TITLE:
Comparison of Clinicopathological and Survival Features of Right and Left Colon Cancers: Experience of the Medical Oncology Department of Fez
AUTHORS:
Soukaina El Anssari, Youssef Elhaitmy, Lamiae Amaadour, Karima Oualla, Zineb Benbrahim, Samia Arifi, Nawfel Mellas
KEYWORDS:
Right-Sided Colon Cancers (RCC), Left-Sided Colon Cancers (LCC), Prognosis, Survival
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.14 No.6,
June
20,
2023
ABSTRACT: Right-sided colon cancers (RCC) and left-sided colon cancers (LCC) have
different epidemiological, physiological, pathological, genetic, and clinical characteristics,
which result in differences in the course, prognosis, and outcome of disease.
The objective of our study is to compare right-sided colon cancers and
left-sided colon cancers regarding clinicopathological and survival
characteristics. This is a retrospective study of 664 patients with colon
cancer treated at the medical oncology department of Fez over a period from
December 2009 to September 2020. Rectosigmoid, descending colon, and splenic
flexure tumors were considered left-sided colon cancers, whereas ascending
colon tumors were considered right-sided colon cancers. The Kaplan Meier method
was used to estimate median survival. The study included 664 patients (female,
47%) having colon cancer with a median age of 60 years (23 - 83). Of
the patients, 78.5% (n = 519) had LCC and 19.36 % (n = 128) had RCC. The rate
of patients aged ≥ 65 years and the rate of patients with a family history of colon cancer was
higher in the LCC patients. The proportion of poorly differentiated
adenocarcinomas represented 3%, of which 63% had cancer of the right colon.
There was a significantly higher proportion of higher T stage (T3-4: 62% vs 38%)
in right sided tumors as compared to left sided tumors. The rate of metastatic
patients was 64.1% in the RCC group and 43% in the LCC group. The median
follow-up period was 14 months in the RCC group and 19 months in the LCC group
with higher median overall survival in the LCC group (32 vs 21 months). We found
histopathological differences between right and left sided colon cancer. Tumors
on the right colon were found to be more aggressive, as expressed by poorer differentiation,
higher T stage associated with a median overall survival better in left colon
cancer.