Adenocarcinomas of the right and left colon: anatomical-clinical differences in the CHUV surgical series from 2015 to 2020
Details

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State: Public
Version: After imprimatur
License: Not specified
Serval ID
serval:BIB_EA2E6DB026A1
Type
A Master's thesis.
Publication sub-type
Master (thesis) (master)
Collection
Publications
Institution
Title
Adenocarcinomas of the right and left colon: anatomical-clinical differences in the CHUV surgical series from 2015 to 2020
Director(s)
SEMPOUX C.
Codirector(s)
FASQUELLE F.
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2022
Language
english
Number of pages
22
Abstract
Introduction
Worldwide, colorectal cancer is the third most common cancer in terms of incidence. In general, literature speaks of colorectal cancer. However, since this work focuses on the differences between left and right colon cancers without considering rectal cancer, we will discuss exclusively colon cancer. For many years, colon cancer was considered and treated as a unique and homogeneous cancer until 1990 when Bufill reported the possible existence of two distinct cancers as he noticed histological, pathological and biological differences between cancers originating from the right and the left side of the colon. Actual knowledge proves the existence of many distinctive features between right colon cancer and left colon cancer in terms of biological and microenvironmental parameters. All these parameters influence the outcome as well as the response to treatment and the mortality of colon cancer.
Aim and methods
The aim of this work is to study the clinicopathological specificities of adenocarcinomas of the right and left colon from a surgical series from which 250 cancers were taken on, including 138 left colon cancers (LCC) and 112 right colon cancers (RCC). Patients with inflammatory bowel disease, rectal cancer and patients who had undergone chemo or radiotherapy before the operation were excluded from this study.
An analysis of various parameters has been performed, considering demographics, comorbidities, clinical and pathological stage, morphological and immunohistochemical characteristics as well as survival of patients with right or left colon cancers
Results and discussion
Our findings about patients with right colon cancer agree with the literature in terms of older age at diagnosis (RCC 71.63 years vs. LCC 69.49 years), presence of more comorbidities, higher tumour stage with poorer prognosis at diagnosis, higher TNM stage (T4 RCC 36% vs. LCC 30%, N0 RCC 50% vs. LCC 60%) and more tumour budding and MSI status (RCC 25% vs. LCC 6%, p<0.001).
There is also no significant difference in the inflammatory T-cell infiltrate (low RCC 46% vs. LCC 45%, moderate RCC 25% vs. LCC 23%, important RCC 5% vs. LCC 6%), which is described to be more abundant in right colon cancers.
A surgical series globally reflects what is known in the literature in terms of differences and similarities. The same study should now be carried out using a database from the Vaud cancer registry in order to be able to perform a study on a more global population, thus reducing the bias of a surgical series.
Worldwide, colorectal cancer is the third most common cancer in terms of incidence. In general, literature speaks of colorectal cancer. However, since this work focuses on the differences between left and right colon cancers without considering rectal cancer, we will discuss exclusively colon cancer. For many years, colon cancer was considered and treated as a unique and homogeneous cancer until 1990 when Bufill reported the possible existence of two distinct cancers as he noticed histological, pathological and biological differences between cancers originating from the right and the left side of the colon. Actual knowledge proves the existence of many distinctive features between right colon cancer and left colon cancer in terms of biological and microenvironmental parameters. All these parameters influence the outcome as well as the response to treatment and the mortality of colon cancer.
Aim and methods
The aim of this work is to study the clinicopathological specificities of adenocarcinomas of the right and left colon from a surgical series from which 250 cancers were taken on, including 138 left colon cancers (LCC) and 112 right colon cancers (RCC). Patients with inflammatory bowel disease, rectal cancer and patients who had undergone chemo or radiotherapy before the operation were excluded from this study.
An analysis of various parameters has been performed, considering demographics, comorbidities, clinical and pathological stage, morphological and immunohistochemical characteristics as well as survival of patients with right or left colon cancers
Results and discussion
Our findings about patients with right colon cancer agree with the literature in terms of older age at diagnosis (RCC 71.63 years vs. LCC 69.49 years), presence of more comorbidities, higher tumour stage with poorer prognosis at diagnosis, higher TNM stage (T4 RCC 36% vs. LCC 30%, N0 RCC 50% vs. LCC 60%) and more tumour budding and MSI status (RCC 25% vs. LCC 6%, p<0.001).
There is also no significant difference in the inflammatory T-cell infiltrate (low RCC 46% vs. LCC 45%, moderate RCC 25% vs. LCC 23%, important RCC 5% vs. LCC 6%), which is described to be more abundant in right colon cancers.
A surgical series globally reflects what is known in the literature in terms of differences and similarities. The same study should now be carried out using a database from the Vaud cancer registry in order to be able to perform a study on a more global population, thus reducing the bias of a surgical series.
Keywords
colon cancer, right colon, left colon, differences, similarities
Create date
12/09/2023 15:04
Last modification date
25/07/2024 5:57