Publication

Impact of Tumor Side on Clinical Outcomes in Stage II and III Colon Cancer With Known Microsatellite Instability Status

Downloadable Content

Persistent URL
Last modified
  • 05/20/2025
Type of Material
Authors
    Mehmet Akce, Emory UniversityKaterina Zakka, Atlanta Medical CenterRenjian Jiang, Emory UniversityShayla Williamson, Emory UniversityOlatunji Alese, Emory UniversityWalid Shaib, Emory UniversityChristina Wu, Emory UniversityMadhusmita Behera, Emory UniversityBassel El-Rayes, Emory University
Language
  • English
Date
  • 2021-03-30
Publisher
  • Frontiers Media
Publication Version
Copyright Statement
  • © 2021 Akce, Zakka, Jiang, Williamson, Alese, Shaib, Wu, Behera and El-Rayes.
License
Final Published Version (URL)
Title of Journal or Parent Work
Volume
  • 11
Grant/Funding Information
  • None declared
Supplemental Material (URL)
Abstract
  • Background Tumor sidedness as a prognostic factor in advanced stage colon cancer (CC) is well established. The impact of tumor sidedness on the clinical outcomes of stage II and III CC has not been well studied. Methods The National Cancer Database (NCDB) was utilized to identify patients with pathological stage II and III primary adenocarcinoma of the colon from 2010 to 2015 using ICD-O-3 morphology and topography codes: 8140-47, 8210-11, 8220-21, 8260-63, 8480-81, 8490 and C18.0, 18.2,18.3, 18.5,18.6, 18.7. Univariate (UVA) and multivariable (MVA) survival analyses and Kaplan–Meier Curves with Log-rank test were utilized to compare overall survival (OS) based on tumor location and treatment received. Results A total of 35,071 patients with stage II (n = 17,629) and III (n = 17,442) CC were identified. 51.3% female; 81.5% Caucasian; median age 66 (range, 18–90). Majority of stage II and III tumors were right sided, 61.2% (n = 10,794) and 56.0% (n = 9,763). Microsatellite instability high (MSI-H) was more common in stage II compared to III, 23.3% (n = 4,115) vs 18.2% (n = 3,171) (p < 0.0001). In stage II MSI-H CC right was more common than left, 78.3% (n = 3223) vs 21.7% (n = 892). There was no significant difference in survival between stage II MSI-H left vs right (5-year OS 76.2 vs 74.7%, p = 0.1578). Stage II MSS CC right was more common than left, 56.0% (n = 7571) vs 44.0% (n = 5943), and survival was better in the left vs right (5-year OS 73.2 vs 70.8%, p = 0.0029). Stage III MSI-H CC was more common in the right than in the left, 75.6% (n = 2,397) vs 24.4% (n = 774) and survival was better in the left (5-year OS 62.5 vs 56.5%, p = 0.0026). Stage III MSS CC was more common in the right than in the left, 51.6% (n = 7,366) vs 48.4% (n = 6,905), and survival was better in the left vs right (5-year OS 67.0 vs 54.4%, p < 0.001). Conclusion Survival was better in left sided tumors compared to right in stage II MSS, stage III MSS, and stage III MSI-H CC.
Author Notes
Keywords
Research Categories
  • Health Sciences, Public Health
  • Health Sciences, Medicine and Surgery
  • Health Sciences, Oncology

Tools

Relations

In Collection:

Items

Thumbnail Title File Description Date Uploaded Visibility Actions
file details Publication File - vv8tq.pdf Primary Content 2025-05-16 Public Download