Clinical-Pathologic Characteristics and Long-term Outcomes of Left Flexure Colonic Cancer: A Retrospective Analysis of an International Multicenter Cohort

Corrado Pedrazzani, Giulia Turri, Soo Yeun Park, Koya Hida, Yudai Fukui, Jacopo Crippa, Giovanni Ferrari, Matteo Origi, Gaya Spolverato, Matteo Zuin, Sung Uk Bae, Seong Kyu Baek, Andrea Costanzi, Dario Maggioni, Gyung Mo Son, Andrea Scala, Timothy Rockall, Alfredo Guglielmi, Gyu Seog Choi, David W. Larson

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Colorectal cancer seldom presents at the splenic flexure. Small series on left flexure tumors reported a high occurrence of negative prognostic factors called into question as causes of poor prognosis. However, because of the small number of cases, no definite conclusions can be drawn. OBJECTIVE: The aim of this study was to compare clinical-pathologic characteristics and short- and long-term outcomes of left flexure tumors with other colonic locations. DESIGN: This was a retrospective analysis of consecutive patients who underwent surgery for tumors at the splenic flexure. Each tumor was paired in a 1 to 1 fashion with a right-sided and sigmoid tumor. SETTINGS: The study was conducted in 10 international centers. PATIENTS: A total of 641 patients with left flexure tumors were included in the study. MAIN OUTCOME MEASURES: Overall survival and cancer-specific survival were measured. RESULTS: Left flexure tumors presented more frequently with stenosis (30.5%; p < 0.001), with lesions infiltrating beyond the serosa (21.9%; p = 0.001) and with a high rate of mucinous histology (8.8%; p = 0.001). Looking at long-term prognosis, no differences were observed among the 3 groups, both considering overall and cancer-specific survival. However, left flexure tumors recurred more frequently as peritoneal carcinomatosis (20.6%; p < 0.001). LIMITATIONS: This study was limited because of its retrospective nature. CONCLUSIONS: Although left flexure tumors display several negative prognostic factors, they are not characterized by a worse prognosis compared with other colon cancer locations.

Original languageEnglish (US)
Pages (from-to)1593-1601
Number of pages9
JournalDiseases of the colon and rectum
DOIs
StateAccepted/In press - 2020

Keywords

  • Colon cancer
  • Left flexure
  • Prognosis
  • Splenic flexure
  • Surgical treatment

ASJC Scopus subject areas

  • Gastroenterology

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