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BACKGROUND

The differences in histopathology and molecular biology between right colon cancer (RCC) and left colon cancer (LCC) were first reported in the literature by Bufill in 1990. Since then, a large number of studies have confirmed their differences in epidemiology, clinical presentation, comorbidities and biological behaviours, which may be related to the difference in prognosis and overall survival (OS) between the two groups.

AIM

To investigate statistically significant differences between Greek patients with LCC and RCC.

METHODS

The present observational study included 144 patients diagnosed with colon cancer of any stage who received chemotherapy in a Greek tertiary oncology hospital during a 2.5-year period. Clinical information, comorbidities, histopathologic characteristics and molecular biomarkers were collected from the patients' medical records retrospectively, while administered chemotherapy regimens, targeted agents, progression-free survival (PFS) periods with first- and second-line chemotherapy and OS were recorded retroactively and prospectively. Data analysis was performed with the SPSS statistical package.

RESULTS

Eighty-six males and 58 females participated in the study. One hundred (69.4%) patients had a primary lesion in the left colon, and 44 (30.6%) patients had a primary lesion in the right colon. Patients with RCC were more likely to display anaemia than patients with LCC [odds ratio (OR) = 3.09], while LCC patients were more likely to develop rectal bleeding (OR = 3.37) and a feeling of incomplete evacuation (OR = 2.78) than RCC patients. Considering comorbidities, RCC patients were more likely to suffer from diabetes (OR = 3.31) and coronary artery disease ( = 0.056) than LCC patients. The mucinous differentiation rate was higher in the right-sided group than in the left-sided group (OR = 4.49), as was the number of infiltrated lymph nodes ( = 0.039), while the percentage of high-grade differentiation was higher in the group of patients with left-sided colon cancer than in RCC patients (OR = 2.78). RAS wild-type patients who received anti-epidermal growth factor receptor (EGFR): Treatment experienced greater benefit (PFS: 16.5 mo) than those who received anti-vascular endothelial growth factor treatment (PFS: 13.7 mo) ( = 0.05), while among RAS wild-type patients who received anti-EGFR treatment, LCC patients experienced greater benefit (PFS: 15.8 mo) than the RCC subgroup (PFS: 5.5 mo) in the first-line chemotherapy setting ( = 0.034). -mutant patients had shorter PFS (9.3 mo) than wild-type patients (14.5 mo) ( = 0.033). RCC patients showed a shorter tumour recurrence period (7.7 mo) than those with LCC (14.5 mo) ( < 0.001), as well as shorter (OS) (58.4 mo for RCC patients; 82.4 mo for LCC patients) ( = 0.018).

CONCLUSION

RCC patients present more comorbidities, worse histological and molecular characteristics and a consequently higher probability of tumour recurrence, poor response to targeted therapy and shorter OS than LCC patients.

BACKGROUND

AIM

To investigate statistically significant differences between Greek patients with LCC and RCC.

METHODS

RESULTS

CONCLUSION

背景

1990年，Bufill首次在文献中报道了右半结肠癌（RCC）和左半结肠癌（LCC）在组织病理学和分子生物学上的差异。从那时起，大量研究证实了它们在流行病学、临床表现、合并症和生物学行为方面的差异，这可能与两组患者的预后和总生存期（OS）差异有关。

目的

研究希腊LCC和RCC患者之间的统计学显著差异。

方法

本观察性研究纳入了144例在希腊一家三级肿瘤医院接受化疗的各期结肠癌患者，研究为期2.5年。回顾性收集患者病历中的临床信息、合并症、组织病理学特征和分子生物标志物，同时追溯性和前瞻性记录所给予的化疗方案、靶向药物、一线和二线化疗的无进展生存期（PFS）以及总生存期。使用SPSS统计软件包进行数据分析。

结果

86例男性和58例女性参与了本研究。100例（69.4%）患者的原发灶位于左半结肠，44例（30.6%）患者的原发灶位于右半结肠。与LCC患者相比，RCC患者更易出现贫血[比值比（OR）=3.09]，而LCC患者比RCC患者更易出现直肠出血（OR = 3.37）和排便不尽感（OR = 2.78）。考虑合并症时，RCC患者比LCC患者更易患糖尿病（OR = 3.31）和冠状动脉疾病（=0.056）。右侧组的黏液分化率高于左侧组（OR = 4.49），浸润淋巴结数量也更多（=0.039），而左侧结肠癌患者组的高分化率高于RCC患者（OR = 2.78）。接受抗表皮生长因子受体（EGFR）治疗的RAS野生型患者比接受抗血管内皮生长因子治疗的患者获益更大（PFS：16.5个月）（=0.05），而在接受抗EGFR治疗的RAS野生型患者中，一线化疗时LCC患者比RCC亚组获益更大（PFS：15.8个月 vs PFS：5.5个月）（=0.034）。KRAS突变患者的PFS（9.3个月）短于KRAS野生型患者（14.5个月）（=0.033）。RCC患者的肿瘤复发期（7.7个月）短于LCC患者（14.5个月）（<0.001），总生存期也较短（RCC患者为58.4个月；LCC患者为82.4个月）（=0.018）。