Differences in risk factors, demographic and clinicopathologic characteristics at diagnosis between proximal and distal colon cancer: A multicenter retrospective cohort analysis

R.A. Muñoz , F.J. Miranda , A.A. Ramírez , D. Regalado , J.C. Ortiz , G. Gallardo , S. Pizarro
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Abstract

Introduction and aims

There are differences, with genetic and embryologic support, in the clinical behavior of proximal colon cancer (PCC) (right colon: cecum, ascending colon, and transverse colon) and distal colon cancer (DCC) (left colon: descending colon, sigmoid colon, rectum). Our aim was to determine whether there was a divergent pattern in the demographic characteristics, risk factors, TNM stage, and clinical stage at diagnosis between patients with PCC and those with DCC.

Material and methods

A retrospective, analytic, and multicenter study was conducted. Medical records of patients diagnosed with colorectal cancer, confirmed by histopathology and with TNM staging, within the time frame of 2018-2023, were collected from two hospital centers in the city of Chihuahua. They were divided into the PCC and DCC groups, for evaluating the abovementioned characteristics.

Results

From a total of 513 cases, 404 were included in the study. Significant differences were found in the demographic characteristics of female sex and a history of cholecystectomy, both with a greater relative frequency for PCC. Distant metastasis was present in 35.6% of patients, despite their younger age at diagnosis. The rectum was the most commonly affected segment in the DCC group, as was the ascending colon in the PCC group. There was a greater prevalence of peritoneal carcinomatosis in the PCC group. In contrast, the DCC group had a greater prevalence of distant metastasis to other organs, as both individual metastasis (M1a) and multiple site metastasis (M1b). There were no considerable differences in the KRAS, NRAS, or BRAF gene mutations between the two groups.

Conclusions

PCC was associated with a history of cholecystectomy and female sex and had more aggressive TNM staging, compared with DCC.
近端和远端结肠癌诊断时危险因素、人口学和临床病理特征的差异:一项多中心回顾性队列分析。
简介和目的:在遗传学和胚胎学的支持下,近端结肠癌(PCC)(右结肠:盲肠、升结肠和横结肠)和远端结肠癌(DCC)(左结肠:降结肠、乙状结肠、直肠)的临床行为存在差异。我们的目的是确定PCC和DCC患者在人口学特征、危险因素、TNM分期和诊断时的临床分期方面是否存在差异。材料与方法:采用回顾性、分析性、多中心研究。从奇瓦瓦市的两家医院中心收集了2018-2023年期间经组织病理学证实并有TNM分期的结直肠癌患者的医疗记录。将其分为PCC组和DCC组,以评价上述特征。结果:513例患者中,404例纳入研究。在女性的人口学特征和胆囊切除术史上发现了显著的差异,两者都有更高的PCC的相对频率。35.6%的患者存在远处转移,尽管他们在诊断时年龄较小。直肠是DCC组中最常见的受累部位,PCC组中升结肠也是如此。PCC组腹膜癌发病率较高。相比之下,DCC组有更高的远处转移到其他器官的患病率,无论是个体转移(M1a)还是多部位转移(M1b)。KRAS、NRAS或BRAF基因突变在两组之间没有显著差异。结论:与DCC相比,PCC与胆囊切除术史和女性相关,并且具有更积极的TNM分期。
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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