Online ISSN 2313-1519
Print    ISSN 1812-2892
Abstract - Comparison of oncological results after curative resection in right and left colon cancers
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Eyüp Murat Yilmaz, Erkan Karacan, Buse Yıldız, Murat Demir, Ahmet Ender Demirkiran

ABSTRACT

Background: Right colon and left colon cancers have different genetic and clinical characteristics. It is thought that right colon cancers have more aggressive course.

Aim: We planned to compare differences between right and left colon cancers, oncological results, survival rate after curative resection.

Material and methods: The patients who had been operated between January 2015 and December 2019 were included in the study, and they were separated into two groups as right colon and left colon cancers. The files of the patients were scanned, and in addition to the demographic data, the tumor stages according to the tumor, nodus, metastasis staging, the number of lymph nodes removed, the type of the operation (laparoscopic/open), average follow-up time, metastasis, recurrence and death/survival were recorded and compared.

Results: A total of 76 patients were included, and 38 (50%) were diagnosed with right colon cancer whereas 38 (50%) had left colon cancer. The average follow-up time was found as 17.14 months (1 - 60 months). While no difference was detected between the two groups in neurovascular invasion, the mean number of lymphovascular invasion positivity was found as 18.34±4.16 and 13.34±5.45 in two groups, respectively (p<0.05). All the recurrences (5) were found in right colon tumors, no recurrence was observed in left colon tumors (p=0.021). When the metastasis and death rates were examined, no statistically significant difference was seen between the two groups.

Conclusion: We observe that lymphovascular invasion and recurrence rates are higher in right colon cancers compared to left colon cancers.

Key words: colon cancer, left colon, oncolocigal results, recurrence, right colon, survival rate

Corresponding author: Eyüp Murat Yilmaz, Department of General Surgery, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey. Tel.: +905056005995. E-mail: drmyilmaz80@gmail.com

 

 

References

1. Brenner H, Kloor M, Pox CP. Colorectal cancer. Lancet. 2014; 383:1490-502
https://doi.org/10.1016/S0140-6736(13)61649-9

2. Dae RL, Jung KK, Taehyung K, Eung JS. Comparison of oncological outcomes of right- sided colon cancer versus left-sided colon cancer after curative resection. Which side is better outcome? Medicine (Baltimore). 2017; 96(42): e8241. https://doi.org/10.1097/MD.0000000000008241

3. Bale AL, Penney MD, Allison MC. The prevalence of iron deficiency among patients presenting with colorectal cancer. Colorectal Dis. 2005; 7:398-402 https://doi.org/10.1111/j.1463-1318.2005.00789.x

4. Baran B, Özüpek NM, Tetik NY, Bekçioğlu O, Baskın Y. Difference Between Left-Sided and Right-Sided Colorectal Cancer: A Focused Review of Literature. Gastroenterology Res. 2018; 11(4): 264-273. https://doi.org/10.14740/gr1062w

5. Benedix F, Kube R, Meyer F, Schmidt U, Gastinger I, Lippert H et al. Comparison of 17,641 patients with right- and left-sided colon cancer: differences in epidemiology, perioperative course, histology, and survival. Dis Colon Rectum. 2010; 53(1):57-64. https://doi.org/10.1007/DCR.0b013e3181c703a4

6. Powell AG, Wallace R, McKee RF, Anderson JH, Going JJ, Edwards J et al. The relationship between tumour site, clinicopathological characteristics and cancer-specific survival in patients undergoing surgery for colorectal cancer. Colorectal Dis. 2012; 14(12):1493-9. https://doi.org/10.1111/j.1463-1318.2012.03048.x

7. Saltzstein SL, Behling CA. Age and time as factors in the left to right shift of the subsite of colorectal adenocarcinoma: a study of 213,383 cases from the California Cancer Registry. J Clin Gastroenterol. 2007; 41:173-7. https://doi.org/10.1097/01.mcg.0000225550.26751.6a

8. Shen H, Yang J, Huang Q, Jiang MJ, Tan YN, Fu JF et al. Different treatment strategies and molecular features between right-sided and left-sided colon cancers. World J Gastroenterol. 2015; 7;21(21):6470-8. https://doi.org/10.3748/wjg.v21.i21.6470

9. MissiagliaE,JacobsBD,ArioG. Distal and proximal colon cancers differ in terms of molecular, pathological, and clinical features. Ann Oncol. 2014; 25:1995-2001. https://doi.org/10.1093/annonc/mdu275

10. Meguid RA, Slidell MB, Wolfgang CL. Is there a difference in survival between right- versus left-sided colon cancers? Ann Surg Oncol. 2008; 15:2388-2394. https://doi.org/10.1245/s10434-008-0015-y

11. Moradi T, Gridley G, Björk J, Dosemeci M, Ji B-T, Berkel HJ, et al.Occupational physical activity and risk for cancer of the colon and rectum in Sweden among men and women by anatomic subsite. Eur J Cancer Prev. 2008; 17(3):201-8. https://doi.org/10.1097/CEJ.0b013e3282b6fd78

12. Tran B, Kopetz S, Tie J, Gibbs P, Jiang ZQ, Lieu CH, et al. Impact of BRAF mutation and microsatellite instability on the pattern of metastatic spread and prognosis in metastatic colorectal cancer. Cancer. 2011; 117(20):4623-32. https://doi.org/10.1002/cncr.26086

13. Sinicrope FA, Shi Q, Smyrk TC, Thibodeau SN, Dienstmann R, Guinney J, et al. Molecular markers identify subtypes of stage III colon cancer associated with patient outcomes. Gastroenterology. 2015; 148(1):88-99. https://doi.org/10.1053/j.gastro.2014.09.041

14. Roth AD, Tejpar S, Delorenzi M, Yan P, Fiocca R, Klingbiel D, et al. Prognostic role of KRAS and BRAF in stage II and III resected colon cancer: results of the translational study on the PETACC-3, EORTC 40993, SAKK 60-00 trial. J Clin Oncol. 2010; 28(3):466-74. https://doi.org/10.1200/JCO.2009.23.3452

15. Mik M, Berut M, Diziki L, Trzcinski R, Dziki A. Right- and left-sided colon cancer - clinical and pathological differences of the disease entity in one organ Arch Med Sci. 2017; 13(1):157-162. https://doi.org/10.5114/aoms.2016.58596

16. Lee MS, Menter DG, Kopetz S. Right Versus Left Colon Cancer Biology: Integrating the Consensus Molecular Subtypes. J Natl Compr Canc Netw. 2017; 15(3):411-419. https://doi.org/10.6004/jnccn.2017.0038

Volume 2, Number 56 (2020)