Impact of Sidedness of Colon Cancer on Epidemiological, Clinical Presentation, Surgical, Pathological, and Oncologic...

Aim: The purpose of the study was to identify potential differences between patients with right colon cancer and left colon cancer in epidemiological, clinical presentation, pathological, and surgical results in addition to the impact of the sidedness on disease-free survival (DFS) and overall survival (OS). Method: Patients with a diagnosis of colon cancer stages I-IV between 2010 and 2020 were identified from a prospective database in a tertiary single center. Right and left-sided cancer were compared regarding epidemiological, clinical presentation, pathological, and surgical results. Survival analysis was conducted using the Kaplan-Meier method and adjusted hazard ratios for mortality (OS) and disease-free survival (DFS) were obtained using Cox proportional hazards regression. Results: The right colon group included 82 (31%) patients and the left colon group 182 (69%). After adjusted analysis, RCC presented less bleeding (RP: 0.31; CI: 0.18-0.56; p: 0.0001) and change in bowel habits (RP: 0.60; CI: 0.41-0.87; p: 0.0069). A laparotomy approach was more performed in LCC (RP: 0.64; CI: 0.47-0.86; p: 0.0029). Regarding pathological results, RCC had more poorly differentiated tumors (RP: 0.81; CI: 0.70-0.94; p: 0.05). In the adjusted analysis, there was no difference in survival for right-sided compared to left-sided colon cancer: the hazard ratios were 1.36 (CI 95%: 0.61-3.01; p: 0.4490) for OS and 2.04 (CI: 0.91-4.59; p: 0.0814) for DFS. Conclusions: In this population-based cohort, we found no impact of colon cancer sidedness on OS and DFS. RCC presented less differentiated tumors and LCC presented more bleeding and change in bowel habits.