Right colon cancer: Long-term results after curative surgery and prognostic significance of duration of symptoms

Objective There is strong evidence that the body composition can affect the progression-free survival (PFS) and overall survival (OS) in patients with a variety of cancers. The main objective of this study was to investigate the effect of body composition on the prognosis of patients with advanced gastrointestinal and colorectal cancers who received first-line palliative chemotherapy. Methods Patients who were newly-diagnosed with advanced gastrointestinal or colorectal cancer and received standard first-line palliative chemotherapy from January 2017 to December 2018 were included in this retrospective study. An analysis of computed tomography images was performed to determine the skeletal muscle index (SMI), which reflects the skeletal muscle mass and skeletal muscle density (SMD) related to muscle strength. A Kaplan-Meier survival analysis and log-rank test were used to compare the survival relationships among groups stratified by the SMI, and a Cox proportional hazard model was used for a multivariate analysis. Results A total of 108 patients met the inclusion criteria, including 41 cases of gastric cancer, 46 cases of left colorectal cancer, and 21 cases of right colon cancer. In patients with gastric cancer, the OS of women was significantly shorter than that of men. The OS of patients with a low SMI, low SMD, and low phase angle (PA) was significantly shorter than that of patients with high values (P ≤ 0.05). In the multivariate analysis, the SMD was significantly associated with the patients' long-term survival [Hazard Ratio (HR) = 0.904, 95% CI: 0.840~0.974, P = 0.008]. For patients with a low SMI and PA, the PFS was significantly shorter than that of patients with high values (P ≤ 0.05). In patients with left colon cancer, the PA and SMD were both independent risk factors for a poorer long-term prognosis (HR = 0.375, 95% CI: = 0.167~0.840, P = 0.017; HR = 0.887, 95% CI: 0.824~0.954, P = 0.001). Among right colon cancer patients, the PFS and OS of those with a low SMD were significantly lower than those for patients with high values (P ≤ 0.05). Conclusion The PA is an independent risk factor for the OS of left colon cancer patients; the SMD is an independent risk factor for the survival of patients with gastric cancer, left colon cancer, and right colon cancer.

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IS THERE A DIFFERENCE BETWEEN RIGHT- VERSUS LEFT-SIDED COLON CANCERS? DOES SIDE MAKE ANY DIFFERENCE IN LONG-TERM FOLLOW-UP?

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-672020190001e1479 ◽

2019 ◽

Vol 32 (4) ◽

Cited By ~ 1

Author(s):

Leonardo Alfonso BUSTAMANTE-LOPEZ ◽

Sergio Carlos NAHAS ◽

Caio Sergio R. NAHAS ◽

Rodrigo Ambar PINTO ◽

Carlos Frederico S. MARQUES ◽

...

Keyword(s):

Colon Cancer ◽

Survival Time ◽

Right Colon ◽

Risk Of Death ◽

Colon Cancers ◽

Right Colon Cancer ◽

Long Term Follow Up ◽

Disease Entities ◽

Left Colon Cancer

ABSTRACT Background: Since 1990 it was proposed that distal and proximal location of colon cancer might follow different biological, epidemiology, pathology and prognosis, probably due to embryologic different development of the two segments of the colon, which may represent two separate disease entities. These differences might have consequences for the treatment of patients with colorectal cancer. Aim: To compare the characteristics between patients with right and left colon cancer, with severity and tumor characteristic that influence in the survival of these patients. Method: Were evaluated the outcomes of surgical treatment of patients with colon cancer with data collected retrospectively from prospectively collected database. Results: The tumor’s side did not influence survival time of patients with colon cancer (p=0.112) in the regression model. Only the diseases stage leads to influence on survival time; patients with right colon cancer have more advanced staging (III or IV) and present a risk of death greater in 3.23 times. Conclusion: This analysis provides evidence that the prognosis of localized left-sided colon cancer is better compared to right-sided colon cancer. Also, the patients with right colon cancer have more advanced stage, mucinous tumor and are older.

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Laparoscopy Offers Better Clinical Outcomes and Long-term Survival in Patients With Right Colon Cancer: Experience From National Cancer Center

Annals of Coloproctology ◽

10.3393/ac.2021.00045.0006 ◽

2021 ◽

Author(s):

Muhammad Fahd Shah ◽

Awais Naeem ◽

Ihtisham ul Haq ◽

Shehryar Riaz ◽

Osama Shakeel ◽

...

