Revista de gastroenterologia de Mexico (English) · 2025
Colon tumor location: Right side versus left side as a prognostic factor for colon cancer survival: Analysis of a retrospective cohort.
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Molina-Meneses S P, Palacios-Fuenmayor L J, Molina-Mercado F D, Caycedo-Medina D F, Castaño-Llano R, Gómez-Wolff L R, Pérez-García Y E
Аннотация
INTRODUCTION: Primary tumor location has emerged as an important prognostic factor due to different biologic characteristics.
AIM: To analyze the prognostic effect of tumor location in patients with colon cancer, comparing right-sided colon cancer with left-sided disease.
MATERIALS AND METHODS: A retrospective cohort study was conducted on patients above 18 years of age operated on for right-sided or left-sided colon cancer within the time frame of January 2016 and June 2022 at a quaternary care hospital. Sociodemographic and histopathologic variables were analyzed. Overall survival and progression-free survival were calculated.
RESULTS: From a total of 247 patients, 145 (58.7%) had right-sided colon cancer and 102 (41.2%) had left-sided disease. Mean age of the right-sided tumor patients was 70 years and mean age of the left-sided tumor patients was 64 years. The majority of the patients were women. Laparoscopic surgery was performed on 71.6% of patients and most of them presented with adenocarcinoma, 68.4% of which were well differentiated tumors. Poorly differentiated tumors were more likely in the right colon than the left, with 9.7% and 0.4%, respectively. Most of the patients did not have lymph node dissemination (N0: 54.7%), but there were more positive lymph nodes (28% vs 16.5%) and more microsatellite instability (48 vs 4 patients) in right-sided tumors. Fifty-three patients presented with metastasis, with no differences regarding laterality. Forty-four patients with right-sided cancer and 18 with left-sided cancer died. Right-sided location was the independent risk variable for overall survival (HR:1.97 [1.10-3.53]). Perineural invasion, metastasis, and disease stage were independent risk variables. Laterality was not a factor in progression-free survival.
CONCLUSION: Tumor located in the right colon was an independent risk factor impacting overall survival in colon cancer.
AIM: To analyze the prognostic effect of tumor location in patients with colon cancer, comparing right-sided colon cancer with left-sided disease.
MATERIALS AND METHODS: A retrospective cohort study was conducted on patients above 18 years of age operated on for right-sided or left-sided colon cancer within the time frame of January 2016 and June 2022 at a quaternary care hospital. Sociodemographic and histopathologic variables were analyzed. Overall survival and progression-free survival were calculated.
RESULTS: From a total of 247 patients, 145 (58.7%) had right-sided colon cancer and 102 (41.2%) had left-sided disease. Mean age of the right-sided tumor patients was 70 years and mean age of the left-sided tumor patients was 64 years. The majority of the patients were women. Laparoscopic surgery was performed on 71.6% of patients and most of them presented with adenocarcinoma, 68.4% of which were well differentiated tumors. Poorly differentiated tumors were more likely in the right colon than the left, with 9.7% and 0.4%, respectively. Most of the patients did not have lymph node dissemination (N0: 54.7%), but there were more positive lymph nodes (28% vs 16.5%) and more microsatellite instability (48 vs 4 patients) in right-sided tumors. Fifty-three patients presented with metastasis, with no differences regarding laterality. Forty-four patients with right-sided cancer and 18 with left-sided cancer died. Right-sided location was the independent risk variable for overall survival (HR:1.97 [1.10-3.53]). Perineural invasion, metastasis, and disease stage were independent risk variables. Laterality was not a factor in progression-free survival.
CONCLUSION: Tumor located in the right colon was an independent risk factor impacting overall survival in colon cancer.