There are well defined clinic and pathologic risk factors in colorectal carsinomas (CRC). One of the most importantone is stage. Adjuvant systemic therapy is a part of standard treatment in stage 3. It is not known whether if location of tumor effects outcome. In current study we aimed to examine the effect of tumor location on prognosis in patients diagnosed as stage 3 CRC treated with adjuvant chemotherapy.
Records of 245 stage 3 CRC patients operated between January 2010 and December 2014 we retrospectively evaluated. All cohorts received either adjuvan FOLFOX6 or infusional FU. They divided 3 subgroups; right colon (includes transver scolon), left colon and rectosigmoid according to the place of the tumor originated. Clinicopathologic differences and their effect on outcome were evaluated.
Median age was 63 (range; 25-80) with slightly male predominance (62%). Tumor was located on right colon (14.3%), left colon (12.2 %) and rectosigmoid 73.5%. All but 3 (neoadjuvant chemoradiotherapy) patients received adjuvant treatment. Adjuvant chemo consisted of FOLFOX6 in nearly 4/5 (77.7 %). There were no statistical significance between groups in terms of demographics, grade, tumor deposits, LVI, PNI and the adjuvan treatment type (p). N2 disease distribution had statistical significance between groups (Right Colon 19.0%, left colon 9.1% and rectosigmoid 32.4% p = 0.024). The 5-year OS was 72% in right colon carsinomas, 90% in left colon carsinomas and 63% in rectosigmoid carsinomas. Difference between OS was nearly statistically significant (p = 0.053). Other negative prognostic factors were ECOG, undifferentiated tumor and N2 disease (p
In stage 3 operated colorectal cancer patients received adjuvant chemotherapy, poor differentiation, ECOG and N2 disease are associated with worse outcome. Left colon carsinomas have better survival rates compared with other locations. This can be associated with high N2 disease rate in patients having primary tumor in right colon and rectosigmoid region.
Clinical trial identification
Legal entity responsible for the study
Ankara Numune Hospital
All authors have declared no conflicts of interest.