Outcome of right- and left-sided colonic and rectal cancer following surgical resection

“…The physiologic basis for this argument may lie in the fact that the right and left colon have different embryologic origins, microenvironments, and distinct blood supplies. Subsequently, there has been growing evidence that right-sided colon cancer (RC) and left-sided colon cancer (LC) represent distinct entities [3,4], with differences observed in epidemiology, biology, pathology and clinical outcomes [5][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Location of colon cancer (right-sided versus left-sided) as a prognostic factor and a predictor of benefit from cetuximab in NCIC CO.17

Brule

Jonker

Karapetis

et al. 2015

European Journal of Cancer

298

233

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“…Most, but not all studies have found poorer survival with RsCC [7–11]. A recent meta-analysis found a statistically significant worse overall survival in patients with RsCC, although there was significant heterogeneity seen due the spectrum of included study designs, disease stage, and limited information about treatment received by patients [12].…”

Section: Introductionmentioning

confidence: 99%

Sidedness is prognostic in locoregional colon cancer: an analysis of 9509 Australian patients

Brungs

Aghmesheh

Souza³

et al. 2017

BMC Cancer

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Background/AimRight sided colon cancer (RsCC) is proposed to be a distinct disease entity to left sided colon cancer (LsCC). We seek to confirm primary tumour location as an independent prognostic factor in locoregional colorectal cancer.MethodsAll patients with stage I – III primary adenocarcinoma of colon were identified from the New South Wales (NSW) clinical cancer registry (2006–2013). Primary tumour location (RsCC vs LsCC) survival analyses were conducted using the Kaplan-Meier method, and adjusted hazard ratios for 5-year all-cause mortality (OS) and 5-year cancer specific mortality (CSS) were obtained using Cox proportional hazards regression.ResultsWe identified 9509 patients including 5051 patients with RsCC and 4458 with LsCC. Patients with RsCC were more likely to be older, female, have a higher Charlson comorbidity index, and have worse tumour prognostic factors. In univariate analysis of all stages combined, those patients with RsCC had a worse overall survival (OS, HR 1.20 95% CI 1.11–1.29, p < 0.0001), although this was not significant in the multivariate analysis (HR 0.96 95% CI 0.89–1.04, p = 0.35). Stage I patients with RsCC had a trend to improved OS (multivariate HR 0.84 95% CI 0.69–1.01, p = 0.07) and a significantly improved CSS (multivariate HR 0.51 95% CI 0.35–0.75, p = 0.0006). In stage II patients with RsCC there was a significantly improved OS (multivariate HR 0.85 95% CI 0.75–0.98, p = 0.02) and CSS (multivariate HR 0.59 95% CI 0.45–0.78, p = 0.0002) compared to LsCC. In stage III patients, those with RsCC had a worse OS (multivariate HR 1.13 95% CI 1.01–1.26, p = 0.032) and a trend to worse CSS (multivariate HR 1.12 95% CI 0.94–1.33, p = 0.22).ConclusionsPrimary tumour location is an important prognostic factor in locoregional colon cancer with an effect that varies by stage. RsCC is associated with lower all-cause mortality in stage II, and higher all-cause mortality in stage III.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-017-3255-z) contains supplementary material, which is available to authorized users.

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Outcome of right- and left-sided colonic and rectal cancer following surgical resection

Abstract: Right-sided colorectal cancers had a worse prognosis than left-sided and rectal cancers, possibly because of more advanced staging and fewer curative resections.

Cited by 90 publications

References 23 publications

TNM staging system of colorectal carcinoma: surgical pathology of the seventh edition

TNM staging system of colorectal carcinoma: surgical pathology of the seventh edition

Location of colon cancer (right-sided versus left-sided) as a prognostic factor and a predictor of benefit from cetuximab in NCIC CO.17

Sidedness is prognostic in locoregional colon cancer: an analysis of 9509 Australian patients

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