Differences Of Clinicopathological Features And Prognosis In Patients With Left-side Colon And Right-side Colon Cancer

Objective To compare the differences in clinicopathological features and gene/protein expression levels among right-sided colon cancer(RSCC)and left-sided colon cancer(LSCC),exploring the factors affecting the prognosis of patients with colon cancer,which would provid a theoretical basis for the precise treatment of colon cancerMethods From January 2013 to December 2015,354 cases of primary colon cancer patients who underwent surgery were recruited from Linyi People's Hospital.The clinicopathological characteristics were extracted from the electronic medical records.To compare age,gender,tumor histological type,tumor maximum diameter,lymph node metastasis,staging and so on,the patients were randomly divided into two groups:RSCC group and LSCC group.All patients were followed up by reexamination,medical record or telephone.The deadline for follow-up was June 30,2018.The survival time was estimated by Kaplan-Meier method,and the survival difference between the two groups was compared.The COX proportional hazard model was used to analyze the prognostic factors affecting the survival of patients with left-and right-colon cancerResults 1.Comparisons of age,gender among RSCC and LSCC group:The majority of patients with colon cancer were male(61.3%,57.5%).The proportion of female patients with RSCC was higher than LSCC(42.5%,38.7%).No significant difference was observed among RSCC and LSCC group in age and gender(P>0.05).2.Comparisons of among pathological parameters RSCC and LSCC group:Significant differences were observed among RSCC and LSCC patients regarding tumor diameter(6.99±2.89cm vs 5.28±2.02cm),gross type,differentiation,pTNM stage(all P<0.05).There were no significant differences in histological type,lymph node metastasis,perineural invasion and vascular invasion and adjuvant chemotherapy among RSCC and LSCC patients(all P>0.05).3.Comparisons of protein expression levels among RSCC and LSCC group:There were no significant difference was observed among RSCC and LSCC patients,regarding protein expression levels of P53,P27,Bcl-2,Ki67 labeling index.4.Comparison of survival time among RSCC and LSCC group:A total of 320 patients with colon cancer were followed up for 1 to 67 months,with a median follow-up of 43months.The median survival of LSCC and RSCC was not observed.The 3-year overall survival rate of LSCC was 84.3%,and the 3-year overall survival rate of RSCC was 73.5%.The difference was statistically significant.5.Influencing factors of overall survival(OS)for colon cancer:By univariate analysis,age,tumor location,lymph node metastasis,vascular invasion,pTNM staging,and differentiation were associated with OS.Multivariate analyses only identified older,advanced TNM stage,poor differentiation,and vascular invasion as predictor of shorter OS.Conclusion 1.There were many differences in RSCC and LSCC patients.Compared with LSCC,RSCC had larger tumors,protuberances,poor differentiation,and advanced pTNM staging.2.There were no significant differences in gender,age composition,histological type,lymph node metastasis,vascular and neural tube invasion,and postoperative adjuvant chemotherapy in LSCC and RSCC.There were no statistical differences in P53 expression,P27 expression,Bcl-2 expression and Ki67 marker index in tumor tissues.3.The 3-year overall survival rate of patients with LSCC 1s higher than RSCC patients,but multivariate analysis indicated that the tumor site was not an independent risk factor for postoperative survival of colon cancer,but older,advanced pTNM staging,poor differentiation,and vascular invasion were independent risk factors for poor prognosis of colon cancer.