Clinicopathological Features of Right vs. Left Colorectal Carcinomas: Do the Differences Really Matter?

TL;DR

This study compares clinicopathological features of colorectal cancers based on their location in the colon or rectum and finds significant differences that may impact treatment and prognosis.

Contribution

The study highlights the importance of tumor location in colorectal cancer as a critical factor for therapeutic management and clinical trials.

Findings

Right colon cancers were more frequently high-grade, deeply invasive, and mucinous compared to other locations.

Left colon and rectal cancers were more common in males, while right colon cancers showed equal sex distribution.

Tumor location was associated with differences in lymphovascular invasion and distant metastases.

Abstract

Background and objectives: Colorectal cancer (CRC) presents a variety of molecular and pathological characteristics due to its location in the large intestine, which influences its management and prognosis. We aimed to evaluate the clinicopathological disparities between right colon (RCC), left colon (LCC), and rectal carcinomas. Materials and methods: A retrospective observational study was conducted to examine consecutive cases of colorectal carcinomas diagnosed at the “Pius Brinzeu” County Emergency Clinical Hospital (PBCECEHT), Romania. The clinicopathological characteristics and metastatic spread were analyzed by the site of the malignant tumor (right colon, left colon, or rectum). Results: A total of 1812 patients met the inclusion criteria, predominantly males (57.95%). Patients with RCC had an almost equal distribution between sexes, while patients with LCC and rectal carcinomas were more frequently males (p < 0.0001). RCC tumors were mostly high-grade (p < 0.0001), deeply invasive (p < 0.0001), and mucinous (p = 0.0109), with lymphovascular invasion and distant metastases. Conclusions: We observed different clinicopathological characteristics of CRC depending on the site of origin. We emphasize that tumor location is a parameter worth considering in CRC patients, both in therapeutic management and in future clinical trials.

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