医学
内科学
结直肠癌
比例危险模型
回顾性队列研究
肿瘤科
淋巴结
体质指数
队列
癌症
胃肠病学
多元分析
阶段(地层学)
生存分析
生物
古生物学
作者
L.J. de la Beltrán,Sagrario González‐Trejo,Doris Carmona-Herrera,José F. Carrillo,Roberto Herrera‐Goepfert,Vincenzo Aiello‐Crocifoglio,Dolores Gallardo‐Rincón,Norma A. Meléndez-Ponce,Francisco Javier Ochoa‐Carrillo,Luis F. Oñate‐Ocaña
标识
DOI:10.1016/j.arcmed.2019.05.011
摘要
Right-colon cancer (RCC) presents differences with Left-colon cancer (LCC) in terms of Overall survival (OS), but certain reports provide conflicting findings. Our objective is to define differences regarding prognostic factors in RCC and LCC by multivariate analysis. Retrospective cohort including patients treated from 1992–2016. The Kaplan-Meier and Cox models were used to define prognostic factors. 871 patients had RCC and 748 LCC; mean age was 58.1. Location was associated with socioeconomic status, body mass, blood hemoglobin, serum albumin, lymphocyte count and Prognostic nutritional index (PNI). Distribution of TNM stages was similar between groups, as well as gender, age, surgical morbidity/mortality; 72.3% of RCC and 83.2% of LCC were well/moderately differentiated (p <0.0001). Mean surgical lymph-node retrieval was 19.3 (SD14.6) for RCC and 15.7 (SD13.1) for LCC (p <0.0001). Median OS was 5.2 (95% CI 3.9–6.5) for RCC, and 3.2 years (95% CI 2.1–4.4) for LCC (p = 0.426). OS was different between RCC and LCC by stratified analyses within PNI, TNM, differentiation and R classification. RCC presents different OS in stages IIIC, and IVB than LCC. Differences between RCC and LCC were mainly by immunonutritional variables. Differences in OS were found after stratified analysis of PNI, TNM stages, differentiation degree, and R classification. Location of the neoplasm in the colon should be considered in the design of clinical trials in patients with colon cancer.
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