Right sided colon cancer at Olabisi Onabanjo University Teaching Hospital, Sagamu Nigeria: a ten year review

Abstract

Recent studies suggest that right sided colon cancer may have a different clinicopathological behaviour and prognosis from carcinoma in the rest of the colon and especially the rectum. Reports in the Nigerian literature had usually considered colon and rectal cancer together, thereby masking these differences. This study is a ten year review of cases of right sided colon cancer seen in our hospital. Twenty-nine patients with operative and histological diagnosis of right sided colon cancer were managed between January 1994 and December 2003. They constituted 22% of all colorectal carcinoma seen over the same period. Sixteen were males and thirteen were females giving a male to female ratio of 1.23: 1. Age range was 35years to 79 years with a modal age of 54years. The most common clinical features were central abdominal colicky pain, weight loss, vomiting, abdominal mass and anaemia. Twelve patients (35%) presented with acute intestinal obstruction. Duration of symptoms ranged between three weeks and four years. 20% of the patients received antacids, antispasmodics, and herbal remedies for up to three years prior to presentation. Seven were Duke's stage C while twenty two were stage D. Right hemicolectomy was performed in thirteen cases (45%) and bypass with tumour biopsy in sixteen (55%). At one year following treatment 24% were alive, 41% were dead and 35% were lost to follow up. Prognosis is poor in right sided colon cancer due to advanced stage at presentation. The disease is usually advanced by the time symptoms appear. Presymptomatic diagnosis through screening and prompt treatment provides the best opportunity for improved survival.

Keywords: colon cancer, prognosis, right hemicolectomy, clinical features

Nigerian Medical Practitioner Vol. 49(4) 2006: 82-84