Differences between right- and left-sided colon cancer in patient characteristics, cancer morphology and histology

J Gastroenterol Hepatol. 2008 Mar;23(3):418-23. doi: 10.1111/j.1440-1746.2007.04923.x. Epub 2007 May 27.

Abstract

Background and aim: Recently, the clinical and biological differences between right- and left-sided colon cancers have been widely debated. However, close analyses of these clinical differences, based on large-scale studies, have been scarcely reported.

Methods: A total of 3552 consecutive Japanese colorectal cancer cases were examined and the clinical differences between right- and left-sided colon cancer cases were investigated.

Results: The proportion of right-sided colon cancer was relatively high in patients aged less than 40 years (33%) and more than 80 years (43%). The proportion of right-sided colon cancer in patients aged 40-59 years was relatively low (male 22% and female 29%). In male patients the proportion increased in the 70-79 years age group (30%), while in female patients the proportion increased in the 60-69 years age group (39%). Right-sided colon cancer was more likely to be detected at an advanced stage (T1 stage; left 22%, right 15%) (P < 0.01) with severe symptoms. Polypoid-type early cancer was dominant in the left colon (left 59%; right 40%) (P < 0.01), while the proportion of flat-type early cancer in the right colon was significantly higher than that in the left colon (left 25%; right 44%) (P < 0.01).

Conclusions: Specific age distribution of right-sided colon cancer was observed and the difference between male and female patients was highlighted. Other clinical features also differed between right- and left-sided colon cancer, suggesting that different mechanisms may be at work during right and left colon carcinogenesis.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma, Mucinous / pathology*
  • Adult
  • Age Distribution
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Carcinoma, Signet Ring Cell / pathology*
  • Cell Differentiation
  • Colonic Neoplasms / pathology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Registries
  • Sex Distribution
  • Sex Factors