Female colon cancer: pattern and prognosis of distant metastases

Background: The purpose of this study was to compare the metastatic pattern and prognosis of female colon cancer (FCC) to that of male colon cancer (MCC) to ascertain the independent factors impacting the prognosis of patients with FCC. Patients and Methods The data of 135503 patients with colon cancer diagnosed between 2010 and 2017 with at least five years of follow-up were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. The Pearson chi-square test and Fisher exact probability method were used to compare clinicopathological features. Kaplan-Meier analysis was used to compare survival differences. The Cox proportional risk model was utilized to evaluate the prognostic factors impacting overall survival. Results: A total of 22977 patients with metastatic colon cancer were identified;12172(53.0%) in males and 10805(47.0%) in females. Compared to non-metastatic FCC patients, a greater proportion of metastatic FCC patients, were less than 60 years of age, black race, and grade III-IV. The primary sites were mainly located on the left side. Compared to metastatic MCC patients, a higher proportion of metastatic FCC patients ranged over 60 years of age, black race, and chemotherapy, while the primary site was located on the right side. Among CC patients who had distant metastasis of a single organ, Liver and lung were the two most common sites, and patients with lung metastases had a better prognosis than those with other types of metastasizes. FCC patients with liver metastasis had a worse prognosis than their MCC counterparts and were more likely to develop lung metastases. Cox multivariate regression analysis showed that the risk ratio was higher in metastatic FCC patients compared to those without metastases. Conclusions: We report the survival comparison of metastatic FCC with non-metastatic FCC through the SEER database. Our results suggest that it has unique clinicopathologic features and differs from metastatic MCC. Furthermore, patients with liver metastatic FCC have a worse prognosis than those with MCC. Emphasis on screening for colon cancer in women and additional clinical care should be paid for, especially for patients with FCC with metastatic liver cancer.