Colon tumor location: Right side versus left side as a prognostic factor for colon cancer survival: Analysis of a retrospective cohort

Revista de gastroenterologia de Mexico (English) Pub Date : 2025-07-01 DOI:10.1016/j.rgmxen.2025.09.004

S.P. Molina-Meneses , L.J. Palacios-Fuenmayor , F.D. Molina-Mercado , D.F. Caycedo-Medina , R. Castaño-Llano , L.R. Gómez-Wolff , Y.E. Pérez-García

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Abstract

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.

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结肠肿瘤位置：右侧与左侧是结肠癌生存的预后因素：回顾性队列分析。

由于不同的生物学特性，原发肿瘤的位置已成为一个重要的预后因素。目的：分析肿瘤部位对结肠癌患者预后的影响，比较右侧结肠癌与左侧结肠癌的差异。材料与方法：回顾性队列研究于2016年1月至2022年6月在某四级护理医院进行的18岁以上右侧或左侧结肠癌手术患者。分析社会人口学和组织病理学变量。计算总生存期和无进展生存期。结果：247例患者中，145例（58.7%）为右侧结肠癌，102例（41.2%）为左侧结肠癌。右侧肿瘤患者平均年龄70岁，左侧肿瘤患者平均年龄64岁。大多数患者是女性。71.6%的患者行腹腔镜手术，以腺癌为主，其中68.4%为高分化肿瘤。低分化肿瘤在右结肠的发生率高于左结肠，分别为9.7%和0.4%。多数患者未见淋巴结播散（N0: 54.7%），但右侧肿瘤中淋巴结阳性较多（28%比16.5%），微卫星不稳定较多（48比4）。53例患者出现转移，侧边无差异。44名右侧癌症患者和18名左侧癌症患者死亡。右侧位置是总生存的独立危险变量（HR:1.97[1.10-3.53]）。神经周围浸润、转移和疾病分期是独立的危险变量。侧边性不是无进展生存期的一个因素。结论：肿瘤位于右结肠是影响结肠癌总生存的独立危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista de gastroenterologia de Mexico (English)

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0.00%

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审稿时长

12 weeks