63P - Tumor sidedness and clinicopathological features of colorectal cancer in Medical Oncology Department, Yangon General Hospital: A retrospective review

Background

Colorectal cancer is one of the most common cancers in our country. Different clinicopathological features and outcome have been demonstrated between right and left CRC. In our study, we aim to characterize tumor sidedness, clinical profile and histological features of colorectal cancer to improve oncological care.

Methods

The data was retrospectively taken from Medical Oncology OPD Registry, YGH, over one year period from January, 2020 to December, 2020. Summary statistics were used to describe results.

Results

Total 225 (63 right side and 162 left side) patients were included in this study. Right sided tumor included from caecum to splenic flexure. Left sided one represented the remaining large bowel including rectum. The sites observed were caecum (6.6%), ascending colon (9.3%), hepatic flexure (6.6%), transverse colon (3.5%), splenic flexure (1.7%), descending colon (5.7%), sigmoid colon (7.5%), recto-sigmoid (12%) and rectum (46%) respectively. Mean age was 52 years, the youngest was 14 years and the oldest was 89 years. Forty percents of patients were <50 years of age. In right side, male patients (52%) were more than female patients (48%). In left side, slight female preponderance over male (51% Vs 49%) was seen. Presentation with intestinal obstruction or perforation was more commonly seen in right side (38%) than left side (22%). The most common histological subtype in both sides was moderately differentiated adenocarcinoma. Special subtype (mucinous and signet ring cell type) was more commonly seen in right side (24%) than left side (10.5%). More than 80% of patients came with advanced stage (stage III and IV) in both sides. The most common site of metastasis from both sides was peritoneum and liver.

Conclusions

In this study, there were more patients with left-sided CRC than right-sided. And like other countries, the burden of disease in younger patients is quite concerning. As most patients were diagnosed at advanced stage, necessary interventions for CRC awareness should be promoted. This study also highlights that clinicopathological differences exist between right and left colorectal cancer, possibly indicating prognostic significance that might improve the oncological care.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.