Skip to main content

Advertisement

SpringerLink
Log in

Variations in clinical features and oncologic behaviors of T1 colorectal cancer according to tumor location

  • Original Article
  • Published:
International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

Background

Different genetic characteristics according to tumor location result in variations in survival rates and treatment responses in advanced colorectal cancer (CRC). However, the effects of tumor location during early CRC are still unclear.

Methods

Patients with T1 CRC treated between 2003 and 2019 were enrolled from a prospectively collected database. Patients were once divided into four groups, then combined into two groups (right- and left-sided CRC) according to the tumor location, and clinical features and oncologic behaviors were compared.

Results

In total, 458 patients were analyzed. Right-sided CRC had a lower incidence of polypoid type tumor than left-sided CRC (36/126 (28.6%) vs 186/332 (56.0%), p < 0.001). There were no differences in tumor size, pathological grade, pT1 substage and lymphovascular invasion between right- and left-sided CRC. Overall, lymph nodal involvement was observed in 42/458 (9.1%) patients. Right-sided CRC had a lower rate of patients with lymph nodal involvement than left-sided CRC (6/126 (4.8%) vs 36/332 (10.8%), p = 0.04).

Conclusion

The present study revealed that there were significant differences in the macroscopic type and the incidence of lymph node involvement between right- and left-sided CRC. The clinical features and oncologic behaviors of T1 CRC are possible to vary according to tumor location.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Missiaglia E, Jacobs B, D’Ario G et al (2014) Distal and proximal colon cancers differ in terms of molecular, pathological, and clinical features. Ann Oncol 25:1995–2001

    Article  CAS  PubMed  Google Scholar 

  2. Loupakis F, Yang D, Yau L et al (2015) Primary tumor location as a prognostic factor in metastatic colorectal cancer. J Natl Cancer Inst 2015:107

    Google Scholar 

  3. Arnold D, Lueza B, Douillard JY et al (2017) Prognostic and predictive value of primary tumour side in patients with RAS wild-type metastatic colorectal cancer treated with chemotherapy and EGFR directed antibodies in six randomised trials. Ann Oncol 28:1713–1729

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Tejpar S, Stintzing S, Ciardiello F et al (2017) Prognostic and predictive relevance of primary tumor location in patients with RAS wild-type metastatic colorectal cancer: retrospective analyses of the CRYSTAL and FIRE-3 Trials. Ann Oncol 28:1713–1729

    Article  Google Scholar 

  5. Dejea CM, Wick EC, Hechenbleikner EM et al (2014) Microbiota organization is a distinct feature of proximal colorectal cancers. Proc Natl Acad Sci USA 111:18321–18326

    Article  CAS  PubMed  Google Scholar 

  6. Shen H, Yang J, Huang Q et al (2015) Different treatment strategies and molecular features between right-sided and left-sided colon cancers. World J Gastroenterol 21:6470–6478

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Petrelli F, Tomasello G, Borgonovo K et al (2016) Prognostic survival associated with left-sided vs right-sided colon cancer: a systematic review and meta-analysis. JAMA Oncol 3:211–219

    Article  Google Scholar 

  8. Yahagi M, Okabayashi K, Hasegawa H et al (2016) The worse prognosis of right-sided compared with left-sided colon cancers: a systematic review and meta-analysis. J Gastrointest Surg 20:648–655

    Article  PubMed  Google Scholar 

  9. Vogelstein B, Fearon ER, Hamilton SR et al (1988) Genetic alterations during colorectal-tumor development. N Engl J Med 319:525–532

    Article  CAS  PubMed  Google Scholar 

  10. Fearon ER, Vogelstein B (1990) A genetic model for colorectal tumorigenesis. Cell 61:759–767

    Article  CAS  PubMed  Google Scholar 

  11. Spratt JS Jr, Ackerman LV (1962) Small primary adenocarcinomas of the colon and rectum. JAMA 179:337–346

    Article  PubMed  Google Scholar 

  12. Kudo S (1993) Endoscopic mucosal resection of flat and depressed types of early colorectal cancer. Endoscopy 25:455–461

    Article  CAS  PubMed  Google Scholar 

  13. Goto H, Oda Y, Murakami Y et al (2006) Proportion of de novo cancers among colorectal cancers in Japan. Gastroenterology 131:40–46

