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.
Keywords: Colorectal neoplasms; Endoscopic mucosal resection; Lymphatic metastasis.