Right colon cancer: Left behind.
- Gervaz P Division of Coloproctology, Clinique Hirslanden La Colline, Geneva, Switzerland. Electronic address: pascalgervaz@gmail.com.
- Usel M Geneva Cancer Registry, Institute of Global Health, Geneva University of Medicine, Switzerland.
- Rapiti E Geneva Cancer Registry, Institute of Global Health, Geneva University of Medicine, Switzerland.
- Chappuis P Division of Genetic Medicine, Geneva University Hospital, Geneva, Switzerland.
- Neyroud-Kaspar I Geneva Cancer Registry, Institute of Global Health, Geneva University of Medicine, Switzerland.
- Bouchardy C Geneva Cancer Registry, Institute of Global Health, Geneva University of Medicine, Switzerland.
- 2016-05-15
Published in:
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. - 2016
Cancer registry
Colon cancer
Location
Population-based study
Survival
Adenocarcinoma
Aged
Aged, 80 and over
Cecal Neoplasms
Colon, Ascending
Colon, Descending
Colon, Transverse
Colonic Neoplasms
Female
Humans
Male
Middle Aged
Prognosis
Proportional Hazards Models
Registries
Sigmoid Neoplasms
Survival Rate
Switzerland
English
INTRODUCTION
Prognosis of colon cancer (CC) has steadily improved during the past three decades. This trend, however, may vary according to proximal (right) or distal (left) tumor location. We studied if improvement in survival was greater for left than for right CC.
METHODS
We included all CC recorded at the Geneva population-based registry between 1980 and 2006. We compared patients, tumor and treatment characteristics between left and right CC by logistic regression and compared CC specific survival by Cox models taking into account putative confounders. We also compared changes in survival between CC location in early and late years of observation.
RESULTS
Among the 3396 CC patients, 1334 (39%) had right-sided and 2062 (61%) left-sided tumors. In the early 1980s, 5-year specific survival was identical for right and left CCs (49% vs. 48%). During the study period, a dramatic improvement in survival was observed for patients with left-sided cancers (Hazard ratio [HR]: 0.42, 95% confidence interval [CI]: 0.29-0.62, p < 0.001) but not for right CC patients (HR: 0.76, 95% CI: 0.50-1.14, p = 0.69). As a consequence, patients with distal CC have a better outcome than patients with proximal CC (HR for left vs. right CC: 0.81, 95% CI: 0.72-0.90, p < 0.001).
CONCLUSION
Our data indicate that, contrary to left CC, survival of patients with right CC did not improve since 1980. Of all colon cancer patients, those with right-sided lesions have by far the worse prognosis. Change of strategic management in this subgroup is warranted.
Prognosis of colon cancer (CC) has steadily improved during the past three decades. This trend, however, may vary according to proximal (right) or distal (left) tumor location. We studied if improvement in survival was greater for left than for right CC.
METHODS
We included all CC recorded at the Geneva population-based registry between 1980 and 2006. We compared patients, tumor and treatment characteristics between left and right CC by logistic regression and compared CC specific survival by Cox models taking into account putative confounders. We also compared changes in survival between CC location in early and late years of observation.
RESULTS
Among the 3396 CC patients, 1334 (39%) had right-sided and 2062 (61%) left-sided tumors. In the early 1980s, 5-year specific survival was identical for right and left CCs (49% vs. 48%). During the study period, a dramatic improvement in survival was observed for patients with left-sided cancers (Hazard ratio [HR]: 0.42, 95% confidence interval [CI]: 0.29-0.62, p < 0.001) but not for right CC patients (HR: 0.76, 95% CI: 0.50-1.14, p = 0.69). As a consequence, patients with distal CC have a better outcome than patients with proximal CC (HR for left vs. right CC: 0.81, 95% CI: 0.72-0.90, p < 0.001).
CONCLUSION
Our data indicate that, contrary to left CC, survival of patients with right CC did not improve since 1980. Of all colon cancer patients, those with right-sided lesions have by far the worse prognosis. Change of strategic management in this subgroup is warranted.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1016/j.ejso.2016.04.002
- PMID 27178778
- Persistent URL
- https://sonar.ch/global/documents/46421
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