TMSS Medical College Journal

Introduction: Colorectal cancer (CRC) is the third most common cancer and the second for mortality over the world. Some researchers suggest that cancers located in the right vs. the left side of the colon are different and they can be regarded as distinct disease entities. The aim of this study was to analyze differences in clinical, epidemiological and pathological features of patients with right-sided (RCC) and left-sided (LCC) colon cancer. Materials and Methods: A cross sectional observational study on a group of 50 patients of resected colon cancer was included from different hospitals of Dhaka and Kishoregonj. Parameters studied included age, sex, location of the tumour, histopathological subtype, grade, stage and lymphovascular (LVI) between LCC and RCC. Results: The age range was from 19 years to 84 years with mean age of 46.6 + 14.8 years. Per rectal bleeding was the commonest symptom at the time of diagnosis. Male patients were presented more with left sided colon cancer. Left sided cancer tended to be more poorly differentiated and higher stage compared to right side colon cancer. Mucinous adenocarcinoma was seen in 6 (12%) cases. Rectum was the most common tumour subsite involved. Conclusion: Cancers of the right and left side of the colon vary according to clinical and pathological features. In our study, cancer of the left side of the colon (LCC) was more advanced stage and grade at diagnosis.

Colorectal cancer (CRC) is the third most common cancer in the world and the second leading cause of cancer related death.! The lifetime risk of developing CRC is about 6% or one in 18. Over 95% of these CRC is adenocarcinoma. In 2040, the global cancer burden is anticipated to reach 28.4 million cases, and developing low-income countries are anticipated to register 64-95% of all these cases.’ The incidence of colorectal cancer in Bangladesh is not exactly known, it appears to be common and occur in younger age group with slight male preponderance. Average age at diagnosis is 10 years less than the developed countries.* Researchers divides CRC into two groups based on the localization of the primary tumor into right-sided colon cancer (RCC) and left-sided colon cancer (LCC). Both of them have different embryological, genetic, and clinical characteristics leading to differences in prognosis and in the outcome. Anatomically, the right colon includes the caecum, ascending colon, liver flexure, and transverse colon and the left colon includes the splenic flexure, descending colon, sigmoid colon and rectum. The proximal colon arises from the midgut and receives its major blood supply through the superior mesenteric artery. The distal colon arises from the hindgut and is supplied by the inferior mesenteric artery. Clinically, patients with RCC are older and more likely to be women. RCC clinically appears early with more advanced and poorly differentiated tumor grade and stages.® Studies have reported that outcome of colon cancer are different according to the location of the tumor. However, some studies have suggested no difference between RCC and LCC.” Two meta-analyses showed that survival is worse for patients with right-sided colon cancer. The aim of our study was to analyze differences in clinical, epidemiological and pathological features of patients with adenocarcinoma located in the right and left side of the colon and rectum.