Survival rates and prognostic factors in right- and left-sided colon cancer stage I-IV: an unselected retrospective single-center trial.

ABSTRACT

PURPOSE: Colorectal cancer revealed over the last decades a remarkable shift with an increasing proportion of a right- compared to a left-sided tumor location. In the current study, we aimed to disclose clinicopathological differences between right- and left-sided colon cancer (rCC and lCC) with respect to mortality and outcome predictors. METHODS: In total, 417 patients with colon cancer stage I-IV were analyzed in the present retrospective single-center study. Survival rates were assessed using the Kaplan-Meier method and uni/multivariate analyses were performed with a Cox proportional hazards regression model. RESULTS: Our study showed no significant difference of the overall survival between rCC and lCC stage I-IV (p = 0.354). Multivariate analysis revealed in the rCC cohort the worst outcome for ASA (American Society of Anesthesiologists) score IV patients (hazard ratio [HR] 16.0; CI 95% 2.1-123.5), CEA (carcinoembryonic antigen) blood level > 100 µg/l (HR 3.3; CI 95% 1.2-9.0), increased lymph node ratio of 0.6-1.0 (HR 5.3; CI 95% 1.7-16.1), and grade 4 tumors (G4) (HR 120.6; CI 95% 6.7-2179.6) whereas in the lCC population, ASA score IV (HR 8.9; CI 95% 0.9-91.9), CEA blood level 20.1-100 µg/l (HR 5.4; CI 95% 2.4-12.4), conversion to laparotomy (HR 14.1; CI 95% 4.0-49.0), and severe surgical complications (Clavien-Dindo III-IV) (HR 2.9; CI 95% 1.5-5.5) were identified as predictors of a diminished overall survival. CONCLUSION: Laterality disclosed no significant effect on the overall prognosis of colon cancer patients. However, group differences and distinct survival predictors could be identified in rCC and lCC patients.