Article Abstract

Tumor location impact in stage II and III colon cancer: epidemiological and outcome evaluation

Authors: Nesrine Mejri, Manel Dridi, Houda El Benna, Soumaya Labidi, Nouha Daoud, Hamouda Boussen


Background: We aimed to describe clinico-pathological characteristics and differences between rightsided (RCC) and left-sided colon cancer (LCC) in Tunisian population. We also analyzed outcome to determine whether location is of prognostic significance.
Methods: Clinico-pathological characteristics and Kaplan Meier survival were compared between two groups of LCC [150] and RCC [53] patients with stage II and III adenocarcinoma treated with curative intent between 2003–2014.
Results: RCC patients were significantly more likely to be female, (56.6% vs. 39.3%, P=0.029) and to have undifferentiated tumor (87.1% vs. 8.4%, P=0.014), then LCC. After a median follow up of 49 months, 5-year overall survival (OS) was significantly worse in RCC vs. LCC [42% vs. 78%; hazard ratio (HR) =2.07; 95% CI: 1.05–4.09; P=0.03], no difference in relapse free survival (RFS) was observed. Median time to relapse was significantly shorter in RCC (15 months) vs. LCC (24 months), P=0.005. Tumor location significantly impacted survival in stage III, 5-year OS was 45% in RCC, and 63% in LCC, (HR =2.28; 95% CI: 1.01–5.24; P=0.04), there was no impact of tumor location in stage II, (HR =1.94; 95% CI: 0.54–6.93; P=0.29).
Conclusions: Prognostic impact of tumor location should be considered as a stratification factor in the future clinical trials.