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Surg Today. 2014 Sep;44(9):1685-91. doi: 10.1007/s00595-013-0748-5. Epub 2013 Oct 16.

Difference in the recurrence rate between right- and left-sided colon cancer: a 17-year experience at a single institution.

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Department of Surgery, School of Medicine, Keio University, 35 Shinano-machi, Shinjuku-ku, Tokyo, Japan,



The prognostic differences between right- and left-sided colon cancer are controversial. This study aimed to clarify the clinical difference between right- and left-sided colon cancer.


We enrolled 820 patients with stage I/II/III colon cancer who underwent radical surgery with curative intent. We explored the impact of the tumor location on the postoperative disease-free survival (DFS) rate using the univariate and multivariate analyses.


Right-sided disease occurred in 399 of the 820 patients. The mean follow-up period was 55.8 ± 34.9 months. The pathological stage distribution was as follows: stage I 261 patients; stage II 283; and stage III 251. There were no significant differences in the five-year DFS of the overall populations (right 88.6%; left 89.4%; P = 0.231). The subgroup analyses demonstrated that patients with stage I right-sided colon cancer had a significantly better 5-year DFS rate than did those with left-sided disease (100 vs. 95.2%, P = 0.034). There were no significant differences in the distributions of the first recurrent sites (P = 0.559).


The tumor location may contribute to postoperative tumor recurrence. However, these effects were inconsistent across tumor stages. Our results provide a better understanding of the prognostic disparity between tumor locations; this may improve patient consent and postoperative surveillance.

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