients.
date: 2016
publisher: BioMed Central; Springer
id_scheme: DOI
ppn_swb: 1658528948
own_urn: urn:nbn:de:bsz:16-heidok-216566
language: eng
bibsort: WARSCHKOWRBETTERSURV2016
full_text_status: public
publication: BMC Cancer
volume: 16
number: 554
place_of_pub: London; Berlin; Heidelberg
pagerange: 1-14
issn: 1471-2407
citation:   Warschkow, Rene ; Sulz, Michael C. ; Marti, Lukas ; Tarantino, Ignazio ; Schmied, Bruno M. ; Cerny, Thomas ; Güller, Ulrich  (2016) Better survival in right-sided versus left-sided stage I - III colon cancer patients.  BMC Cancer, 16 (554).  pp. 1-14.  ISSN 1471-2407     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/21656/1/12885_2016_Article_2412.pdf