The primary tumor location in colorectal cancer: A focused review on its impact on surgical management

Nagai, Yoshinori; Kiyomatsu, Tomomichi; Gohda, Yoshimasa; Otani, Kensuke; Deguchi, Katsuya; Yamada, Katsushi

doi:10.35772/ghm.2020.01096

Cited by 13 publications

(7 citation statements)

References 47 publications

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“…Several clinical studies have demonstrated that left- and right-sided colon tumors are different diseases, based also on their surgical procedures, as well as complication rates and recurrence patterns [ 50 ]. In particular, right-sided colon cancers are characterized by high immunogenicity and a worse prognosis [ 3 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

Serum Cytokine and miRNA Levels Are Differently Expressed in Right- and Left-Sided Colon Cancer

De Nunzio,

Donghia,

Pesole

et al. 2023

JCM

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The tumor location in colorectal cancer (right- or left-sided colon cancer) is a key factor in determining disease progression. Right- and left-sided colon tumors are different in their clinical and molecular characteristics. Dysregulation of serum levels of proinflammatory cytokines, such as Transforming Growth Factor β (TGF-β) and Tumor Necrosis Factor-α (TNF-α), and Peroxisome Proliferator Activated Receptor-γ (PPAR-γ), known to be a growth-limiting and differentiation-promoting factor, as well as changes in miRNAs expression, are the major signaling pathways involved in the pathogenesis of this neoplasia. In the serum from 60 colorectal cancer (CRC) patients, we compared the differences in the expression of the levels of TGF-β, TNF-α, and PPAR-γ and in the expression of the main human miRNAs between right and left CRC. A significant over-expression in the TGF-β and TNF-α levels was observed in the serum from right-sided colon cancer patients. For the PPAR-γ, the patients with CRC located on the right-side showed lower levels than those detected in the serum from left-sided CRC subjects. Furthermore, significant differences also existed in the expression of specific circulating miRNAs between right- and left-sided CRC. In particular, the right upregulated miRNAs were all involved in the cell growth and proliferation related pathways. These findings confirm that the analysis of circulating levels of TGF-β, TNF-α, and PPAR-γ, as well as the study of the specific miRNAs in the serum, are able to identify specific characteristics of CRC patients, useful for choosing a personalized treatment protocol.

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Section: Discussionmentioning

confidence: 99%

Serum Cytokine and miRNA Levels Are Differently Expressed in Right- and Left-Sided Colon Cancer

De Nunzio,

Donghia,

Pesole

et al. 2023

JCM

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“…CRC is a highly heterogeneous group of tumors, and the pathogenesis of CRC is a complex and multifactorial process involving the accumulation of various genetic and epigenetic alterations [ 5 ]. Beyond these alterations, it is widely accepted that tumor location (right- and left-sided colon cancer, rectal cancer) is a crucial factor involved in disease progression as well as prognosis and influences disease management [ 6 , 7 , 8 ]. Right-sided colon cancer (RSCC) occurs within the cecum, ascending colon, hepatic flexure and transverse colon, while left-sided colon cancer (LSCC) arises in the splenic flexure, descending colon and sigmoid colon.…”

Section: Introductionmentioning

confidence: 99%

Colon Cancer Microbiome Landscaping: Differences in Right- and Left-Sided Colon Cancer and a Tumor Microbiome-Ileal Microbiome Association

