Clinical impact of tumor location on the colon cancer survival and recurrence: Analyses of pooled data from three large phase III randomized clinical trials

Toru Aoyama, Kosuke Kashiwabara, Koji Oba, Michitaka Honda, Sotaro Sadahiro, Chikuma Hamada, Hiromichi Maeda, Shuhei Mayanagi, Mitsuro Kanda, Junichi Sakamoto, Shigetoyo Saji, Takaki Yoshikawa

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

The aim of the present study was to determine whether or not the overall survival (OS) and disease-free survival (DFS) were affected by the tumor location in patients who underwent curative resection for colon cancer in a pooled analysis of three large phase III studies performed in Japan. In total, 4029 patients were included in the present study. Patients were classified as having right-side colon cancer (RC) if the primary tumor was located in the cecum, ascending colon, hepatic flexure or transverse colon, and left-side colon cancer (LCC) if the tumor site was within the splenic flexure, descending colon, sigmoid colon or recto sigmoid junction. The risk factors for the OS and DFS were analyzed. In the present study, 1449 patients were RC, and 2580 were LCC. The OS rates at 3 and 5 years after surgery were 87.6% and 81.6% in the RC group and 91.5% and 84.5% in the LCC group, respectively. Uni- and multivariate analyses showed that RRC increased the risk of death by 19.7% (adjusted hazard ratio = 1.197; 95% confidence interval, 1.020-1.408; P = 0.0272). In contrast, the DFS was similar between the two locations. The present study confirmed that the tumor location was a risk factor for the OS in patients who underwent curative treatment for colon cancer. Tumor location may, therefore, need to be considered a stratification factor in future phase III trials of colon cancer.

Original languageEnglish
JournalCancer Medicine
DOIs
Publication statusAccepted/In press - 2017

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Phase III Clinical Trials
Survival Analysis
Colonic Neoplasms
Randomized Controlled Trials
Recurrence
Neoplasms
Disease-Free Survival
Transverse Colon
Sigmoid Colon
Survival
Descending Colon
Ascending Colon
Cecum
Patient Rights
Japan
Multivariate Analysis
Survival Rate
Confidence Intervals
Liver

Keywords

  • Colorectal cancer
  • Left side colon cancer
  • Recurrence
  • Right side colon cancer
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Clinical impact of tumor location on the colon cancer survival and recurrence : Analyses of pooled data from three large phase III randomized clinical trials. / Aoyama, Toru; Kashiwabara, Kosuke; Oba, Koji; Honda, Michitaka; Sadahiro, Sotaro; Hamada, Chikuma; Maeda, Hiromichi; Mayanagi, Shuhei; Kanda, Mitsuro; Sakamoto, Junichi; Saji, Shigetoyo; Yoshikawa, Takaki.

In: Cancer Medicine, 2017.

Research output: Contribution to journalArticle

Aoyama, Toru ; Kashiwabara, Kosuke ; Oba, Koji ; Honda, Michitaka ; Sadahiro, Sotaro ; Hamada, Chikuma ; Maeda, Hiromichi ; Mayanagi, Shuhei ; Kanda, Mitsuro ; Sakamoto, Junichi ; Saji, Shigetoyo ; Yoshikawa, Takaki. / Clinical impact of tumor location on the colon cancer survival and recurrence : Analyses of pooled data from three large phase III randomized clinical trials. In: Cancer Medicine. 2017.
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AU - Honda, Michitaka

AU - Sadahiro, Sotaro

AU - Hamada, Chikuma

AU - Maeda, Hiromichi

AU - Mayanagi, Shuhei

AU - Kanda, Mitsuro

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AU - Saji, Shigetoyo

AU - Yoshikawa, Takaki

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AB - The aim of the present study was to determine whether or not the overall survival (OS) and disease-free survival (DFS) were affected by the tumor location in patients who underwent curative resection for colon cancer in a pooled analysis of three large phase III studies performed in Japan. In total, 4029 patients were included in the present study. Patients were classified as having right-side colon cancer (RC) if the primary tumor was located in the cecum, ascending colon, hepatic flexure or transverse colon, and left-side colon cancer (LCC) if the tumor site was within the splenic flexure, descending colon, sigmoid colon or recto sigmoid junction. The risk factors for the OS and DFS were analyzed. In the present study, 1449 patients were RC, and 2580 were LCC. The OS rates at 3 and 5 years after surgery were 87.6% and 81.6% in the RC group and 91.5% and 84.5% in the LCC group, respectively. Uni- and multivariate analyses showed that RRC increased the risk of death by 19.7% (adjusted hazard ratio = 1.197; 95% confidence interval, 1.020-1.408; P = 0.0272). In contrast, the DFS was similar between the two locations. The present study confirmed that the tumor location was a risk factor for the OS in patients who underwent curative treatment for colon cancer. Tumor location may, therefore, need to be considered a stratification factor in future phase III trials of colon cancer.

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