Department of Surgery, Chonnam National University Hospital, Gwangju, Republic of Korea.
Department of Surgery, Chonnam National University Hwasun Hospital, Hwasun-gun, Jeonnam, Republic of Korea.
J Invest Surg. 2021 Feb;34(2):142-147. doi: 10.1080/08941939.2019.1608334. Epub 2019 May 10.
The colon originates from the midgut and hindgut, with subsequent differentiation into the right and left colon. The embryology, clinical symptoms, incidence, molecular pathways, and oncologic outcomes differ between right and left colorectal cancers. However, the differences have not been fully accepted.
This study compared short- and long-term outcomes between right and left colon cancers.
This study included 966 patients who underwent laparoscopic resection with radical lymph node dissection for stage I, II, and III colon cancers between 2009 and 2014 at a tertiary teaching hospital. We excluded cases with fewer than 12 retrieved lymph nodes, emergency operations, synchronous or multiple cancers, and those located in the transverse colon and rectum.Results The right colon group included 343 (35.5%) patients and the left colon group 623. Female patients had a high incidence of right colon cancer ( < 0.001). Right colon cancer had longer operative times ( = 0.012), and more bleeding during the operation ( = 0.001). The size of the tumor was larger ( < 0.001) and more lymph nodes were harvested ( < 0.001) on the right side. Vascular ( = 0.006) and lymphatic ( = 0.004) invasion was greater in the right colon, but left colon cancer showed greater neural invasion ( = 0.008). Cancers on the right side also had a tendency to be poorly differentiated ( < 0.001). The groups did not differ in disease-free, overall, and cancer-specific survival rates for stage.
Although the oncologic outcomes show no significant differences, colon cancer has characteristic, perioperative, and histopathologic differences according to its embryologic origin.
结肠起源于中肠和后肠，随后分化为右结肠和左结肠。右半结肠癌和左半结肠癌的胚胎学、临床症状、发病率、分子途径和肿瘤学结果不同。然而，这些差异尚未被完全接受。
本研究比较了右半结肠癌和左半结肠癌的短期和长期结果。
本研究纳入了 2009 年至 2014 年期间在一家三级教学医院接受腹腔镜根治性淋巴结清扫术治疗 I、II 和 III 期结肠癌的 966 例患者。我们排除了淋巴结少于 12 枚、急诊手术、同时性或多发性癌症以及位于横结肠和直肠的病例。结果：右半结肠癌组 343 例（35.5%），左半结肠癌组 623 例。女性右半结肠癌发病率较高（ < 0.001）。右半结肠癌的手术时间较长（ = 0.012），术中出血量较多（ = 0.001）。右侧肿瘤较大（ < 0.001），淋巴结清扫较多（ < 0.001）。右侧血管（ = 0.006）和淋巴管（ = 0.004）侵犯更为严重，而左侧结肠癌神经侵犯更为严重（ = 0.008）。右侧癌症也有向低分化发展的趋势（ < 0.001）。两组在各期无病生存率、总生存率和癌症特异性生存率方面无差异。
尽管肿瘤学结果无显著差异，但根据胚胎起源，结肠癌具有特征性的围手术期和组织病理学差异。
