eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
Current issue Archive Manuscripts accepted About the journal Special issues Editorial board Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
vol. 13
Clinical research

Right- and left-sided colon cancer – clinical and pathological differences of the disease entity in one organ

Michal Mik, Maciej Berut, Lukasz Dziki, Radzislaw Trzcinski, Adam Dziki

Arch Med Sci 2017; 13, 1: 157–162
Online publish date: 2016/03/16
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
Introduction: Some researchers suggest that cancers located in the right vs. the left side of the colon are different and they can be regarded as distinct disease entities. The aim of this study was to analyze differences in clinical, epidemiological and pathological features of patients with right-sided (RCC) and left-sided (LCC) colon cancer.

Material and methods: One thousand two hundred and twenty-four patients were operated on due to colorectal cancer. A group of 477 patients (254 women, mean age 65.5 ±11 for the whole group) with colon cancer was included (212 RCC vs. 265 LCC).

Results: Right colon cancer patients were older (67.8 ±11.3 vs. 63.2 ±11.2; p = 0.0087). Left colon cancer patients underwent surgery for urgent indications more often (17.0% vs. 8.5%; p = 0006). Tumor diameter was greater in the RCC group (55 ±60 mm vs. 38 ±21 mm; p = 0.0003). Total number of removed lymph nodes was higher in the RCC group (11.7 ±6 vs. 8.3 ±5; p = 0.0001). Lymph node ratio was higher in the LCC group (0.45 ±0.28 vs. 0.30 ±0.25; p = 0.0063). We found a strong positive correlation between tumor diameter and the number of removed lymph nodes in the LCC group (r = 0.531).

Conclusions: These differences may result from the fact that RCC patients are diagnosed at an older age. The smaller number of removed lymph nodes in LCC patients may result in incorrect staging. It is still necessary to find other biological dissimilarities of adenocarcinoma located on different sides of the colon.

colon cancer, pathology, surgery, location, right-sided, left-sided

Bufill JA. Colorectal cancer: evidence for distinct genetic categories based on proximal or distal tumor location. Ann Intern Med 1990; 113: 779-88.
Saltzstein SL, Behling CA. Age and time as factors in the left-to-right shift of the subside of colorectal adenocarcinoma: a study of 213,383 cases from the California Cancer Registry. J Clin Gastroenterol 2007; 41: 173-7.
Nawa T, Kato J, Kawamoto H, et al. Differences between right- and left-sided colon cancer in patient characteristics, cancer morphology and histology. J Gastroenterol Hepatol 2008; 23: 418-23.
Benedix F, Meyer F, Kube R, Gastinger I, Lippert H. Right- and left-sided colonic cancer – different tumour entities. Zentralbl Chir 2010; 135: 312-7.
Konopke R, Distler M, Ludwig S, Kersting S. Location of liver metastases reflects the side of the primary colorectal carcinoma. Scand J Gastroenterol 2008; 43: 192-5.
Jess P, Hansen IO, Gamborg M, Jess T; Danish Colorectal Cancer Group. A nationwide Danish cohort study challenging the categorisation into right-sided and left-sided colon cancer. BMJ Open 2013; 3 pii: e002608. doi: 10.1136/bmjopen-2013-002608.
Benedix F, Schmidt U, Mroczkowski P, Gastinger I, Lippert H, Kube R; Study Group “Colon/Rectum Carcinoma (Primary Tumor)”. Colon carcinoma – classification into right and left sided cancer or according to colonic subside? Analysis of 29,568 patients. Eur J Surg Oncol 2011; 37: 134-9.
Wessa P. Free Statistics Software, Office for Research Development and Education, version 1.1.23-r7, 2014; URL http://www.wessa.net/.
Charlier P, Huynh-Charlier I, Poupon J, et al. A glimpse into the early origins of medieval anatomy through the oldest conserved human dissection (Western Europe, 13(th) c. A.D.). Arch Med Sci 2014; 12: 366-73.
Maruta M, Kotake K, Maeda K. Colorectal cancer in Japan. Rozhl Chir 2007; 86: 618-21.
Christodoulidis G, Spyridakis M, Symeonidis D, Kapatou K, Manolakis A, Tepetes K. Clinicopathological differences between right- and left-sided colonic tumors and impact upon survival. Tech Coloproctol 2010; 14: S45-7.
Benedix F, Kube R, Meyer F, Schmidt U, Gastinger I, Lippert H; Colon/Rectum Carcinomas (Primary Tumor) Study Group. 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: 57-64.
Brenner H, Altenhofen L, Katalinic A, Lansdorp-Vogelaar I, Hoffmeister M. Sojourn time of preclinical colorectal cancer by sex and age: estimates from the German national screening colonoscopy database. Am J Epidemiol 2011; 174: 1140-6.
Singh H, Nugent Z, Demers AA, Bernstein CN. Rate and predictors of early/missed colorectal cancers after colonoscopy in Manitoba: a population-based study. Am J Gastroenterol 2010; 105: 2588-96.
Hansen IO, Jess P. Possible better long-term survival in left versus right-sided colon cancer – a systematic review. Dan Med J 2012; 59: A4444.
Sabbagh C, Mauvais F, Cosse C, et al. A lymph node ratio of 10% is predictive of survival in stage III colon cancer: a French Regional Study. Int Surg 2014; 99: 344-53.
Meza R, Jeon J, Renehan AG, Luebeck EG. Colorectal cancer incidence trends in the United States and United kingdom: evidence of right- to left-sided biological gradients with implications for screening. Cancer Res 2010; 70: 5419-29.
Quick links
© 2019 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe