Colon tumor location: Right side versus left side as a prognostic factor for colon cancer survival: Analysis of a...

Primary tumor location has emerged as an important prognostic factor due to different biologic characteristics.

To analyze the prognostic effect of tumor location in patients with colon cancer, comparing right-sided colon cancer with left-sided disease.

A retrospective cohort study was conducted on patients above 18 years of age operated on for right-sided or left-sided colon cancer within the time frame of January 2016 and June 2022 at a quaternary care hospital. Sociodemographic and histopathologic variables were analyzed. Overall survival and progression-free survival were calculated.

From a total of 247 patients, 145 (58.7%) had right-sided colon cancer and 102 (41.2%) had left-sided disease. Mean age of the right-sided tumor patients was 70 years and mean age of the left-sided tumor patients was 64 years. The majority of the patients were women. Laparoscopic surgery was performed on 71.6% of patients and most of them presented with adenocarcinoma, 68.4% of which were well differentiated tumors. Poorly differentiated tumors were more likely in the right colon than the left, with 9.7% and 0.4%, respectively. Most of the patients did not have lymph node dissemination (N0: 54.7%), but there were more positive lymph nodes (28% vs 16.5%) and more microsatellite instability (48 vs 4 patients) in right-sided tumors. Fifty-three patients presented with metastasis, with no differences regarding laterality. Forty-four patients with right-sided cancer and 18 with left-sided cancer died. Right-sided location was the independent risk variable for overall survival (HR:1.97 [1.10-3.53]). Perineural invasion, metastasis, and disease stage were independent risk variables. Laterality was not a factor in progression-free survival.

Tumor located in the right colon was an independent risk factor impacting overall survival in colon cancer.