Impact of Primary Tumor Site on the Prognosis in T4 Colorectal Cancer Patients

Objective: To retrospectively analyze the prognostic differences between LCC and RCC, and to explore the occurrence of such differences in the relevant factors. Provide clinical basis for the individualization and precise treatment of CRC. Methods: The clinical and follow-up data of 155 T4 CRC patients who underwent surgery in the first Affiliated Hospital of Sun Yat-sen University between August, 1994 and December, 2005. The age, sex, family history, staging, pathologic features, DFS, OS and other information were collected. The survival of the LCC (Left colon cancer) and RCC (Right colon cancer) patients was analyzed by Kaplan-Meier method. The survival curves of the LCC and RCC patients were compared by log-rank test. Results: There are statistically significant differences in N stage, CCR, family history and histological grade between two groups. Gender, histological grade and CCR were factors associated with OS and DFS of the T4 LCC according to the univariate and multivariate analyses. In addition, only the CCR was found to be the factor associated with OS and DFS of the T4 RCC. The mean survival of the patients was 104.23 months (range, 87.32 - 121.15 months) in the T4 RCC and 76.96 months (range, 61.32 - 92.60 months) in the T4 LCC groups. The complete cytoreduction had significant survival benefit than the palliative surgery group. Conclusion: The T4 RCC patients with CCR had a relatively better prognosis than LCC. Compared with palliative surgery, the incomplete cytoreduction fails to improve the prognosis of patient.