Outcome of right- and left-sided colonic and rectal cancer following surgical resection.
OBJECTIVE
To determine the outcome of surgery for colorectal cancer from a single region and to see whether location of the primary cancer influences prognosis.


METHODS
Patients with colorectal cancer diagnosed from January 2002 to December 2006, entered into a prospective database were followed until death or to December 2008. Right-sided (caecum to transverse colon) and left-sided (splenic flexure to rectosigmoid junction) colonic cancers and rectal cancers (distal to rectosigmoid junction to the anus) were identified. Statistical analysis was performed using Pearson's chi-square test, Kaplan-Meier (log-rank statistic) and Cox regression analysis with a P-value < 0.05 denoting significance.


RESULTS
Of 841 patients with solitary colorectal cancers identified (median age 72 [30-101] years; 53% male), 283 (33.7%) were right-sided colonic, 330 (39.2%) were left-sided colonic and 228 (27.1%) were rectal. Respective resection rates were 82.7%, 77.9% and 91.6%, and curative resection rates were 79.9%, 82.9.0% and 85.7%, respectively. There was no significant difference in recurrence rates between right- (16.1%), left-sided (23.0%) colonic and rectal (20.7%) cancers (P = 0.207). Respective mean survival rates were 54.4, 59.8 and 63.6 months (P = 0.007).


CONCLUSIONS
Right-sided colorectal cancers had a worse prognosis than left-sided and rectal cancers, possibly because of more advanced staging and fewer curative resections.
Suttie
S A
SA
Department of Colorectal Surgery, Queen Margaret Hospital, Dunfermline, UK.
Shaikh
I
I
Mullen
R
R
Amin
A I
AI
Daniel
T
T
Yalamarthi
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044682:Colon, Ascending / Q000473:pathology / Q000601:surgery; D044683:Colon, Descending / Q000473:pathology / Q000601:surgery; D012809:Colon, Sigmoid / Q000473:pathology / Q000601:surgery; D044684:Colon, Transverse / Q000473:pathology / Q000601:surgery; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D012007:Rectum / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome