TY - JOUR
T1 - Clinical impact of tumor location on the colon cancer survival and recurrence
T2 - analyses of pooled data from three large phase III randomized clinical trials
AU - Aoyama, Toru
AU - Kashiwabara, Kosuke
AU - Oba, Koji
AU - Honda, Michitaka
AU - Sadahiro, Sotaro
AU - Hamada, Chikuma
AU - Maeda, Hiromichi
AU - Mayanagi, Shuhei
AU - Kanda, Mitsuro
AU - Sakamoto, Junichi
AU - Saji, Shigetoyo
AU - Yoshikawa, Takaki
N1 - Funding Information:
1Department of Surgery, Yokohama City University, Yokohama, Japan 2Department of Biostatistics, The University of Tokyo, Tokyo, Japan 3Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Japan 4Department of Surgery, Tokai University, Isehara, Japan 5Faculty of Engineering, Tokyo University of Science, Tokyo, Japan 6Cancer Treatment Center, Kochi Medical School Hospital, Kochi, Japan 7Department of Surgery, Keio University School of Medicine, Tokyo, Japan 8Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan 9Tokai Central Hospital, Kakamigahara, Japan 10Japanese Foundation for Multidisciplinary Treatment of Cancer, Tokyo, Japan 11Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
Publisher Copyright:
© 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
PY - 2017/11
Y1 - 2017/11
N2 - 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.
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.
KW - Colorectal cancer
KW - left side colon cancer
KW - recurrence
KW - right side colon cancer
KW - survival
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U2 - 10.1002/cam4.1208
DO - 10.1002/cam4.1208
M3 - Article
C2 - 28948714
AN - SCOPUS:85030624196
VL - 6
SP - 2523
EP - 2530
JO - Cancer Medicine
JF - Cancer Medicine
SN - 2045-7634
IS - 11
ER -
