Mirón Fernández Irene, Mera Velasco Santiago, Turiño Luque Jesús Damián, González Poveda Iván, Ruiz López Manuel, Santoyo Santoyo Julio
Department of General, Digestive and Transplant Surgery, Malaga Regional University Hospital, Malaga's University, 29010 Málaga, Spain.
Colorectal Unit, Department of General, Digestive and Transplant Surgery, Malaga Regional University Hospital, 29010 Málaga, Spain.
Cancers (Basel). 2021 May 28;13(11):2647. doi: 10.3390/cancers13112647.
(1) There is evidence of the embryological, anatomical, histological, genetic and immunological differences between right colon cancer (RCC) and left colon cancer (LCC). This research has the general objective of studying the differences in outcome between RCC and LCC. (2) A longitudinal analytical study with prospective follow-up of the case-control type was conducted from 1 January 2010 to 31 December 2017 including 398 patients with 1:1 matching, depending on the location of the tumor. Inclusion criteria: programmed colectomies, 15 cm above the anal margin, adults and R0 surgery. (3) Precisely 6.8% of the exitus occurred in the first 6 months of the intervention. At 6 months, patients with LCC presented a mean survival of 7 months higher than RCC ( = 0.028). In the first stages, it can be observed that most of the exitus are for patients with RCC (stage I = 0.021, stage II = 0.014). In the last stages, the distribution of the deaths does not show differences between locations (stage III = 0.683, stage IV = 0.898). (4) The results show that RCC and LCC are significantly different in terms of evolution, progression, complications and survival. Patients with RCC have a worse prognosis, even in the early stages of the disease, due to more advanced N stages, larger tumor size, more frequently poorly differentiated tumors and a greater positivity of lymphovascular invasion than LCC.
(1) 有证据表明右结肠癌(RCC)和左结肠癌(LCC)在胚胎学、解剖学、组织学、遗传学和免疫学方面存在差异。本研究的总体目标是研究RCC和LCC在预后方面的差异。(2) 从2010年1月1日至2017年12月31日进行了一项病例对照类型的前瞻性随访纵向分析研究,包括398例患者,根据肿瘤位置进行1:1匹配。纳入标准:计划性结肠切除术,距肛缘15厘米以上,成年患者及R0手术。(3) 确切地说,6.8%的死亡发生在干预后的前6个月。在6个月时,LCC患者的平均生存期比RCC高7个月(P = 0.028)。在疾病早期阶段,可以观察到大多数死亡病例是RCC患者(I期P = 0.021,II期P = 0.014)。在疾病晚期,不同部位的死亡分布没有差异(III期P = 0.683,IV期P = 0.898)。(4) 结果表明,RCC和LCC在病程进展、并发症和生存方面存在显著差异。RCC患者的预后较差,即使在疾病早期也是如此,这是因为RCC患者的N分期更晚、肿瘤更大、低分化肿瘤更常见,且淋巴管侵犯阳性率高于LCC。