Are Right- and Left-Sided Colon Neoplasms Distinct Tumors?

Distler, Peter; Holt, Peter R.

doi:10.1159/000171605

Cited by 116 publications

(91 citation statements)

References 36 publications

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“…[13][14][15][16] These reports indicated that right-sided cancer was frequently found in older patients, whereas left-sided cancer was more common in younger patients. Histopathological and morphological differences have been reported between proximal and distal colon cancer.…”

Section: Discussionmentioning

confidence: 99%

“…17,18 Moreover, epidemiological studies have revealed that the clinical risk factors for cancer development are also different between proximal and distal colon cancer. 13,19 However, the reasons for these differences between left-and right-sided cancer remain unknown. In recent study, Yamaji et al 20 reported right-side shift of colorectal adenomas with aging, similar to cancer.…”

Section: Discussionmentioning

confidence: 99%

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A Matched Case-Control Study Using the Propensity Score on Differences in the Characteristics of Colorectal Polyps between Younger and Older Koreans: Proximal Shift in the Distribution of Colorectal Polyps among Older Koreans

Jang

Kim²,

Moon³

et al. 2010

Gut Liver

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Matched Case-Control Study Using the Propensity Score on Differences in the Characteristics of Colorectal Polyps between Younger and Older Koreans: Proximal Shift in the Distribution of Colorectal Polyps among Older Koreans

Jang

Kim²,

Moon³

et al. 2010

Gut Liver

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“…Conversely, patients with metastases from left-sided colon cancer showed favorable local control rates following radiotherapy. CRC biological behavior was previously shown to depend on tumor location, as it varies for tumors originating from the right-sided colon, left-sided colon and rectum (27)(28)(29)(30)(31)(32)(33). Significant overexpression of p53 that can affect the response to radiotherapy in rectal cancer in comparison with colon cancer has been reported (33,34).…”

Section: Discussionmentioning

confidence: 99%

Effect of primary tumor location and tumor size on the response to radiotherapy for liver metastases from colorectal cancer

et al. 2017

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Abstract. Metastatic liver tumors (MLTs) from colorectal cancer (CRC) are often treated with stereotactic body radiation therapy (SBRT). The present study aimed to examine the predictive factors for response of MLTs to SBRT. A total of 39 MLTs from 24 patients with CRC were retrospectively analyzed. Radiotherapy for MLT was typically performed with a prescribed dose equivalent to a biologically effective dose (BED) 10 of 100 Gy. The median follow-up period was 16 months (range, 5-64 months). The median prescribed dose and total BED 10 were 56 Gy (range, 45-72 Gy) and 97.5 Gy (range, 71.7-115.5 Gy), respectively, in a median of 8 fractions (range, 4-33 fractions). The 1-and 2-year local control rates were 67.2 and 35.9%, respectively. For patients with MLT treated with ablative SBRT (BED 10 ≥100 Gy in ≤5 fractions), the 1-and 2-year local control rates were 83.3 and 62.5%, respectively. Univariate analysis showed that primary tumor location (left-sided colon), maximum tumor diameter (≤30 mm) and ablative SBRT (BED 10 ≥100 Gy in ≤5 fractions) were significantly associated with improved local control (P=0.0058, P=0.0059 and P=0.0268, respectively). Multivariate analysis showed that tumor diameter was significantly associated with improved local control (P=0.0314). In addition, patients who received ablative SBRT had significantly prolonged overall survival times compared with those treated with non-ablative SBRT (P= 0.0261). To conclude, tumors ≤30 mm that can be treated with ablative SBRT are associated with good local control rates. The primary tumor location may affect the radiosensitivity of MLTs. IntroductionPatients with colorectal cancer (CRC) often have metastases at initial presentation or during follow-up (1,2). The liver is one of the most frequent sites of metastasis (1,2). Newly developed chemotherapeutic agents, including targeted therapies, have improved the progression-free and overall survival times of patients with metastatic CRC (3,4). There is also evidence supporting the benefit of surgery to treat metastases from CRCs, with surgery improving overall survival time (5-7). The prolonged survival times of patients have highlighted the importance of local therapy for CRC and limited metastatic disease. In patients who are unfit for surgery, alternative local therapeutic approaches, including radiofrequency ablation (RFA), are available to treat liver metastases; these approaches are minimally invasive and can achieve good local control (8,9). However, their indication is currently limited to relatively small tumors that are located far away from critical structures (8,9).Modern radiotherapeutic techniques, including intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT), have recently become more frequently utilized to curatively treat limited metastatic tumors (10-14). SBRT, also termed stereotactic ablative radiation therapy, is a proven curative treatment for medically inoperable small tumors in the lung and liver; it delivers highly conformal radiation in a ...

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“…Since then several other groups, particularly in Europe, have continued to develop the theme of differences between right and left colon cancers. [7][8][9][10][11][12][13] Despite this, many researchers fail to take into account the possibility that multiple categories of colon cancers with distinctive biologic and clinical properties could have implications for the evaluation of their data. In particular, clinical trials of adjuvant chemotherapies are conducted with apparent disregard for the likely existence of more than 1 CRC type.…”

mentioning

confidence: 99%

Are there two sides to colorectal cancer?

Iacopetta

2002

Intl Journal of Cancer

685

558

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Colorectal carcinomas (CRC) that arise proximal (right) or distal (left) to the splenic flexure exhibit differences in incidence according to geographic region, age and gender. Together with observations that tumours in the hereditary cancer syndromes HNPCC and FAP occur predominantly in the right and left colon, respectively, the existence of 2 categories of CRC based on site of origin in the large bowel was proposed more than a decade ago. Differences between normal right and left colonic segments that could favour progression through different tumourigenic pathways are summarized in this review. Accumulating evidence suggests that the risk of CRC conferred by various environmental and genetic factors is different for proximal and distal tumours. Right-and left-sided tumours also exhibit different sensitivities to fluorouracil-based chemotherapy. Such differences are probably related to the molecular characteristics of the tumours, with the microsatellite instability and CpG island methylator phenotypes being associated with right-sided tumours and chromosomal instability with left-sided tumours. Future molecular-based classification systems for CRC that rely upon distinctive gene expression patterns may allow a clearer discrimination of subgroups than that provided by tumour site alone. Until then however, the existence of 2 broadly different groups of cancer defined by site of origin in the colon should be considered in the design of future epidemiologic studies as well as in the design of new clinical trials aimed at testing novel adjuvant therapies.

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Are Right- and Left-Sided Colon Neoplasms Distinct Tumors?

Cited by 116 publications

References 36 publications

A Matched Case-Control Study Using the Propensity Score on Differences in the Characteristics of Colorectal Polyps between Younger and Older Koreans: Proximal Shift in the Distribution of Colorectal Polyps among Older Koreans

A Matched Case-Control Study Using the Propensity Score on Differences in the Characteristics of Colorectal Polyps between Younger and Older Koreans: Proximal Shift in the Distribution of Colorectal Polyps among Older Koreans

Effect of primary tumor location and tumor size on the response to radiotherapy for liver metastases from colorectal cancer

Are there two sides to colorectal cancer?

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