Is right-sided colon cancer different to left-sided colorectal cancer? – A systematic review

Lee, Gui Han; Malietzis, George; Askari, Alan; Bernardo, David; Al-Hassi, Hafid O.; Clark, Susan

doi:10.1016/j.ejso.2014.11.001

Cited by 323 publications

(280 citation statements)

References 77 publications

Supporting

Mentioning

253

Contrasting

Unclassified

Order By: Relevance

“…36 , 37 Noteworthy, a significant part of studies regarding the prognostic impact of PD-L1 have not discriminated between its expression in tumour cells and tumour-infiltrating immune cells. The results from the present study, with immune cell-specific PD-L1 expression being an independent prognostic factor while its expression in tumour cells was not, are coherent with previous research 16 , 23-26 and demonstrate that PD-L1 expression in immune cells and tumour cells might carry different prognostic values and might be regulated by distinct mechanisms. Furthermore, although tumour cell-specific PD-L1 expression has been validated as a predictive marker for response to PD-1 or PD-L1 blockade in several cancers, 11 , 38 , 39 recent studies now suggest that PD-L1 expression in tumour-infiltrating myeloid and T cells also play a critical role in immunosuppression, 38 , 40-43 and should possibly be taken into account in assessment scoring for PD-1/PD-L1 blockade.…”

Section: Discussionsupporting

confidence: 91%

“…These findings further support previous evidence suggesting that proximal and distal CRC may represent different epidemiological, pathological, genetic, and clinical entities. 23 , 24 Right-sided tumours, often defined as proximal to the splenic flexure, are generally poorly differentiated, diagnosed in more advanced tumour stages, displaying different molecular patterns, and carrying a poorer prognosis than left-sided tumours. 24 , 25 Several studies also demonstrate the importance of taking PTL into account when evaluating treatment response, 26-28 and retrospective analyses from large phase III trials have demonstrated that patients with right-sided tumours have less benefit from the addition of EGFR-targeted therapy.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Expression of programmed cell death protein 1 (PD-1) and its ligand PD-L1 in colorectal cancer: Relationship with sidedness and prognosis

et al. 2018

View full text Add to dashboard Cite

Expression of programmed cell death protein 1 (PD-1) and its ligand PD-L1 has been demonstrated to confer a prognostic value in colorectal cancer (CRC), but no studies have investigated whether this association differs according to tumour location. In this study, immunohistochemical expression of PD-1 and PD-L1 was analysed in tissue microarrays with primary tumours from 557 incident CRC cases from a prospective population-based cohort. Univariable and multivariable Cox regression analyses, adjusted for age, sex, TNM stage, differentiation grade and vascular invasion, were applied to determine the impact of biomarker expression on 5-year overall survival (OS), in the entire cohort and in subgroup analysis of right colon, left colon, and rectum. High PD-L1 expression on tumour-infiltrating immune cells was an independent factor of a prolonged OS in the entire cohort (hazard ratio [HR] = 0.49; 95% confidence interval [CI] CI 0.35 – 0.68), and in tumours of the right colon (HR = 0.43; 95% CI 0.25 – 0.74) and the left colon (HR = 0.28; 95% CI 0.13 – 0.61), but not in rectal cancer. Tumour-specific PD-L1-expression was not prognostic, neither in the full cohort nor according to tumour location. High immune cell-specific PD-1 expression was associated with a prolonged OS in the entire cohort and in tumours of the right colon, but not in the left colon or rectum, and only in univariable analysis. In conclusion, these results demonstrate that immune cell-specific PD-L1 and PD-1 expression is prognostic in a site-dependent manner, whereas tumour-specific PD-L1-expression is not prognostic in CRC.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Expression of programmed cell death protein 1 (PD-1) and its ligand PD-L1 in colorectal cancer: Relationship with sidedness and prognosis