Kneis

Wirtz

Weber

et al. 2023

IJMS

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In the current era of precision oncology, it is widely acknowledged that CRC is a heterogeneous disease entity. Tumor location (right- or left-sided colon cancer or rectal cancer) is a crucial factor in determining disease progression as well as prognosis and influences disease management. In the last decade, numerous works have reported that the microbiome is an important element of CRC carcinogenesis, progression and therapy response. Owing to the heterogeneous nature of microbiomes, the findings of these studies were inconsistent. The majority of the studies combined colon cancer (CC) and rectal cancer (RC) samples as CRC for analysis. Furthermore, the small intestine, as the major site for immune surveillance in the gut, is understudied compared to the colon. Thus, the CRC heterogeneity puzzle is far from being solved, and more research is necessary for prospective trials that separately investigate CC and RC. Our prospective study aimed to map the colon cancer landscape using 16S rRNA amplicon sequencing in biopsy samples from the terminal ileum, healthy colon tissue, healthy rectal tissue and tumor tissue as well as in preoperative and postoperative stool samples of 41 patients. While fecal samples provide a good approximation of the average gut microbiome composition, mucosal biopsies allow for detecting subtle variations in local microbial communities. In particular, the small bowel microbiome has remained poorly characterized, mainly because of sampling difficulties. Our analysis revealed the following: (i) right- and left-sided colon cancers harbor distinct and diverse microbiomes, (ii) the tumor microbiome leads to a more consistent cancer-defined microbiome between locations and reveals a tumor microbiome–ileal microbiome association, (iii) the stool only partly reflects the microbiome landscape in patients with CC, and (iv) mechanical bowel preparation and perioperative antibiotics together with surgery result in major changes in the stool microbiome, characterized by a significant increase in the abundance of potentially pathogenic bacteria, such as Enterococcus. Collectively, our results provide new and valuable insights into the complex microbiome landscape in patients with colon cancer.

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“…The contributors include more mutations of the C-K-RAS proto-oncogene, mucinous type of tumor, older age, female sex and comorbidities [ 10 ], which may result in R-CC being more likely to relapse after surgery. R-CC patients may have a better prognosis after curative resection in TNM stage I-II and a worse survival after recurrence in TNM stage III [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Is serum thymidine kinase 1 a prognostic biomarker in primary tumor location of colorectal carcinomas?

Skog²,

et al. 2023

Discov Onc

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Aim To assess whether serum thymidine kinase 1 (STK1p), CEA and CA19.9 can be used as prognostic biomarkers in the primary tumor location (PTL) of colorectal carcinoma (CRC). Additional clinical factors of TNM stage, pathological grade, age and sex were also included. Methods STK1p was determined by an ECL-dot-blot assay, and CEA/CA19.9 was determined by an automatic electrochemiluminescence analyzer in a retrospective presurgery of right-colon carcinoma (R-CC, n = 90), left-colon carcinoma (L-CC, n = 128) and rectal carcinoma (RC, n = 270). Prognostic factors were evaluated by COX and overall survival (OS). Results The multivariate-COX and OS in relation to the prognostic factors of PTL in CRC were different and complex. An elevated STK1p value was significantly associated with poor OS in RC (P = 0.002) and L-CC (P = 0.037) but not in R-CC (P > 0.05). Elevated CEA (P≈.000) and CA19.9 (P≈.000) were significantly associated with poor OS in RC but not in L-CC and R-CC. Multivariate-COX showed that STK1p (P = 0.02, HR = 1.779, 95%CI 1.30–7.582), CEA (P = 0.001, HR = 2.052, 95%CI 1.320–3.189), CA19.9 (P≈.000, HR = 2.574, 95%CI 1.592–4.162) and TNM-stage (P≈.000, HR = 2.368, 95%CI 1.518–3.694) were independent prognostic factors in RC, while TNM-stage was an independent prognostic factor only in R-CC (P = 0.011, HR = 3.139, 95% CI 1.30–7.582) and L-CC (P≈.000, HR = 4.168, 95%CI 1.980–8.852). Moreover, elevated STK1p was significantly more sensitive (P < .001) for predicting mortality than CEA and CA19.9. No correlation was found between STK1p, CEA or AFP. Conclusion Combining TNM stage and suitable biomarkers, STK1p provides further reliable information on the survival of PTL of CRC.

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The primary tumor location in colorectal cancer: A focused review on its impact on surgical management

Cited by 13 publications

References 47 publications

Serum Cytokine and miRNA Levels Are Differently Expressed in Right- and Left-Sided Colon Cancer

Serum Cytokine and miRNA Levels Are Differently Expressed in Right- and Left-Sided Colon Cancer

Colon Cancer Microbiome Landscaping: Differences in Right- and Left-Sided Colon Cancer and a Tumor Microbiome-Ileal Microbiome Association

Is serum thymidine kinase 1 a prognostic biomarker in primary tumor location of colorectal carcinomas?

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