The Society of Surgical Oncology, inc.
The American Society of Breast Surgeons.
Annals of Surgical Oncology

Log in | Register

Oncologic Effects of Primary Tumor-Sidedness on Patients with Stages 1–3 Colon Cancer: A Meta-Analysis

Gi Won Ha MD, PhD, Jong Hun Kim MD, PhD, Min Ro Lee MD, PhD
Colorectal Cancer
Volume 26, Issue 5 / May , 2019



Previous studies comparing the oncologic outcomes of primary tumor-sidedness for patients with colon cancer have reported a worse prognosis for those with right-sided tumors. However, most of these studies evaluated patients with metastatic disease.


PubMed, EMBASE, and the Cochrane Library were searched for studies that assessed the effects of primary tumor-sidedness on survival outcomes for patients with stages 1, 2, and 3 colon cancer. The hazard ratio (HR) for primary tumor location was estimated for overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS).


The inclusion criteria were met by 37 studies involving 581,542 patients. The patients with a right-sided tumor had better CSS (HR, 0.67; 95% confidence interval [CI], 0.56–0.80; p < 0.0001) among those with stage 1 cancer as well as better OS (HR, 0.89; 95% CI 0.86–0.92; I2 = 19%) and CSS (HR, 0.78; 95% CI 0.70–0.86; I2 = 78%) among those with stage 2 cancer. In contrast, among the patients with stage 3 cancer, those with a right-sided tumor had worse OS (HR, 1.12; 95% CI 1.04–1.20; p = 0.002), CSS (HR, 1.05; 95% CI 1.01–1.10; p = 0.02), and DFS (HR, 1.32; 95% CI 1.07–1.63; p = 0.008).


Primary tumor location may be a prognostic factor for patients with non-metastatic colon cancer. The prognosis for patients with right-sided tumor may be better for those with stage 1 or 2 cancer, but worse for those with stage 3 cancer.

Add a comment

0 comment(s)



Join the conversation!

Follow the journal on Twitter and Facebook

Help to expand the reach of the journal to support the research and practice needs of surgical oncologists and their patients.