Keyword(s):

Colon Cancer ◽

Clinical Outcomes ◽

Cancer Center ◽

Right Colon ◽

Term Survival ◽

Long Term Survival ◽

Right Colon Cancer ◽

Cancer Experience

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Laparoscopic Complete Mesocolic Excision with Central Vascular Ligation in right colon cancer: long-term oncologic outcome between mesocolic and non-mesocolic planes of surgery

Scandinavian Journal of Surgery ◽

10.1177/1457496914557017 ◽

2014 ◽

Vol 104 (4) ◽

pp. 219-226 ◽

Cited By ~ 21

Author(s):

L. M. Siani ◽

C. Pulica

Keyword(s):

Colon Cancer ◽

Oncologic Outcome ◽

Complete Mesocolic Excision ◽

Right Colon ◽

Central Vascular Ligation ◽

Right Colon Cancer ◽

Vascular Ligation ◽

Mesocolic Excision

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Modified Complete Mesocolic Excision (mCME) for Right Colon Cancer

Case Medical Research ◽

10.31525/ct1-nct03992599 ◽

2019 ◽

Author(s):

Keyword(s):

Colon Cancer ◽

Complete Mesocolic Excision ◽

Right Colon ◽

Right Colon Cancer ◽

Mesocolic Excision

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A learning curve in using organ retractor for single-incision laparoscopic right colectomy

Scientific Reports ◽

10.1038/s41598-021-86168-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Toshio Shiraishi ◽

Tetsuro Tominaga ◽

Takashi Nonaka ◽

Kiyoaki Hamada ◽

Masato Araki ◽

...

Keyword(s):

Colon Cancer ◽

Laparoscopic Surgery ◽

Blood Loss ◽

Learning Curve ◽

Single Incision ◽

Operation Time ◽

Perioperative Outcomes ◽

Single Incision Laparoscopic Surgery ◽

Right Colon ◽

Right Colon Cancer

AbstractSingle-incision laparoscopic surgery (SILS) has the potential to improve perioperative outcomes, including less postoperative pain, shorter operation time, less blood loss, and shorter hospital stay. However, SILS is technically difficult and needs a longer learning curve. Between April 2016 and September 2019, a total of 198 patients with clinical stage I/II right colon cancer underwent curative resection. In the case of the SILS approach, an organ retractor was usually used to overcome SILS-specific restrictions. The patients were divided into two groups by surgical approach: the SILS with organ retractor group (SILS-O, n = 33) and the conventional laparoscopic surgery group (LAC, n = 165). Clinical T status was significantly higher in the LAC group (p = 0.016). Operation time was shorter and blood loss was lower in the SILS-O group compared to the LAC group (117 vs. 197 min, p = 0.027; 10 vs. 25 mL, p = 0.024, respectively). In the SILS-O group, surgical outcomes including operation time, blood loss, number of retrieved lymph nodes, and postoperative complications were not significantly different between those performed by experts and by non-experts. Longer operation time (p = 0.041) was significantly associated with complications on univariate and multivariate analyses (odds ratio 2.514, 95%CI 1.047–6.035, p = 0.039). SILS-O was safe and feasible for right colon cancer. There is a potential to shorten the learning curve of SILS using an organ retractor.

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Comparison of postoperative recovery of patients who underwent laparoscopic-assisted radical resection of right colon cancer with modified triangular anastomosis or tubular anastomosis: a retrospective cohort study

BMC Surgery ◽

10.1186/s12893-021-01086-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tianfang Xia ◽

Zhenguo Pan ◽

Jie Zhang ◽

Guo Xu

Keyword(s):

Colon Cancer ◽

Digestive Tract ◽

Transverse Colon ◽

Retrospective Cohort ◽

Radical Resection ◽

Anastomosis Group ◽

Group Differences ◽

Right Colon ◽

Right Colon Cancer ◽

Laparoscopic Assisted

Abstract Background We compared the advantages and disadvantages of modified triangular anastomosis and tubular anastomosis for digestive tract reconstruction in patients undergoing laparoscopic-assisted radical resection of right colon cancer. Methods This was a retrospective cohort analysis of 92 cases of laparoscopic-assisted resection of right colon cancer, treated from June 2017 to June 2018, at the Huai’an No. 1 People’s Hospital in China. Patients were divided into a modified triangular anastomosis group (n = 33) and a tubular anastomosis group (n = 59). In the modified triangular anastomosis group, digestive tract reconstruction was conducted using side-to-side anastomosis of the ileo-transverse colon with a 60-mm linear stapler. The common entry hole was closed with a running suture. The tubular anastomosis group underwent end-to-side anastomosis of the ileo-transverse colon with a tubular stapler anchor placed at the end of the ileum. Results At baseline and perioperatively, there were no significant between-group differences in age, sex, body mass index, tumor location, pathological stage, or tumour size (P > 0.05). There were also no significant between-group differences in operation time, estimated blood loss, the number of harvested lymph nodes, the first postoperative flatulence time, hospitalisation time, or postoperative complications (P > 0.05); however, the total cost of hospitalization for the triangular anastomosis group was significantly lower than the tubular anastomosis group (P < 0.05). Conclusion Modified triangular anastomosis is a safe and feasible procedure for laparoscopic-assisted radical resection of right colon cancer. These results affirm the safety and effectiveness of total laparoscopic radical resection of right colon cancer. Given the equivalent outcomes between the two procedures, the modified triangular procedure may be more a more cost-effective option for clinical application.

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