Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Nov 15, 2018; 10(11): 410-420
Published online Nov 15, 2018. doi: 10.4251/wjgo.v10.i11.410
Prognostic significance of primary tumor localization in stage II and III colon cancer
Abdullah Sakin, Serdar Arici, Saban Secmeler, Orcun Can, Caglayan Geredeli, Nurgul Yasar, Cumhur Demir, Osman Gokhan Demir, Sener Cihan
Abdullah Sakin, Department of Medical Oncology, Yuzuncu Yil University Medical School, Van 65090, Turkey
Serdar Arici, Saban Secmeler, Orcun Can, Caglayan Geredeli, Nurgul Yasar, Cumhur Demir, Sener Cihan, Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul 34384, Turkey
Osman Gokhan Demir, Department of Medical Oncology, Acıbadem University, Istanbul 34396, Turkey
Author contributions: All authors helped perform the research; Sakin A wrote the manuscript, and performed procedures and data analysis; Sakin A and Secmeler S wrote the manuscript, drafted study conception and design, and performed experiments and data analysis; Arici S and Geredeli C contribution to writing the manuscript, drafting conception and design; Sakin A, Yasar N, Demir OG, Demir C and Cihan S contribution to writing the manuscript; Sakin A, Cihan S, Yasar N and Can O contribution to writing the manuscript, drafting conception and design.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the University of Health Sciences, Okmeydani Training and Research Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Abdullah Sakin, MD, Doctor, Department of Medical Oncology, Yuzuncu Yil University Medical School, Tuşba/Van 65090, Turkey. drsakin@hotmail.com
Telephone: +90-555-4809988
Received: August 13, 2018
Peer-review started: August 13, 2018
First decision: August 24, 2018
Revised: September 14, 2018
Accepted: October 17, 2018
Article in press: October 17, 2018
Published online: November 15, 2018
Processing time: 96 Days and 4 Hours
Abstract
AIM

To investigate the effects of tumor localization on disease free survival (DFS) and overall survival (OS) in patients with stage II-III colon cancer.

METHODS

This retrospective study included 942 patients with stage II and III colon cancer, which were followed up in our clinics between 1995 and 2017. The tumors from the caecum to splenic flexure were defined as right colon cancer (RCC) and those from splenic flexure to the sigmoid colon as left colon cancer (LCC).

RESULTS

The median age of the patients was 58 years (range: 19-94 years). Male patients constituted 54.2%. The rates of RCC and LCC were 48.4% (n = 456) and 51.6% (n = 486), respectively. During the median follow-up of 90 mo (range: 6-252 mo), 14.6% of patients developed recurrence and 9.1% of patients died. In patients with stage II and III disease with or without adjuvant therapy, DFS was similar in terms of primary tumor localization (stage II; P = 0.547 and P = 0.481, respectively; stage III; P = 0.976 and P = 0.978, respectively). In patients with stage II and III disease with or without adjuvant therapy, OS was not statistically significant with respect to primary tumor localization (stage II; P = 0.381 and P = 0.947, respectively; stage III; P = 0.378 and P = 0.904, respectively). The difference between median OS of recurrent RCC (26 ± 6.2 mo) and LCC (34 ± 4.9 mo) cases was eight months (P = 0.092).

CONCLUSION

Our study showed no association of tumor localization with either DFS or OS in patients with stage II or III colon cancer managed with or without adjuvant therapy. However, post-recurrence OS appeared to be worse in RCC patients.

Keywords: Colon cancer; Tumor localization; Adjuvant treatment; Overall survival; Disease free survival

Core tip: It is well known that metastatic right colon cancer is more aggressive than left colon cancer. However, the effects of tumor location on the decision of adjuvant therapy and survival are not clearly known in early stage disease. In this retrospective study, we investigated the effects of tumor location on disease free survival and overall survival in patients with and without adjuvant therapy for stage II-III colon cancer. There was no difference for disease free survival or overall survival between patients with right or left localized colon cancer, but we established that right localized tumors were more aggressive than left side after recurrence.