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Differences could be explained by unequal molecular profiles characterized by allelic losses on chromosomes 17p, 18, and 5q, KRAS and p53 mutations observed more frequently in the left-side colon cancers [6][7] . Epidermal growth factor receptor (EGFR) is also overexpressed in distal colorectal cancers.…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of oncologic outcomes in colon cancer

et al. 2016

View full text Add to dashboard Cite

PURPOSE:In this paper we report clinical variables on colon cancer series. Oncological outcomes were compared to low-income and high-income countries. METHODS:We analysed a prospective database of 51 colon cancer patients submitted to primary tumor resection between 2010 and 2011, showing clinical variables and oncologic outcomes.RESULTS: R0 resection obtained in 80.4%, 21.6% of patients was TNM stage IV, and only 13.7% showed TNM stage I. Diseasefree survival was 32 months, overall survival was 46 months, and the tumoral recurrence rate was 9.8%. Univariate analysis showed association of serum CEA levels ≥ 5 ng/dl (p= 0.004), presence of metastasis at diagnosis (p= 0.012), compromised surgical margins (p < 0.001) and poorer tumor differentiation (p= 0.041) to death. Multivariate analysis identified compromised surgical margins as an independent risk factor for death due to colon cancer (P=0.003; odds ratio=0.36; 95% confidence interval=0.004-0.33). Nowadays, 62.7% of patients are alive. CONCLUSION:Recurrence rate, disease-free survival and overall survival was similar to those observed in more developed countries.Serum CEA levels ≥ 5 ng/dl, the presence of metastasis at diagnosis, compromised surgical margins and poorer tumor differentiation were associated with death. A compromised surgical margin was the only independent risk factor for death.

show abstract

“…В ходе исследования обнару-жилось, что в источниках литературы не представлены в полном объеме данные по отдаленным результатам экстренной хирургии рака ОК. В большинстве проведенных исследований и сис-тематических обзоров было продемонстрировано, что показатели 5-летней выживаемости в плановой хирургии рака ОК были несколько лучше при левосто-ронней локализации опухоли по сравнению с право-сторонней [15][16][17][18][19][20]. Так, в исследовании K. Moritani и соавт.…”

Section: Discussionunclassified

Emergency resections in patients with complicated rightand left-sided colon cancer: long-term outcomes

Щаева¹

2018

Onkol. koloproktol.

View full text Add to dashboard Cite

Objective: to evaluate five-year overall and relapse-free survival in patients with complicated rightand left-sided colon cancer that underwent emergency resection.Materials and methods. The study included 501 patients with urgent complications of rightand left-sided colon cancer that underwent emergency resection. The data was obtained from an electronic register containing the information on patients with urgent complications of colorectal cancer treated in general and specialized surgical hospitals in Smolensk between 2001 and 2013 (13 years). We assessed fiveyear overall and relapse-free survival in these patients.Results. A total of 501 resections were performed during the study period. We observed significant differences in resection statuses of patients after emergency resection: the R1 resection status was more frequent in individuals with right-sided colon cancer compared to those with left-sided colon cancer (20.8 % vs. 6.9 %, p = 0.0002). Mean number of lymph nodes examined was 4.6 ± 2.0 in patients with right-sided cancer and 5.3 ± 3.0 in patients with left-sided cancer (p = 0.18). There were no differences in the number of patients receiving adjuvant treatment between the groups (p = 0.11). Patients with left-sided stage II/IIIB/IIIСcomplicated colon cancer demonstrated better overall and relapse-free survival than those with right-sided tumors of the same stages (overall survival: p = 0.007, p = 0.0002, p = 0.0001 for stages II, IIIB, IIIСrespectively; relapse-free survival: p = 0.005, p = 0.0003, p = 0.0002 for stages II, IIIB, IIIСrespectively).Conclusion. The observed differences in the outcomes of treatment for rightand left-sided complicated colon cancer can be explained by the fact that the majority of emergency resections for right-sided tumors were one-stage and were performed in general surgery hospitals. Patients with left-sided cancer underwent tumor removal on the second stage more often than those with right-sided cancer (32 % vs. 13 %). Treatment of patients with complicated colon cancer should be consistent, stepwise, and pathogenetically reasonable.

show abstract

Is right-sided colon cancer different to left-sided colorectal cancer? – A systematic review

Cited by 323 publications

References 77 publications

Expression of programmed cell death protein 1 (PD-1) and its ligand PD-L1 in colorectal cancer: Relationship with sidedness and prognosis

Expression of programmed cell death protein 1 (PD-1) and its ligand PD-L1 in colorectal cancer: Relationship with sidedness and prognosis

Comparative evaluation of oncologic outcomes in colon cancer

Emergency resections in patients with complicated rightand left-sided colon cancer: long-term outcomes

Contact Info

Product

Resources

About