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Outcome of right‐ and left‐sided colonic and rectal cancer following surgical resection
Author(s) -
Suttie S. A.,
Shaikh I.,
Mullen R,
Amin A. I.,
Daniel T.,
Yalamarthi S.
Publication year - 2011
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2010.02356.x
Subject(s) - medicine , colorectal cancer , splenic flexure , rectum , anus , proportional hazards model , transverse colon , colonic cancer , prospective cohort study , surgery , gastroenterology , log rank test , cancer , colonoscopy
Aim To determine the outcome of surgery for colorectal cancer from a single region and to see whether location of the primary cancer influences prognosis. Method Patients with colorectal cancer diagnosed from January 2002 to December 2006, entered into a prospective database were followed until death or to December 2008. Right‐sided (caecum to transverse colon) and left‐sided (splenic flexure to rectosigmoid junction) colonic cancers and rectal cancers (distal to rectosigmoid junction to the anus) were identified. Statistical analysis was performed using Pearson’s chi‐square test, Kaplan–Meier (log‐rank statistic) and Cox regression analysis with a P ‐value < 0.05 denoting significance. Results Of 841 patients with solitary colorectal cancers identified (median age 72 [30–101] years; 53% male), 283 (33.7%) were right‐sided colonic, 330 (39.2%) were left‐sided colonic and 228 (27.1%) were rectal. Respective resection rates were 82.7%, 77.9% and 91.6%, and curative resection rates were 79.9%, 82.9.0% and 85.7%, respectively. There was no significant difference in recurrence rates between right‐ (16.1%), left‐sided (23.0%) colonic and rectal (20.7%) cancers ( P = 0.207). Respective mean survival rates were 54.4, 59.8 and 63.6 months ( P = 0.007). Conclusion Right‐sided colorectal cancers had a worse prognosis than left‐sided and rectal cancers, possibly because of more advanced staging and fewer curative resections.