Prognostic Survival Associated With Left-Sided vs Right-Sided Colon Cancer

作者：Fausto Petrelli, Gianluca Tomasello, Karen Borgonovo, Michele Ghidini, Luca Turati, P Dallera, Rodolfo Passalacqua, Giovanni Sgroi, Sandro Barni · 发表于：JAMA Oncology · 年份：2016 · DOI：10.1001/jamaoncol.2016.4227 · 被引用次数：756 · 研究领域：Colorectal Cancer Screening and Detection、Colorectal Cancer Surgical Treatments、Multiple and Secondary Primary Cancers

IMPORTANCE: Primary tumor location is emerging as an important prognostic factor owing to distinct biological features. However, the side of origin of colon cancer (CC) still does not represent a prognostic parameter when deciding for adjuvant or palliative chemotherapy. OBJECTIVE: To determine the prognostic role of left vs right-sidedness of primary tumor location in patients with CC. DATA SOURCES: We searched PubMed, EMBASE, The Cochrane Library, Web of Science, LILACS, CINAHL, and SCOPUS for prospective or retrospective studies reporting data on overall survival for left-sided colon cancer (LCC) compared with right-sided colon cancer (RCC). STUDY SELECTION: Studies were selected if: (1) side of CC was reported among variables entered into survival analysis, (2) survival information was available (overall survival [OS] was reported in the article as hazard ratio (HR) according to multivariate analysis, (3) articles were published in the English language. DATA EXTRACTION AND SYNTHESIS: Data were pooled using HRs for OS of LCC vs RCC according to fixed or random-effects models. Subgroup analysis and multivariate random-effects model meta-regression was also implemented adjusting for stage distribution, sample size, race, year of publication, type and quality of studies, and adjuvant chemotherapy. MAIN OUTCOMES AND MEASURES: HRs for OS (the primary outcome measure) were pooled to provide an aggregate value. In this analysis, all HRs with 95% CIs were pooled to obtain prognost...