PROGNOSTIC DIFFERENCES IN SPORADIC COLONIC TUMORS ACCORDING PRIMARY SITE

Introduction: although considered as a single disease, colonic adenocarcinomas have shown distinct behaviors according to the primary site. Several studies have pointed out important behavior differences in colonic adenocarcinomas, however the national literature is scarce. Objective: to evaluate the impact of tumor sidedness on clinical-pathological variables and tumor behavior in a cohort of patients with colon cancer undergoing surgical treatment. Method: we conducted a retrospective analysis of medical records of patients undergoing surgery to treat sporadic colon adenocarcinoma. Patients were divided into two groups: (1) right colon (RC), tumors located between the cecum and splenic flexure and (2) left colon (LC), tumors located between the descending and sigmoid colon. Clinical-pathological aspects and oncological outcomes were evaluated in the first two years of follow-up. Results: among the 237 patients analyzed, there was no difference between the groups regarding gender, age, body mass index, ASA classification, serum albumin levels and percentage of advanced disease. There was a predominance of the LC group when compared to the RC group, with 141 patients (59.5%) and 96 patients (40.5%), respectively. There was a higher incidence of anemia in the RC group (81.2% × 59.6%; p <0.001). Urgent surgery rates (17% × 2.1%; p <0.001) and laparoscopic access (21.3% × 4.2%; p <0.001) were higher in the LC group, as well as longer duration (190min × 167min; p = 0.007) and higher stoma rates (36.9% × 18.8%; p = 0.004). Regarding surgical aspects, the rates of intraoperative accidents, length of stay, readmission rates, reoperation and early death were similar. RC tumors had higher lesion rates > 5cm (66.7% × 44.6%; p = 0.001), poorly differentiated (13.5% × 5%; p = 0.03) and with mucinous differentiation (33.3% × 15.6%; p = 0.002). There were no statistical differences between relapse and death rates at 2-year follow-up. Conclusions: in the present study, RC tumors were larger, poorly differentiated and with more mucinous differentiation, and were more associated with anemia. Urgent surgery and stoma surgery were more frequent in tumors of the LC. There were no differences in relapse and death rates at 2-year follow-up.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
23 October 2019