Ann Coloproctol.
2018 Dec;34(6):286-291. 10.3393/ac.2018.10.29.
Female Sex and Right-Sided Tumor Location Are Poor Prognostic Factors for Patients With Stage III Colon Cancer After a Curative Resection
- Park JH
- Park HC
- Park SC
- Oh JH
- Kim DW
- Kang SB
- Heo SC
- Kim MJ
- Park JW
- Jeong SY
- Park KJ
- for the Seoul Colorectal Group (SECOG)
- Affiliations
-
- 1Department of Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea. greatpa1@ncc.re.kr
- 2Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
- 3Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
- 4Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
- 5Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
- KMID: 2434374
- DOI: http://doi.org/10.3393/ac.2018.10.29
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 (≥0.4) 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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