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[Right-Sided Colon Cancer: Is Hepatic Flexure Location a Factor of Poor Oncologic Prognosis?]
Felipe Silva1, Daniel Moreno1, Javier Vela1
1Departamento de Cirugía Digestiva, Pontificia Universidad Católica de Chile, Santiago, Chile.
None:
Limited evidence exists regarding survival outcomes among different subsites of right-sided colon tumors, thus contributing to uncertainty regarding their prognostic implications.
Aim:
To assess the oncological impact of hepatic flexure tumor location compared with other subsites in patients with right-sided colon cancer undergoing conventional right colectomy with curative intent.
Methods:
This retrospective study included patients with right-sided colon cancer stage I-III undergoing right colectomy with curative intent between January 2010 and December 2021. Demographic, clinical, perioperative, histopathologic and follow-up data were analyzed according to tumor location, categorized as cecum/ascending (CA) colon or hepatic flexure (HF) using Cox proportional models.
Results:
Of the 279 patients included, 82.4% (n=230) had CA colon tumors, while 17.6% (n=49) had HF tumors. The 5-year overall survival (OS) and disease-free survival (DFS) rates were 74.6% and 70.7% for CA tumors, respectively, and 82.7% and 82.7% for HF. Existing comorbidities and emergency surgery were significantly associated with OS, whereas existing comorbidities and surgical approach were significantly associated with DFS. HF was not identified as a poor prognosis factor for either OS (HR:0.81; CI95%:0.43-1.50) or DFS (HR:0.67; CI95%:0.38-1.29).
Conclusion:
In our results, a tumor located in the HF did not demonstrate an association with an impaired oncologic prognosis in patients undergoing curative-intent surgery for stage I-III colon cancer.
