1/27/2024 0 Comments Hepatic flexture![]() If your colorectal tumor is left-sided, also known as distal, (located in the splenic flexure, descending colon, sigmoid colon, or rectum) Bevacizumab added to conventional chemotherapy is more effective than EGFR inhibitors combined with conventional chemotherapy in right-sided cancers.Immune checkpoint inhibitors use your own immune system to kill cancer cells by promoting stronger responses against cancer cells from white blood cells in your tumor (tumor-infiltrating lymphocytes).Immunotherapy with immune checkpoint inhibitors, such as pembrolizumab (Keytruda), nivolumab (Opdivo), and ipilimumab (Yervoy), is often effective against right-sided colorectal cancer.If your colorectal cancer is right-sided, also known as proximal, (located in the cecum, ascending colon, hepatic flexure, or transverse colon) How do my tumor location or tumor sidedness results impact my treatment? The specific location of your colorectal tumor will also be noted, such as splenic flexure, sigmoid colon, or rectum. Tumor location may be reported as “right-sided” or “left-sided”, or as “proximal” or “distal”. How is tumor location or tumor sidedness reported? It can be noted in reports from surgical procedures like colonoscopy and colectomy (colon resection), or in pathology reports that describe the histology (microscopic characteristics) of your colorectal carcinoma. It may be described in imaging reports like CT scan, PET scan, or MRI scan. The location of your colorectal cancer (CRC) may be identified in several ways. How is tumor location or tumor sidedness determined? Left-sided tumors tend to be polyp shaped and are more likely to be tubular or villous adenocarcinomas. Right-sided tumors tend to be flat shaped and are more likely to be part of the mucinous subgroup of adenocarcinomas. Right-sided colon cancers and left-sided colorectal cancers may also have differences in their tumor shape and in their subtype of adenocarcinoma. Left-sided colon cancer has a better prognosis at advanced stages (stage III and stage IV / metastatic colorectal cancer). Right-sided colon cancer has a better prognosis in early stages (stage I and stage II). How are right-sided colon cancer and left-sided colorectal cancer different? The populations of normal gut bacteria (intestinal microbiome) that live in the large intestine vary between the right side of the colon and the left side of the colon and rectum.As digested food travels through the large intestine, the right and left sides are exposed to different nutrients and digestive substances, such as bile acids.The right and left sides of the colon develop from two different parts of the embryo, the midgut and the hindgut.Several factors likely contribute to the differences in right-sided colon cancers and left-sided colorectal cancers. Why are right sided colon cancers and left sided colon and rectal cancers different? ![]() Tumor sidedness gives information about the likely course of the disease (prognosis), and tumor location is a predictor of which treatments may be more or less effective for a particular colorectal cancer. ![]() Tumor location is both a prognostic factor and a predictive biomarker. Left-sided tumors, also called distal tumors, are located in the splenic flexure, descending colon, sigmoid colon, or rectum. Right-sided tumors, also known as proximal tumors, are located in the cecum, ascending colon, hepatic flexure, or the transverse colon. Often, colorectal cancer is referred to as “right sided” or “left sided”. Colorectal cancer (bowel cancer) can develop in any of these locations. The splenic flexure (left colic flexure) is the turning point between the transverse colon and descending colon. The hepatic flexure (right colic flexure) is the turning point between the ascending colon and transverse colon. The large intestine (bowel) is made up of 6 segments, cecum (caecum), ascending colon, transverse colon, descending colon, sigmoid colon, and rectum. Tumor location refers to the site of the primary tumor (tumour) of your colorectal cancer.
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