    Article  PubMed  Google Scholar 

  14. Jass JR, Whitehall VL, Young J et al (2002) Emerging concepts in colorectal neoplasia. Gastroenterology 123:862–876

    Article  CAS  PubMed  Google Scholar 

  15. Jass JR (2007) Classification of colorectal cancer based on correlation of clinical, morphological and molecular features. Histopathology 50:113–130

    Article  CAS  PubMed  Google Scholar 

  16. Shimoda T, Ikegami M, Fujisaki J et al (1989) Early colorectal carcinoma with special reference to its development de novo. Cancer 64:1138–1146

    Article  CAS  PubMed  Google Scholar 

  17. Ikegami M (1987) A pathological study on colorectal cancer. From de novo carcinoma to advanced carcinoma. Acta Pathol Jpn 37:21–37

    CAS  PubMed  Google Scholar 

  18. Japanese Society for Cancer of the Colon and Rectum (2009) Japanese classification of colorectal carcinoma, 2nd, English edn. Kanehara-& Co., Ltd., Tokyo

    Google Scholar 

  19. Okamoto M, Kawabe T, Yamaji Y et al (2005) Flat-type early colorectal cancer preferentially develops in right-sided colon in older patients. Dis Colon Rectum 48:101–107

    Article  PubMed  Google Scholar 

  20. Participants in the Paris Workshop (2003) The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc 58:S3–43

    Article  Google Scholar 

  21. Yagi K, Takahashi H, Akagi K et al (2012) Intermediate methylation epigenotype and its correlation to KRAS mutation in conventional colorectal adenoma. Am J Pathol 180:616–625

    Article  CAS  PubMed  Google Scholar 

  22. Yagi K, Akagi K, Hayashi H et al (2010) Three DNA methylation epigenotypes in human colorectal cancer. Clin Cancer Res 16:21–33

    Article  CAS  PubMed  Google Scholar 

  23. Sakai E, Fukuyo M, Ohata K et al (2016) Genetic and epigenetic aberrations occurring in colorectal tumors associated with serrated pathway. Int J Cancer 138:1634–1644

    Article  CAS  PubMed  Google Scholar 

  24. Watanabe T, Itabashi M, Shimada Y et al (2015) Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2014 for treatment of colorectal cancer. Int J Clin Oncol 20:207–239

    Article  PubMed  PubMed Central  Google Scholar 

  25. Guo J, Zhu C, Yang K et al (2017) Poly(C)-binding protein 1 mediates drug resistance in colorectal cancer. Oncotarget 8:13312–13319

    Article  PubMed  PubMed Central  Google Scholar 

  26. De Sousa E, Melo F, Wang X et al (2013) Poor-prognosis colon cancer is defined by a molecularly distinct subtype and develops from serrated precursor lesions. Nat Med 19:614–618

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank Dr. Eichi Sasaki and Dr. Yasushi Yatabe (Aichi Cancer Center Hospital, Department of Pathology and Molecular Diagnostics) for pathological diagnosis. We also thank JAM Post Inc. (WA, USA) for proofreading our draft.

Author information

Author notes

  1. Akira Ouchi and Kazuhiro Toriyama contributed equally to this work.

Authors and Affiliations

  1. Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa, Nagoya, Aichi, 464-8681, Japan

    Akira Ouchi, Takashi Kinoshita, Yasuhiro Shimizu & Koji Komori

  2. Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan

    Kazuhiro Toriyama

  3. Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan

    Tsutomu Tanaka, Yasumasa Niwa & Masahiro Tajika

Authors
  1. Akira Ouchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kazuhiro Toriyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takashi Kinoshita
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tsutomu Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yasuhiro Shimizu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yasumasa Niwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Masahiro Tajika
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Koji Komori
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Koji Komori.

Ethics declarations

Conflict of interest

All authors have no potential conflicts of interest, financial or otherwise.

Ethical approval

The present experimental protocols were approved by the institutional review committee at ACCH.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ouchi, A., Toriyama, K., Kinoshita, T. et al. Variations in clinical features and oncologic behaviors of T1 colorectal cancer according to tumor location. Int J Clin Oncol 25, 1130–1136 (2020). https://doi.org/10.1007/s10147-020-01642-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10147-020-01642-9

Keywords

Search

Navigation