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Additional prognostic factors in right colon cancer staging

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Abstract

Based on the theory—which is now acknowledged—of a clinical difference between proximal and distal colon cancer and on the results of recent genetic and microbiological studies, a minority of authors have assumed that also in the sphere of right-sided colon cancer, tumors at three different locations, namely, the cecum and ascending and transverse colon, can be considered to be biologically different. These studies have provided the basis for a retrospective study carried out on 50 patients admitted to our department from 1996 to 2008 for tumor pathology of the right colon. The tumor was considered to be a unified biological entity and assessed in relation to the three above-mentioned locations. The results verify that the aggressive of the tumor increases from the cecum to the transverse, with a higher percentage of cecal tumors being in I stage, more tumors in the ascending colon being in II stage, and more transverse tumors, with the largest percentage of N+ and M+, in stages III and IV. This difference in biological behavior for the three tumor locations has been also found in terms of sensitiveness, both pre- and post-operation, of tumor markers CEA, TPA, and CA19-9. Clinical data revealed a binary relationship between the transverse, cecum, and ascending tumors, which ultimately affects patient mortality, which increases in a directly proportional way from the cecum to the transverse—in the case of a tumor at one of these locations.

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Authors and Affiliations

  1. Dipartimento di Scienze Anestesiologiche, Chirurgiche e dell’Emergenza, Seconda Università di Napoli, V.Aniello Falcone 290/A, 80100, Naples, Italy

    Domenico Parmeggiani, Adelmo Gubitosi, Francesco Gilio, Pietro Francesco Atelli & Massimo Agresti

  2. Dipartimento di Endocrinochirurgia, University Hospital of Terni, Terni, Italy

    Nicola Avenia

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  1. Domenico Parmeggiani
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  2. Nicola Avenia
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  3. Adelmo Gubitosi
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  4. Francesco Gilio
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  5. Pietro Francesco Atelli
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  6. Massimo Agresti
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Correspondence to Domenico Parmeggiani.

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Parmeggiani, D., Avenia, N., Gubitosi, A. et al. Additional prognostic factors in right colon cancer staging. Updates Surg 63, 155–161 (2011). https://doi.org/10.1007/s13304-011-0078-3

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  • DOI: https://doi.org/10.1007/s13304-011-0078-3

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