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Variations in demography and prognosis by colon cancer location.

AIM
Tumours of the right and left colon are suggested to be different entities with different prognosis. The aim was to explore differences related to the location of a colonic tumour.


PATIENTS AND METHODS
A single-centre retrospective analysis of all patients treated for colon cancer during 1999-2008 (n=1558) was carried out. Assessed data included demography, pathology and survival by cancer location, with left colon also sub-divided into left and sigmoid colon.


RESULTS
Right colon carcinoma was associated with female gender, higher age and poor grade of differentiation; left colon carcinoma had characteristics of worse stages and requiring emergency surgery. Sigmoid tumours were of better grade and stage. Survival was related the staging, which varied with location. Right colon carcinoma conferred a worse overall survival (OS) (p<0.037) but not cancer-specific survival (CSS) or disease-free survival compared to the entire left colon, whilst sigmoid tumours conferred a better OS and CSS (p<0.001) when the left colon was sub-divided.


CONCLUSION
There are differences in demography and pathology related to the location of colon cancer. Sigmoid location carries the best prognosis.