title: Different treatment strategies and molecular features between right-sided and left-sided colon cancers.
abstract: The colon is derived from the embryological midgut and hindgut separately, with the right colon and left colon having different features with regards to both anatomical and physiological characteristics. Cancers located in the right and left colon are referred to as right colon cancer (RCC) and left colon cancer (LCC), respectively, based on their apparent anatomical positions. Increasing evidence supports the notion that not only are there differences in treatment strategies when dealing with RCC and LCC, but molecular features also vary between them, not to mention the distinguishing clinical manifestations. Disease-free survival after radical surgery of both RCC and LCC are similar. In the treatment of RCC, the benefit gained from adjuvant FOLFIRI chemotherapy is superior, or at least similar, to LCC, but inferior to LCC if FOLFOX regimen is applied. On the other hand, metastatic LCC exhibits longer survival than that of RCC in a palliative chemotherapy setting. For KRAS wild-type cancers, LCC benefits more from cetuximab treatment than RCC. Moreover, advanced LCC shows a higher sensitivity to bevacizumab treatment in comparison with advanced RCC. Significant varieties exist at the molecular level between RCC and LCC, which may serve as the cause of all apparent differences. With respect to carcinogenesis mechanisms, RCC is associated with known gene types, such as MMR, KRAS, BRAF, and miRNA-31, while LCC is associated with CIN, p53, NRAS, miRNA-146a, miRNA-147b, and miRNA-1288. Regarding protein expression, RCC is related to GNAS, NQO1, telomerase activity, P-PDH, and annexin A10, while LCC is related to Topo I, TS, and EGFR. In addition, separated pathways dominate progression to relapse in RCC and LCC. Therefore, RCC and LCC should be regarded as two heterogeneous entities, with this heterogeneity being used to stratify patients in order for them to have the optimal, current, and novel therapeutic strategies in clinical practice. Additional research is needed to uncover further differences between RCC and LCC.
authors.affiliation: Hong Shen, Jiao Yang, Qing Huang, Meng-Jie Jiang, Yi-Nuo Tan, Jian-Fei Fu, Li-Zhen Zhu, Xue-Feng Fang, Ying Yuan, Department of Medical Oncology, 2 Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Shen
authors.affiliation: Hong Shen, Jiao Yang, Qing Huang, Meng-Jie Jiang, Yi-Nuo Tan, Jian-Fei Fu, Li-Zhen Zhu, Xue-Feng Fang, Ying Yuan, Department of Medical Oncology, 2 Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Jiao
authors.initials: J
authors.lastname: Yang
authors.affiliation: Hong Shen, Jiao Yang, Qing Huang, Meng-Jie Jiang, Yi-Nuo Tan, Jian-Fei Fu, Li-Zhen Zhu, Xue-Feng Fang, Ying Yuan, Department of Medical Oncology, 2 Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Huang
authors.affiliation: Hong Shen, Jiao Yang, Qing Huang, Meng-Jie Jiang, Yi-Nuo Tan, Jian-Fei Fu, Li-Zhen Zhu, Xue-Feng Fang, Ying Yuan, Department of Medical Oncology, 2 Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Meng-Jie
authors.initials: MJ
authors.lastname: Jiang
authors.affiliation: Hong Shen, Jiao Yang, Qing Huang, Meng-Jie Jiang, Yi-Nuo Tan, Jian-Fei Fu, Li-Zhen Zhu, Xue-Feng Fang, Ying Yuan, Department of Medical Oncology, 2 Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Yi-Nuo
authors.initials: YN
authors.lastname: Tan
authors.affiliation: Hong Shen, Jiao Yang, Qing Huang, Meng-Jie Jiang, Yi-Nuo Tan, Jian-Fei Fu, Li-Zhen Zhu, Xue-Feng Fang, Ying Yuan, Department of Medical Oncology, 2 Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Jian-Fei
authors.initials: JF
authors.lastname: Fu
authors.affiliation: Hong Shen, Jiao Yang, Qing Huang, Meng-Jie Jiang, Yi-Nuo Tan, Jian-Fei Fu, Li-Zhen Zhu, Xue-Feng Fang, Ying Yuan, Department of Medical Oncology, 2 Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Li-Zhen
authors.initials: LZ
authors.lastname: Zhu
authors.affiliation: Hong Shen, Jiao Yang, Qing Huang, Meng-Jie Jiang, Yi-Nuo Tan, Jian-Fei Fu, Li-Zhen Zhu, Xue-Feng Fang, Ying Yuan, Department of Medical Oncology, 2 Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Xue-Feng
authors.initials: XF
authors.lastname: Fang
authors.affiliation: Hong Shen, Jiao Yang, Qing Huang, Meng-Jie Jiang, Yi-Nuo Tan, Jian-Fei Fu, Li-Zhen Zhu, Xue-Feng Fang, Ying Yuan, Department of Medical Oncology, 2 Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Yuan
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000235:genetics*; D017024:Chemotherapy, Adjuvant; D003082:Colectomy / Q000009:adverse effects / Q000401:mortality; D003110:Colonic Neoplasms / Q000737:chemistry / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018450:Disease Progression; D018572:Disease-Free Survival; D020022:Genetic Predisposition to Disease; D006801:Humans; D058990:Molecular Targeted Therapy; D009154:Mutation; D009364:Neoplasm Recurrence, Local; D010641:Phenotype; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor
keywords: Colon cancer; Left; Molecular; Right; Survival