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CES Medicina

Print version ISSN 0120-8705

Abstract

VILLEGAS-MEJIA, Carlos Raúl; CHACON-CARDONA, José Arnoby; VILLEGAS-JARAMILLO, Manuel  and  VILLEGAS-JARAMILLO, Pedro. Colon cancer, a single entity? Considerations about laterality in a Colombian oncology institution 2001-2016. CES Med. [online]. 2018, vol.32, n.3, pp.191-202. ISSN 0120-8705.  http://dx.doi.org/10.21615/cesmedicina.32.3.1.

Introduction:

It has been suggested that cancers on the right and left sides of the colon are presented as different entities and as such should be addressed for study, treatment and follow-up. The purpose of this research is to make an analysis of patients with colon cancer according to laterality.

Materials and methods:

A retrospective cohort of 442 patients referred to Oncólogos del Occidente from January 2001 to December 2016 with a diagnosis of colon cancer.

Results:

54% of the cases were in the left colon; 52% female sex; average age: 60.5 years on the left and 62.5 on the right; mucinous histology (40% vs 60%), signet ring cells (40% vs 60%) and poorly differentiated (40% vs 60%); mean carcino-embryonic antigen 51.7 vs 63.9 ng/mL; resected lymph nodes greater than or equal to 13 (41% vs 59%); presence of obstruction (22% vs 18%), serosa involvement (16% vs 18%) and ulceration (21% vs 17%). There was relapse in 58% vs 42% and of them to liver (33% vs 23%), lung (18% vs 15%) and carcinomatosis (15% vs 14%). The mean global follow-up was 40.1 ± 39 with 38.3 months for the left side and 42.2 months for the right, and survival at 5 years of 61% vs 64% for the left and right colon, respectively.

Conclusion:

The pattern of occurrence of colon cancer according to its laterality is presented on the right side in smaller numbers, older age, more aggre- ssive histology, higher nodal level, greater serosal involvement, longer follow-up and similar survival. The above, added to the mutational state, could help to define the initial therapeutic management. There are still many doubts to understand the difference in results not explained only based on laterality.

Keywords : Colon cancer; Laterality; Epidemiology; Treatment; Survival.

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