Right- and left-sided colon cancer – clinical and pathological differences of the disease entity in one organ

Mik, Michał; Berut, Maciej; Dziki, Łukasz; Trzciński, Radzisław; Dziki, Adam

doi:10.5114/aoms.2016.58596

Cited by 101 publications

(115 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, the number of HLNs was higher in the RCC group than in the LCC group (23.8 vs. 19.2, p = 0.003). Mik et al also reported that the total number of HLNs was higher in the RCC group (11.7 vs, 8.3 ; p = 0.0001), and these results are similar to our own findings [32]. The reason for this was due to the differences in the resected area, depending on the tumor location.…”

Section: Discussionsupporting

confidence: 91%

Tumor Sidedness Could be a Prognostic Factor in Patients with Stage II Colon Cancer

Iguchi

Mushiake²,

Hasegawa

et al. 2020

Preprint

View full text Add to dashboard Cite

Background : The search for high-risk factors in stage II colon cancer (CC) is ongoing and several highrisk factors for stage II CC have been identified; however, the effects of tumor sidedness on prognosis is not clear. This study aims to determine whether tumor sidedness could be identified as another high-risk factor for stage II CC.Methods : We retrospectively analyzed 189 patients with stage II CC, following consecutive curative resection surgery performed between 2008 and 2014. We compared clinicopathological findings and long-term outcomes between the patients with right colonic cancer (RCC) and patients with left colonic cancer (LCC). Prognostic factors for survival were determined using univariate and Cox proportional regression analyses.Results : A total of 72 patients were diagnosed with RCC and 117 patients were diagnosed with LCC.Patients with RCC were significantly older (p < 0.001) than those with LCC, and the number of harvested lymph nodes (HLNs) was greater in the RCC group (RCC: 25 vs. LCC: 19; p = 0.003). The overall survival (OS) was notably worse in the RCC group than the OS in the LCC group (5 year survival rate-RCC: 81.3% vs. LCC: 90.4%; p = 0.025), whereas no significant difference was observed in disease-free survival (5 year survival rate-RCC: 74.8% vs. LCC: 83.4%; p = 0.065). Cox proportional regression analysis showed that tumor sidedness (hazard ratio (HR): 3.78, 95% confidence interval (CI): 1.61-8.85, p = 0.022), gender (HR: 3.27, 95% CI: 1.27-8.47, p = 0.014), and the number of HLNs (HR: 4.58, 95% CI: 1.95-10.74, p < 0.001) were independent prognostic factors for OS.Conclusion : Patients with a right-sided primary tumor location have more negative prognostic factors and worse long-term outcomes than those with a left-sided primary tumor location in stage II CC. BackgroundColorectal cancer (CRC) is a major health problem worldwide. CRC is the third most common cancer in the world and the second highest cause of cancer-related death [1,2]. Recently, several molecular and genetic mechanisms of CRC carcinogenesis have been identified [3,4]. It has also been reported that the oncological features differ between colon cancer (CC) and rectal cancer [5]. In stage II CC, Recurrence pattern and post-recurrence therapy between the groups Recurrence patterns and treatments for recurrence are summarized in Table 2. Ten patients (13.9%) recurred in the RCC group, compared with 14 patients (12.0%) in the LCC group. The recurrence sites were the liver, lungs, peritoneum, and bone. The liver was the most commonly recurring organ in both groups. There was no significant difference between the two groups in recurrence sites (p = 0.44).Treatments for recurrence were performed in 90% and 92.9% of cases in the RCC and LCC groups,

show abstract

Section: Discussionsupporting

confidence: 91%

Tumor Sidedness Could be a Prognostic Factor in Patients with Stage II Colon Cancer

Iguchi

Mushiake²,

Hasegawa

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Proximal and distal colon tumors are suggested to be clinically, pathologically and transcriptionally distinct within CRC [4,61]. Multi-omics studies aimed at identifying differences between RSCC and LSCC have often targeted a direct comparison between the two tumor sides (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Right-sided colon cancers (RSCC or proximal tumors) occur in the cecum, ascending colon, hepatic flexure and/ or transverse colon, while left-sided colon cancers (LSCC or distal tumors) arise in the splenic flexure, descending colon, and/or sigmoid colon. This distinction has been observed at physiological, molecular and therapeutic levels for RSCC and LSCC [4]. For example, from the perspective of disease management, National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology outline differences in therapeutic sensitivities of targeted drugs differ between sites in CRC for e.g.…”

