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Right and left colon carcinoma: a retrospective comparative study.
Journal of Surgical Oncology
|August 1, 1987
Summary
Right-sided colon cancer (RSC) is not typically diagnosed at advanced stages. Survival rates for RSC patients are comparable or better than left-sided colon cancer (LSC) patients.
Area of Science:
- Oncology
- Gastroenterology
- Surgical Oncology
Background:
- Colorectal carcinoma presents with varying locations, including right-sided colon carcinoma (RSC) and left-sided colon carcinoma (LSC).
- Clinical presentation and prognostic factors may differ based on tumor location.
- Previous beliefs suggested a tendency for RSC to be diagnosed at later disease stages.
Purpose of the Study:
- To compare the clinical characteristics and survival outcomes of patients with right-sided colon carcinoma (RSC) versus left-sided colon carcinoma (LSC).
- To investigate whether RSC is diagnosed at more advanced stages compared to LSC.
- To evaluate the 5-year survival rates for RSC and LSC.
Main Methods:
- Retrospective analysis of 347 patients with primary colorectal carcinoma treated surgically between 1973 and 1983.
- Categorization of tumors into right colon, left colon, transverse colon, and rectal.
- Comparison of obstruction rates, advanced disease (Dukes stages C and D), and 5-year survival between RSC and LSC groups using life table methods.
Main Results:
- A total of 347 patients were analyzed: 64 (18.2%) with RSC, 158 (45.7%) with LSC, 14 (4.2%) with transverse colon carcinoma, and 110 (31.9%) with rectal carcinoma.
- Obstruction rates were similar between RSC (17.2%) and LSC (20.3%) groups (P > 0.05).
- Advanced disease (Dukes C and D) was significantly more prevalent in LSC (47.8%) compared to RSC (34.4%) (P = 0.01).
- Crude 5-year survival rates were 71% for RSC and 66% for LSC (P > 0.05).
- A significant difference in 5-year survival favoring RSC was observed when comparing Dukes stage B patients (P = 0.03).
Conclusions:
- Contrary to common belief, patients with right-sided colon carcinoma (RSC) are not necessarily diagnosed at advanced disease stages.
- The 5-year survival rates for patients with RSC are comparable to, and occasionally better than, those with left-sided colon carcinoma (LSC).
- Tumor location in the colon may influence disease stage at diagnosis and survival outcomes.