Official Journal Health Science of Prince of Songkla University

  • Home
  • Search
  • Current
  • Archives
  • Announcements
  • Guide for Authors
  • Publication Ethics
  • Editorial Board
  • Submit
  • About
  • Contact
  • Online-first Articles
  • EVENTS
  • Review Process
Home > Online-first > Paonariang

Does the Sidedness of Colon Cancer Affect Long-Term Oncological Outcomes?

Krisada Paonariang, Chawisa Thongoumyai, Weeraput Chadbunchachai

Abstract

Objective: Tumor location, or sidedness, affects the prognosis of colon cancer. While recent studies generally suggest better prognoses for left-sided colon cancer, some report conflicting results. This study examined the association between colon cancer sidedness and oncologic outcomes at Khon Kaen University Hospital.
Material and Methods: Patients with non-metastatic adenocarcinoma of the colon (stage I-III) who received curative treatment at Khon Kaen University Hospital from January 2012 to December 2015 were included. Survival analyses according to primary tumor location (right-sided vs. left-sided) were conducted using the Kaplan-Meier method. Cox proportional hazards regression was used to calculate the adjusted hazard ratios for 5-year overall survival (OS) and 5-year disease-free survival.
Results: Among the 212 patients, 126 had left-sided colon cancer, and 86 had right-sided colon cancer. Those with left-sided colon cancer had better OS in the univariate analysis (hazard ratio [HR] 0.57, 95% confidence interval [CI] 0.34-0.96, p-value=0.037), but this was not significant in the multivariate analysis (HR 0.63, 95% CI 0.36-1.09, p-value=0.11). No relationship was found between cancer-sidedness and disease-free survival (Log-rank p-value=0.83). Other factors, including gender, lymph node status, tumor staging, and grading, were non-significant, except for T4 tumor status, which significantly affected OS (HR 3.71, 95% CI 1.91-7.12, p-value<0.001) and disease-free survival (HR 4.42, 95% CI 2.26-8.65, p-value<0.001).
Conclusion: The sidedness of colon cancer did not significantly affect OS and disease-free survival. However, left-sided colon cancer tended to have a better prognosis. T4 tumor status significantly affected oncologic outcomes.

 Keywords

colon cancer; left-sided; oncological outcomes; right-sided; sidedness

 Full Text:

PDF

References

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424.

Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin 2023;73:17-48.

Tiankanon K, Aniwan S, Rerknimitr R. Current status of colorectal cancer and its public health burden in Thailand. Clin Endosc 2021;54:499-504.

Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors. Prz Gastroenterol 2019;14:89-103.

Lohsiriwat V, Chaisomboon N, Pattana-Arun J. Current colorectal cancer in Thailand. Ann Coloproctol 2020;36:78-82.

Li M, Li JY, Zhao AL, Gu J. Colorectal cancer or colon and rectal cancer? Clinicopathological comparison between colonic and rectal carcinomas. Oncology 2007;73:52-7.

Warschkow R, Sulz MC, Marti L, Tarantino I, Schmied BM, Cerny T, et al. Better survival in right-sided versus left-sided stage I - III colon cancer patients. BMC Cancer 2016;16:554.

Yahagi M, Okabayashi K, Hasegawa H, Tsuruta M, Kitagawa Y. The worse prognosis of right-sided compared with left-sided colon cancers: a systematic review and meta-analysis. J Gastrointest Surg 2016;20:648-55.

Ulanja MB, Rishi M, Beutler BD, Sharma M, Patterson DR, Gullapalli N, et al. Colon cancer sidedness, presentation, and survival at different stages. J Oncol 2019;2019:4315032.

Lee JM, Han YD, Cho MS, Hur H, Min BS, Lee KY, et al. Impact of tumor sidedness on survival and recurrence patterns in colon cancer patients. Ann Surg Treat Res 2019;96:296-304.

Meguid RA, Slidell MB, Wolfgang CL, Chang DC, Ahuja N. Is there a difference in survival between right- versus left-sided colon cancers? Ann Surg Oncol 2008;15:2388-94.

Weiss JM, Pfau PR, O’Connor ES, King J, LoConte N, Kennedy G, et al. Mortality by stage for right- versus left-sided colon cancer: analysis of surveillance, epidemiology, and end results--medicare data. J Clin Oncol 2011;29:4401-9.

Karim S, Brennan K, Nanji S, Berry SR, Booth CM. Association between prognosis and tumor laterality in early-stage colon cancer. JAMA Oncol 2017;3:1386-92.

