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Right Versus Left Colon Cancer: Resectable and Metastatic Disease

  • Lower Gastrointestinal Cancers (AB Benson, Section Editor)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

Colorectal cancer does not represent a single anatomic entity and side of origin has a key impact on prognosis and response to different systemic therapies. Compared to tumours arising in left colon, right colorectal cancers rely on the activation of different molecular pathways (e.g. BRAF mutation and MSI status). From a clinical point of view, this results in a different response to anti-EGFR agents. Current guidelines suggest the use of cetuximab or panitumumab in RAS wild-type disease and left colon cancer especially for cytoreduction/conversion purposes, since the expected benefit in right colon cancer is absent or clinically modest. The prognostic role of microbiota in colorectal cancer disease deserves more clarification before being considered in common clinical practice. Screening policies could also be affected by these new acquisitions. At the moment, sidedness should be considered as a strong prognostic variable and a surrogate predictor of different activity of anti-EGFR agents in the metastatic setting. Its role in early stages of resected disease is still uncertain.

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Authors and Affiliations

  1. Oncology Unit, Oncology Department, ASST of Cremona, Hospital of Cremona, Viale Concordia 1, 26100, Cremona, Italy

    Michele Ghidini & Gianluca Tomasello

  2. Oncology Unit, ASST Bergamo Ovest, Piazzale Ospedale 1, 24047, Treviglio, Italy

    Fausto Petrelli MD

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  1. Michele Ghidini
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Correspondence to Fausto Petrelli MD.

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Michele Ghidini, Fausto Petrelli, and Gianluca Tomasello declare they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Lower Gastrointestinal Cancers

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Ghidini, M., Petrelli, F. & Tomasello, G. Right Versus Left Colon Cancer: Resectable and Metastatic Disease. Curr. Treat. Options in Oncol. 19, 31 (2018). https://doi.org/10.1007/s11864-018-0544-y

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