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Aim <p>To investigate whether colorectal cancer (CRC) sidedness is associated with intraoperative lavage cytology results, tumor recurrence, and prognosis.</p> Method <p>Using data from a multicenter prospective observational study conducted by the Japanese Society for Cancer of the Colon and Rectum (JSCCR), we retrospectively analyzed prognosis and recurrence patterns in pathological stage II/III right-sided and left-sided CRC, stratified by positive versus negative lavage cytology results.</p> Results <p>A total of 1500 patients met the inclusion criteria and were enrolled. Of these, 534 had right-sided CRC and 966 had left-sided CRC. Fifty-nine patients (3.9%) had positive lavage cytology. Among patients with recurrence, pT4, positive lavage cytology, and right-sided tumor location were independently associated with peritoneal recurrence.</p> <p>Among cytology-negative patients, the 5-year relapse-free survival (RFS) rate was significantly higher in right-sided than in left-sided CRC (79.6% vs. 73.4%, <i>p</i> = 0.01), whereas the 5-year overall survival (OS) rate did not differ significantly (89.2% vs. 87.7%, <i>p</i> = 0.52). Among cytology-positive patients, no statistically significant differences in RFS or OS were observed between tumor locations. However, among cytology-positive patients who developed recurrence, post-recurrence survival was significantly worse in right-sided CRC than in left-sided CRC (<i>p</i> = 0.04).</p> Conclusion <p>Among cytology-negative patients, left-sided CRC was associated with poorer RFS than right-sided CRC, although OS did not differ. Right-sided tumor location and positive lavage cytology were independently associated with peritoneal recurrence among patients who developed recurrence. Among cytology-positive patients, right-sided CRC was associated with poorer post-recurrence survival.</p>

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Evaluation of the prognostic impact of intraoperative cytology results according to tumor sidedness in stage II/III resectable colorectal cancer

  • 期刊论文

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  • 发表日期：

    2026年6月15日

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  • Akihiro Usui,
  • Hirotoshi Kobayashi,
  • Kenjiro Kotake,
  • Kotaro Maeda,
  • Takeshi Shuto,
  • Masayasu Kawasaki,
  • Koji Komori,
  • Heita Ozawa,
  • Chihiro Kosugi,
  • Masayuki Ohue,
  • Kimihiko Funahashi,
  • Ichiro Takemasa,
  • Hideyuki Ishida,
  • Shinsuke Kazama,
  • Yoshifumi Shimada,
  • Hajime Motohashi,
  • Yusuke Kinugasa,
  • Yukihide Kanemitsu,
  • Hiroki Ochiai,
  • Soichiro Ishihara,
  • Michio Itabashi,
  • Kenichi Sugihara,
  • Hideki Ueno

摘要

Aim

To investigate whether colorectal cancer (CRC) sidedness is associated with intraoperative lavage cytology results, tumor recurrence, and prognosis.

Method

Using data from a multicenter prospective observational study conducted by the Japanese Society for Cancer of the Colon and Rectum (JSCCR), we retrospectively analyzed prognosis and recurrence patterns in pathological stage II/III right-sided and left-sided CRC, stratified by positive versus negative lavage cytology results.

Results

A total of 1500 patients met the inclusion criteria and were enrolled. Of these, 534 had right-sided CRC and 966 had left-sided CRC. Fifty-nine patients (3.9%) had positive lavage cytology. Among patients with recurrence, pT4, positive lavage cytology, and right-sided tumor location were independently associated with peritoneal recurrence.

Among cytology-negative patients, the 5-year relapse-free survival (RFS) rate was significantly higher in right-sided than in left-sided CRC (79.6% vs. 73.4%, p = 0.01), whereas the 5-year overall survival (OS) rate did not differ significantly (89.2% vs. 87.7%, p = 0.52). Among cytology-positive patients, no statistically significant differences in RFS or OS were observed between tumor locations. However, among cytology-positive patients who developed recurrence, post-recurrence survival was significantly worse in right-sided CRC than in left-sided CRC (p = 0.04).

Conclusion

Among cytology-negative patients, left-sided CRC was associated with poorer RFS than right-sided CRC, although OS did not differ. Right-sided tumor location and positive lavage cytology were independently associated with peritoneal recurrence among patients who developed recurrence. Among cytology-positive patients, right-sided CRC was associated with poorer post-recurrence survival.