Analysis Of Survival Difference And TCM Syndromes Distribution Between Left-Sided And Right-Sided Colon Cancer Treated By Integrated Chinese And Western Medicine

Objective Through the retrospective study of the cases of postoperative patients with colon cancer in the database of the research group,the survival differences of postoperative patients with left-sided and right-sided colon cancer were compared.To analyze the distribution of TCM syndromes of left-sided and right-sided colon cancer,so as to provide evidence-based basis for the study of the difference between left-sided and right-sided colon cancer and TCM syndrome differentiation and treatment.Method The patients treated with traditional Chinese medicine and with complete TCM diagnosis data after radical or palliative resection of colon cancer were selected from the database of the research group from January 2004 to December 2018.According to the splenic flexure of colon,the patients were divided into right-sided colon group and left-sided colon group.The study reviewed the case data by referring to the medical history and telephone follow-up,including age,sex,pathological type,degree of differentiation,stage,recurrence and metastasis,site of metastasis,mode of treatment,survival condition,survival and TCM syndromes and so on.The overall survival(OS),disease-free survival(DFS)and 1-,3-and 5-year survival rates were used as the main observation indexes to analyze and compare the survival differences between patients with left-sided and right-sided colon cancer after operation.The correlation between TCM syndromes and general data was analyzed,and the distribution differences of TCM syndromes of patients with left-sided and right-sided colon cancer after operation were compared.Results A total of 261 cases in accordance with the criteria were included in this study,215 cases were confirmed to have died and 46 cases survived.Among them,119 cases died and 14 cases survived in the right-sided colon group,and 96 cases died and 32 cases survived in the left-sided colon group.The median OS in the right-sided colon group was 59.43 months,respectively,while that in the left-sided colon group as 72.5months,respectively.The 1-,3-and 5-year overall survival rates of the right-sided colon group were 94.0%,66.9% and 48.5%,respectively,and the 1-,3-and 5-year overall survival rates of the left-sided colon cancer group were 95.3%,74.6% and 60.5%,respectively.The median OS and 1-,3-and 5-year overall survival rate in the left-sided colon group were higher than those in the right-sided colon group(P<0.05).The median DFS in the right-sided colon group was 20.10 months,respectively,while that in the left-sided colon group was 39.57 months,respectively.The 1-,3-and 5-year disease-free survival rates of the right-sided colon cancer group were 63.8%,33.6% and31.8%,respectively,and the 1-,3-and 5-year disease-free survival rates of the left-sided colon cancer group were 73.3%,53.2% and 42.6%,respectively.The median DFS and 1-,3-and 5-year disease-free survival rate in the left-sided colon group were higher than those in the right-sided colon group(P<0.05).Syndrome of spleen deficiency and qi stagnation was the most common TCM syndrome in postoperative patients with left-sided and right-sided colon cancer,with a total of 79 cases,accounting for 30%,followed by syndrome of damp-heat accumulation in 54 cases,accounting for 21%.There was no significant difference in the distribution of TCM syndromes in terms of sex,age,degree of differentiation,stage,chemotherapy and metastasis site(P>0.05).Syndrome of spleen deficiency and qi stagnation,yin deficiency of liver and kidney syndrome and deficiency of both qi and blood were common in patients with right-sided colon cancer,while syndrome of damp-heat accumulation was common in patients with left-sided colon cancer after operation,and the difference was statistically significant(P<0.05).Conclusion(1)The survival,recurrence and metastasis of postoperative patients with left-sided colon cancer were better than those of right-sided colon cancer.(2)There is a significant difference in the distribution of TCM syndromes in postoperative patients with left-sided and right-sided colon cancer.Syndrome of spleen deficiency and qi stagnation,yin deficiency of liver and kidney syndrome and deficiency of both qi and blood were common in right-sided colon cancer,while syndrome of damp-heat accumulation was common in left-sided colon cancer.