J Minim Invasive Surg.  2022 Jun;25(2):53-62. 10.7602/jmis.2022.25.2.53.

Oncological impact of vascular invasion in colon cancer might differ depending on tumor sidedness

• Abdelgawaad Shalkamy MS
• Bae JH
• Lee CS
• Han SR
• Kim JH
• Kye BH
• Lee IK
• Lee YS

• KMID: 2530498
• DOI: http://doi.org/10.7602/jmis.2022.25.2.53

Abstract

Purpose
Vascular invasion is a well-known independent prognostic factor in colon cancer and tumor sidedness is also being considered a prognostic factor. The aim of this study was to compare the oncological impact of vascular invasion depending on the tumor location in stages I to III colon cancer.
Methods
A retrospective analysis was performed using data from patients who underwent curative resection between 2004 and 2015. Patients were divided into right-sided colon cancer (RCC) and left-sided colon cancer (LCC) groups according to the tumor location. Disease-free survival (DFS) and overall survival (OS) were compared between the RCC and LCC groups, depending on the presence of vascular invasion.
Results
A total of 793 patients were included, of which 304 (38.3%) had RCC and 489 (61.7%) had LCC. DFS and OS did not differ significantly between the RCC and LCC groups. Vascular invasion was a poor prognostic factor for DFS in both RCC (hazard ratio [HR], 2.291; 95% confidence interval [CI], 1.186–4.425; p = 0.010) and LCC (HR, 1.848; 95% CI, 1.139–2.998; p = 0.011). Additionally, it was associated with significantly worse OS in the RCC (HR, 3.503; 95% CI, 1.681–7.300; p < 0.001), but not in the LCC group (HR, 1.676; 95% CI, 0.885–3.175; p = 0.109). Multivariate analysis revealed that vascular invasion was independently poor prognostic factor for OS in the RCC (HR, 3.186; 95% CI, 1.391–7.300; p = 0.006).
Conclusion
This study demonstrated that RCC with vascular invasion had worse OS than LCC with vascular invasion.

Keyword

Colonic neoplasms; Vascular invasion; Survival; Tumor sidedness