Right-Sided and Left-Sided Colon Cancers are Two Distinct Disease Entities: an Analysis of 200 Cases in Pakistan.
BACKGROUND
There is growing evidence that there are differences in histological and genetic characteristics along with clinical behavior between right- and left-sided colon carcinomas. We have compared various parameters of the two types and assessed associations of the results with prognosis in patients in Pakistan.


METHODS
We reviewed 200 cases from our institutional database; 100 cases of right-sided and 100 cases of left-sided colon cancer. Parameters including age, gender, TNM stage, histological features and clinical outcome were analyzed.


RESULTS
The patients with right-sided colon cancer were significantly older as compared to their counterparts with left-sided cancer. They presented with a lumbar mass rather than symptoms of obstruction and perforation as seen in left-sided colon cancers, and the histology showed higher percentage of poorly differentiated tumors with advanced pT stage. Moreover, Crohn's-like reactions, intra tumoral lymphocyte responses and other poor prognostic factors like lymph vascular invasion and perineural invasion were more common in right-sided cancers.


CONCLUSIONS
We found that right- and left-sided colon cancers are different from each other in terms of clinical presentation, histology and clinical behavior. Right-sided colon cancers are more aggressive and are associated with poorer clinical outcome as compared to left sided colon cancers in our population.
Department of Pathology, Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan E-mail : drusmanhassan256@gmail.com.
Mudassar
M
Hussain
Omer
O
Waqas
Usman
U
Hassan
Asif
A
Loya
Noreen
N
Akhtar
Sajid
S
Mushtaq
Muhammad Aasim
MA
Yusuf
Aamir Ali
AA
Syed
D002288:Adenocarcinoma, Mucinous / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D018279:Carcinoma, Signet Ring Cell / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D003110:Colonic Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010154:Pakistan / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate