Retrospective Cohort Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 14, 2017; 23(42): 7618-7625
Published online Nov 14, 2017. doi: 10.3748/wjg.v23.i42.7618
Right- and left-sided colorectal cancers respond differently to traditional Chinese medicine
Shan-Shan Liu, Qi Shi, Hong-Jia Li, Wei Yang, Su-Su Han, Shao-Qi Zong, Wen Li, Feng-Gang Hou
Shan-Shan Liu, Qi Shi, Hong-Jia Li, Wei Yang, Su-Su Han, Shao-Qi Zong, Wen Li, Feng-Gang Hou, Oncology Department of Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
Author contributions: Liu SS and Hou FG designed the research; all authors involved in patients recruitment and data collecting; Liu SS analyzed the data and edited manuscript.
Supported by the Scientific Research Foundation of Traditional Chinese Medicine of the Shanghai Health Bureau, No. 2014LZ079A; the Scientific Research Plan Project of the Shanghai Science and Technology Committee, No. 14401930800; the Program of Shanghai Municipal Technology and Education Commission, No. 16401970500.
Institutional review board statement: The study was reviewed and approved by IRB of Shuguang Hospital affiliated with Shanghai University of TCM.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors have declared no conflicts of interest.
Data sharing statement: No additional data were available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Feng-Gang Hou, PhD, Oncology Department of Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Road, Shanghai 200071, China. 1127@szy.sh.cn
Telephone: +86-21-56639828 Fax: +86-21-56639484
Received: July 3, 2017
Peer-review started: July 5, 2017
First decision: August 30, 2017
Revised: September 12, 2017
Accepted: September 26, 2017
Article in press: September 26, 2017
Published online: November 14, 2017
Processing time: 131 Days and 21 Hours
ARTICLE HIGHLIGHTS
Research background

The background, present status and significance of the study have been described detailedly in the section “Introduction” of the text.

Research motivation

The background, present status and significance of the study have been described detailedly in the section “Introduction” of the text.

Research objectives

The main objectives, the objectives that were realized, and the significance of realizing these objectives for future research in this field were described in the last sentence of “Introduction”, “Discussion”.

Research methods

“Statistical analysis” has introduced the methods used in realizing the objectives of our manuscript in detail.

Research results

Research results have been detailedly described in the first and last paragraphs of “Discussion”.

Research conclusions

The authors have addressed the above questions mainly in “Statistical analysis” and “Discussion”. Recently, the sidedness of primary colon cancer was demonstrated to be a prognostic factor in survival. Because of their distinct biological characteristics, LSCRC and RSCC tend to be treated separately. However, there was no evidence regarding whether TCM exerts variable effects on CRC based on the side where the lesion is located. This is the first study discussing the effects of TCM on LSCRC and RSCC separately. Our results showed that patients with LSCRC exhibited a relatively longer DFS than those with RSCC regardless of TCM administration, whereas patients with RSCC who took TCM gained a greater benefit regarding DFS. Because of their distinct biological characteristics and the therapeutic effect, LSCRC and RSCC should be treated separately in future. The DFS was evaluated using Kaplan-Meier curves and log-rank tests. The authors adopted propensity score matching to model the probability that a patient exhibited a specific characteristic based on gender, age, location, histodifferentiation, TNM stage, lymph node status, chemotherapy, radiotherapy and comorbidities to test the stability of the research. In addition, the authors applied multivariate regression analyses for multicollinearity diagnosis and Cox proportional hazards regression model for multivariate factor analysis.

Research perspectives

Recent studies have proposed that location of primary tumor was related to recurrence, metastasis and the therapeutic effect. The author’s results indicated that patients with LSCRC and RSCC responded differently to TCM; those with RSCC benefited more from TCM than those with LSCRC. Thus, TCM was recommended to postoperative patients with CRC of both sides, especially the right side. In the future research, CRC should be treated separately based on the primary tumor sides.