Colorectal adenocarcinoma in Uganda: are right-sided and left-sided colon cancers two distinct disease entities?

Abstract Introduction In Western countries, right-sided colon cancers (RSCC) present at an older age and advanced stage. Researchers believe that there is a difference between left-sided colon cancer (LSCC) and RSCC. In Uganda, however, it is unknown whether differences exist in the pathological pro...

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Main Authors: Richard Wismayer, Julius Kiwanuka, Henry Wabinga, Michael Odida
Format: Article
Language:English
Published: BMC 2023-07-01
Series:World Journal of Surgical Oncology
Subjects:
Online Access:https://doi.org/10.1186/s12957-023-03094-7
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author Richard Wismayer
Julius Kiwanuka
Henry Wabinga
Michael Odida
author_facet Richard Wismayer
Julius Kiwanuka
Henry Wabinga
Michael Odida
author_sort Richard Wismayer
collection DOAJ
description Abstract Introduction In Western countries, right-sided colon cancers (RSCC) present at an older age and advanced stage. Researchers believe that there is a difference between left-sided colon cancer (LSCC) and RSCC. In Uganda, however, it is unknown whether differences exist in the pathological profile between RSCC and LSCC. The aim of this study was to determine the differences in clinicopathological characteristics between RSCC and LSCC in Ugandan patients. Methodology A cross-sectional study was conducted in which colorectal adenocarcinoma formalin-fixed paraffin-embedded tissue (FFPE) blocks were obtained from 2008 to 2021. Colorectal specimens were obtained from prospectively recruited patients. In the retrospective study arm, FFPE blocks and data were obtained from the archives of pathology laboratory repositories. Parameters studied included age, sex, location of the tumour, grade, stage, lymphovascular (LVI) status, and histopathological subtype between LSCC and RSCC. Results Patients with RSCC were not older than those with LSCC (mean age, 56.3 years vs 53.5 years; p = 0.170). There was no difference in the stage between RSCC and LSCC. Poorly differentiated tumours were more commonly found in RSCC than in LSCC (18.7% vs 10.1%; p = 0.038). Moderately and poorly differentiated colonic tumours were more common with RSCC (89.3%) than with LSCC (75.1%) (p = 0.007). Younger patients had more poorly differentiated tumours than older patients (19.6% versus 8.6%; p = 0.002). LVI was more common with RSCC than with LSCC (96.8% vs 85.3%; p = 0.014). Mucinous adenocarcinoma (MAC) was more common with RSCC (15.8%) compared with LSCC (8.5%) (p = 0.056) although statistical significance was borderline. Conclusions Clinicopathological features of RSCCs tend to be different from those of LSCCs. RSCCs tend to be associated with MAC, a higher grade and LVI status compared to LSCC. LSCC and RSCC present predominantly with an advanced stage; therefore, national screening programmes for the early detection of CRC are necessary to reduce mortality in our Ugandan population.
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spelling doaj.art-420d0067ac9d497986b20572910ce29e2023-07-23T11:16:16ZengBMCWorld Journal of Surgical Oncology1477-78192023-07-0121111310.1186/s12957-023-03094-7Colorectal adenocarcinoma in Uganda: are right-sided and left-sided colon cancers two distinct disease entities?Richard Wismayer0Julius Kiwanuka1Henry Wabinga2Michael Odida3Department of Surgery, Masaka Regional Referral HospitalDepartment of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere UniversityDepartment of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere UniversityDepartment of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere UniversityAbstract Introduction In Western countries, right-sided colon cancers (RSCC) present at an older age and advanced stage. Researchers believe that there is a difference between left-sided colon cancer (LSCC) and RSCC. In Uganda, however, it is unknown whether differences exist in the pathological profile between RSCC and LSCC. The aim of this study was to determine the differences in clinicopathological characteristics between RSCC and LSCC in Ugandan patients. Methodology A cross-sectional study was conducted in which colorectal adenocarcinoma formalin-fixed paraffin-embedded tissue (FFPE) blocks were obtained from 2008 to 2021. Colorectal specimens were obtained from prospectively recruited patients. In the retrospective study arm, FFPE blocks and data were obtained from the archives of pathology laboratory repositories. Parameters studied included age, sex, location of the tumour, grade, stage, lymphovascular (LVI) status, and histopathological subtype between LSCC and RSCC. Results Patients with RSCC were not older than those with LSCC (mean age, 56.3 years vs 53.5 years; p = 0.170). There was no difference in the stage between RSCC and LSCC. Poorly differentiated tumours were more commonly found in RSCC than in LSCC (18.7% vs 10.1%; p = 0.038). Moderately and poorly differentiated colonic tumours were more common with RSCC (89.3%) than with LSCC (75.1%) (p = 0.007). Younger patients had more poorly differentiated tumours than older patients (19.6% versus 8.6%; p = 0.002). LVI was more common with RSCC than with LSCC (96.8% vs 85.3%; p = 0.014). Mucinous adenocarcinoma (MAC) was more common with RSCC (15.8%) compared with LSCC (8.5%) (p = 0.056) although statistical significance was borderline. Conclusions Clinicopathological features of RSCCs tend to be different from those of LSCCs. RSCCs tend to be associated with MAC, a higher grade and LVI status compared to LSCC. LSCC and RSCC present predominantly with an advanced stage; therefore, national screening programmes for the early detection of CRC are necessary to reduce mortality in our Ugandan population.https://doi.org/10.1186/s12957-023-03094-7Colorectal adenocarcinomaStageGradeLymphovascular invasion (LVI)Right-sided colon cancerLeft-sided colon cancer
spellingShingle Richard Wismayer
Julius Kiwanuka
Henry Wabinga
Michael Odida
Colorectal adenocarcinoma in Uganda: are right-sided and left-sided colon cancers two distinct disease entities?
World Journal of Surgical Oncology
Colorectal adenocarcinoma
Stage
Grade
Lymphovascular invasion (LVI)
Right-sided colon cancer
Left-sided colon cancer
title Colorectal adenocarcinoma in Uganda: are right-sided and left-sided colon cancers two distinct disease entities?
title_full Colorectal adenocarcinoma in Uganda: are right-sided and left-sided colon cancers two distinct disease entities?
title_fullStr Colorectal adenocarcinoma in Uganda: are right-sided and left-sided colon cancers two distinct disease entities?
title_full_unstemmed Colorectal adenocarcinoma in Uganda: are right-sided and left-sided colon cancers two distinct disease entities?
title_short Colorectal adenocarcinoma in Uganda: are right-sided and left-sided colon cancers two distinct disease entities?
title_sort colorectal adenocarcinoma in uganda are right sided and left sided colon cancers two distinct disease entities
topic Colorectal adenocarcinoma
Stage
Grade
Lymphovascular invasion (LVI)
Right-sided colon cancer
Left-sided colon cancer
url https://doi.org/10.1186/s12957-023-03094-7
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AT henrywabinga colorectaladenocarcinomainugandaarerightsidedandleftsidedcoloncancerstwodistinctdiseaseentities
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