Section: Introductionmentioning

confidence: 99%

Right and left-sided colon cancers - specificity of molecular mechanisms in tumorigenesis and progression

et al. 2020

View full text Add to dashboard Cite

Background: Given the differences in embryonic origin, vascular and nervous supplies, microbiotic burden, and main physiological functions of left and right colons, tumor location is increasingly suggested to dictate tumor behavior affecting pathology, progression and prognosis. Right-sided colon cancers arise in the cecum, ascending colon, hepatic flexure and/or transverse colon, while left-sided colon cancers arise in the splenic flexure, descending, and/or sigmoid colon. In contrast to prior reports, we attempt to delineate programs of tumorigenesis independently for each side. Methods: Four hundred and eleven samples were extracted from The Cancer Genome Atlas-COAD cohort, based on a conservative sample inclusion criterion. Each side was independently analyzed with respect to their respective normal tissue, at the level of transcription, post-transcription, miRNA control and methylation in both a stage specific and stage-agnostic manner. Results: Our results indicate a suppression of enzymes involved in various stages of carcinogen breakdown including CYP2C8, CYP4F12, GSTA1, and UGT1A within right colon tumors. This implies its reduced capacity to detoxify carcinogens, contributing to a genotoxic tumor environment, and subsequently a more aggressive phenotype. Additionally, we highlight a crucial nexus between calcium homeostasis (sensing, mobilization and absorption) and immune/GPCR signaling within left-sided tumors, possibly contributing to its reduced proliferative and metastatic potential. Interestingly, two genes SLC6A4 and HOXB13 show opposing regulatory trends within right and left tumors. Post-transcriptional regulation mediated by both RNA-binding proteins (e.g. NKRF (in left) and MSI2 (in right)) and miRNAs (e.g. miR-29a (in left); miR-155, miR181-d, miR-576 and miR23a (in right)) appear to exhibit side-specificity in control of their target transcripts and is pronounced in right colon tumors. Additionally, methylation results depict location-specific differences, with increased hypomethylation in open seas within left tumors, and increased hypermethylation of CpG islands within right tumors. Conclusions: Differences in molecular mechanisms captured here highlight distinctions in tumorigenesis and progression between left and right colon tumors, which will serve as the basis for future studies, influencing the efficacies of existing and future diagnostic, prognostic and therapeutic interventions.

show abstract

“…The left side of the colon derives from the embryonic hindgut, whereas its right side derives from the midgut. Some authors therefore postulate that leftand right-sided colon cancers should be viewed as two distinct disease entities [6,7]. In advanced neoplasia of the colon, distal tumors are characterized by their polypoid structure and are easier to detect in colonoscopy compared with flat proximal tumors.…”

Section: Introductionmentioning

confidence: 99%

Selected Oxidative Stress Markers in Colorectal Cancer Patients in Relation to Primary Tumor Location—A Preliminary Research

et al. 2020

View full text Add to dashboard Cite

Background and objectives: Ample evidence indicates that oxidative stress, including complex lipid peroxidation processes, may play a significant role in the pathogenesis of colorectal cancer. The goal of this study was to evaluate selected oxidative stress markers in patients with colorectal cancer depending on some clinical features, with particular attention paid to the location of the primary tumor. Materials and Methods: The study was conducted on a group of 66 patients with colorectal cancer. The study consisted of two stages. The first stage involved the analysis of medical records; the second consisted of determining selected oxidative stress markers by measuring malondialdehyde as well as total oxidant and antioxidant status. Results: Of all patients, 43 (65.15%) had colon cancer, of whom 30 (69.77%) had a tumor on the left side and 13 (30.23%) had a tumor on the right side of the colon. Of all the patients, 23 (34.85%) had rectal cancer. The mean total oxidant and antioxidant status was 809.76 (SD ± 392.65) µmol/L and 253.19 (233.33–310.66) µmol/L, respectively. The mean malondialdehyde serum level was 2478.04 (SD ± 1397.05) ng/mL. The mean malondialdehyde serum concentration in patients with primary tumors located on the right side was higher in a statistically significant way compared with the remaining patients. Conclusions: It was demonstrated that the intensity of lipid peroxidation processes is correlated with the development of colorectal cancer, particularly on the right side. The results should be interpreted rather cautiously due to certain limitations of the study.

show abstract

Right- and left-sided colon cancer – clinical and pathological differences of the disease entity in one organ

Cited by 101 publications

References 15 publications

Tumor Sidedness Could be a Prognostic Factor in Patients with Stage II Colon Cancer

Tumor Sidedness Could be a Prognostic Factor in Patients with Stage II Colon Cancer

Right and left-sided colon cancers - specificity of molecular mechanisms in tumorigenesis and progression

Selected Oxidative Stress Markers in Colorectal Cancer Patients in Relation to Primary Tumor Location—A Preliminary Research

Contact Info

Product

Resources

About