An MS, Yoo JH, Kim KH, Bae KB, Choi CS, Hwang JW, et al. T4 stage and preoperative anemia as prognostic factors for the patients with colon cancer treated with adjuvant FOLFOX chemotherapy. World J Surg Oncol 2015;13:64.

Tamas K, Walenkamp AM, de Vries EG, van Vugt MA, Beets-Tan RG, van Etten B, et al. Rectal and colon cancer: not just a different anatomic site. Cancer Treat Rev 2015;41:671-9.

Wang S, Xu X, Guan J, Huo R, Liu M, Jiang C, et al. Better survival of right-sided than left-sided stage II colon cancer: a propensity scores matching analysis based on SEER database. Turk J Gastroenterol 2020;31:805-13.

Hutchins G, Southward K, Handley K, Magill L, Beaumont C, Stahlschmidt J, et al. Value of mismatch repair, KRAS, and BRAF mutations in predicting recurrence and benefits from chemotherapy in colorectal cancer. J Clin Oncol 2011;29:1261-70.

Petrelli F, Tomasello G, Borgonovo K, Ghidini M, Turati L, Dallera P, et al. Prognostic survival associated with left-sided vs right-sided colon cancer: a systematic review and meta-analysis. JAMA Oncol 2017;3:211-9.

Guinney J, Dienstmann R, Wang X, de Reyniès A, Schlicker A, Soneson C, et al. The consensus molecular subtypes of colorectal cancer. Nat Med 2015;21:1350-6.

Seppälä TT, Böhm JP, Friman M, Lahtinen L, Väyrynen VM, Liipo TK, et al. Combination of microsatellite instability and BRAF mutation status for subtyping colorectal cancer. Br J Cancer 2015;112:1966-75.

Lee DW, Han SW, Lee HJ, Rhee YY, Bae JM, Cho NY, et al. Prognostic implication of mucinous histology in colorectal cancer patients treated with adjuvant FOLFOX chemotherapy. Br J Cancer 2013;108:1978-84.

Popat S, Hubner R, Houlston RS. Systematic review of microsatellite instability and colorectal cancer prognosis. J Clin Oncol 2005;23:609-18.

Yamauchi M, Morikawa T, Kuchiba A, Imamura Y, Qian ZR, Nishihara R, et al. Assessment of colorectal cancer molecular features along bowel subsites challenges the conception of distinct dichotomy of proximal versus distal colorectum. Gut 2012;61:847-54.

Tran B, Kopetz S, Tie J, Gibbs P, Jiang ZQ, Lieu CH, et al. Impact of BRAF mutation and microsatellite instability on the pattern of metastatic spread and prognosis in metastatic colorectal cancer. Cancer 2011;117:4623-32.

DOI: http://dx.doi.org/10.31584/jhsmr.20251191

Refbacks

  • There are currently no refbacks.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

SUBMIT A PAPER

JHSMR accepts online submission through

AHR-iCON 2025

Journal Metrics


2020
Acceptance rate: 52%
2021
Acceptance rate: 27.8%
2022 (March)
Acceptance rate: 15.6%
2023 (June)
Acceptance rate: 23.6%
2024 (June)
Acceptance rate: 19%


Submission to final decision
74 days

Acceptance to publication
40 days

0.6
2024CiteScore
 
 
31st percentile
Powered by Scopus
About The Authors

Krisada Paonariang
Department of Surgery, Faculty of Medicine, Khon Kaen University, Mueang, Khon Kaen 40002,
Thailand

Chawisa Thongoumyai
Department of Surgery, Faculty of Medicine, Khon Kaen University, Mueang, Khon Kaen 40002,
Thailand

Weeraput Chadbunchachai
Department of Surgery, Faculty of Medicine, Khon Kaen University, Mueang, Khon Kaen 40002,
Thailand

Article Tools
Abstract
Print this article
Indexing metadata
How to cite item
Email this article (Login required)
Email the author (Login required)

Supported by

 

JHSMR now Indexed in



Scopus logo.svg






Image result for crossref





PSUMJ Homepage

Keywords COVID-19 SARS-CoV-2 Thailand Vietnam children computed tomography cross-cultural adaptation depression diabetes diabetes mellitus elderly knowledge mental health mortality prevalence quality of life reliability risk factor risk factors treatment validity
Journal Content

Browse
  • By Issue
  • By Author
  • By Title
Font Size
Make font size smaller Make font size default Make font size larger

Open Journal Systems