No abstract

No abstract

were correlations between laterality and clinicopathological features including molecular markers (RAS, BRAF) and microsatellite instability.Results: We queried the data of 320 patients. Due to the lack of follow up data (n ¼ 21), stage (n¼17), and location (n¼11), 49 patients were excluded from the analysis (Final number¼271). Right colic cancer (RCC) and Left colic cancer (LCC) proportions in our population were 29% (38 males, 45 females, median age 57, range 22-84) and 67%, (93 males, 100 females, median age 56, range 23-88), respectively. For stages III-IV, 81% of patients (n¼220) were identified. Of those, 40,5 % had left-sided tumors and 42% had right-sided tumors. Patients presenting with surgical emergencies such as obstructive or perforated tumor were most likely to have a left-sided location (35% vs 21%). For stage II tumors, patients with right-sided tumors had significantly greater rates of poor prognosis histopathologic features (RCC vs LCC: vascular emboli: 75% vs 65%, perineural invasion: 54% vs 46%, positive Lymph nodes: 64% vs 61%). For stage III tumors, left-sided tumors showed better clinical outcomes than proximal colon cancers after adjuvant chemotherapy. For stage VI, although a more marked number of metastatic sites was observed on right-sided tumors, there was no significant association with clinical outcome and survival with regard to the number of metastatic sites between the two locations. Available data of the MSI, KRAS, NRAS, and BRAF mutation status were too scarce for statistical analysis to report the correlation between molecular markers and laterality.We concluded that patients with left-sided tumors were observed to reach longer benefit for first-line chemotherapy progression-free survival (13 vs 8 months). Stage IV right colon tumors were less responsive to systemic therapy and had a poorer overall survival (OS: 13 vs 16 months). Thus, our patients exhibited lower median overall survival compared to literature data.This can mainly be attributed to limited early screening programs, as most patients were diagnosed with late-stage disease, and lack of treatment facilities, in the era of target therapies and immunotherapy. Conclusion:Colon cancer laterality seems to maintain clinical relevance, most likely in the advanced and metastatic stages. These findings are convincing arguments to support the standardization of this indicator for better prognosis grading.