{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T22:25:41Z","timestamp":1791584741439,"version":"4.3.4"},"reference-count":50,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T00:00:00Z","timestamp":1617321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The incidence of early\u2010onset colorectal cancer (EOCRC) is rising. Left\u2010sided colorectal cancer (LCC) is associated with better survival compared to right\u2010sided colon cancer (RCC) in metastatic disease. NCCN guidelines recommend the addition of EGFR inhibitors to KRAS\/NRAS WT metastatic CRC originating from the left only. Whether laterality impacts survival in locoregional disease and EOCRC is of interest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>65,940 CRC cases from the National VA Cancer Cube Registry (2001\u20132015) were studied. EOCRC (2096 cases) was defined as CRC diagnosed at &lt;50\u00a0years. Using ICD codes, RCC was defined from the cecum to the hepatic flexure (C18.0\u2013C18.3), and LCC from the splenic flexure to the rectum (C18.5\u201318.7; C19 and C20).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>EOCRC is more likely to originate from the left side (66.65% LCC in EOCRC vs. 58.77% in CRC). Overall, LCC has better 5\u2010year Overall Survival (OS) than RCC in stages I (61.67% vs. 58.01%) and III (46.1% vs. 42.1%) and better 1\u2010year OS in stage IV (57.79% vs. 49.49%). Stage II RCC has better 5\u2010year OS than LCC (53.39% vs. 49.28%). In EOCRC, there is no statistically significant difference between LCC and RCC in stages I\u2010III. Stage IV EOCRC patients with LCC and RCC have a 1\u2010year OS of 73.23% and 59.84%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In EOCRC, LCC is associated with better OS than RCC only stage IV. In the overall population, LCC is associated with better OS in all stages except stage II. The better prognosis of stage II RCC might be due to the high incidence of mismatch repair deficient tumors in this subpopulation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.3757","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T10:40:12Z","timestamp":1617360012000},"page":"2987-2995","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["The impact of primary tumor sidedness on survival in early\u2010onset colorectal cancer by stage: A National Veterans Affairs retrospective analysis"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1008-1807","authenticated-orcid":false,"given":"Ibrahim","family":"Azar","sequence":"first","affiliation":[{"name":"Karmanos Cancer Institute Detroit MI USA"},{"name":"Wayne State University Detroit MI USA"},{"name":"Albany Medical College Albany NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada","family":"Al Masalmeh","sequence":"additional","affiliation":[{"name":"Wayne State University Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saghi","family":"Esfandiarifard","sequence":"additional","affiliation":[{"name":"University of Maryland Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurjiwan","family":"Virk","sequence":"additional","affiliation":[{"name":"Albany Medical College Albany NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wissam","family":"Kiwan","sequence":"additional","affiliation":[{"name":"Wayne State University Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Frank Shields","sequence":"additional","affiliation":[{"name":"Karmanos Cancer Institute Detroit MI USA"},{"name":"Wayne State University Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed","family":"Mehdi","sequence":"additional","affiliation":[{"name":"Stratton Veterans\u2019 Affairs Medical Center Albany NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A.","family":"Philip","sequence":"additional","affiliation":[{"name":"Karmanos Cancer Institute Detroit MI USA"},{"name":"Wayne State University Detroit MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21220"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21590"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djw322"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21457"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-14-767"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001326"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.1756"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11888-018-0412-y"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.61.4503"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.04.030"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djx104"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2019-0552"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.9.2413"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-019-07373-0"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.1558"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-019-07209-x"},{"key":"e_1_2_9_18_1","first-page":"10","article-title":"Colon cancer","volume":"97","author":"Blocks NE","year":"2018","journal-title":"Am Fam Phys"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)70330-4"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.3797"},{"issue":"23","key":"e_1_2_9_21_1","first-page":"2392","article-title":"Wild\u2010type advanced or metastatic colorectal","volume":"94158","author":"Venook AP","year":"2020","journal-title":"Cancer"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i17.5167"},{"issue":"6","key":"e_1_2_9_23_1","first-page":"A444","article-title":"Possible better long\u2010term survival in left versus right\u2010sided colon cancer \u2010 a systematic review","volume":"59","author":"Hansen IO","year":"2012","journal-title":"Dan Med J"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e3180338e56"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clcc.2015.07.004"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-113-10-779"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.10635"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu275"},{"key":"e_1_2_9_29_1","unstructured":"MarkowitzSD BertagnolliMM.Molecular basis of colorectal cancer.2009."},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm.3967"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.7105"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0167540"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.36.4414"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-016-2412-0"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-008-0015-y"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(98)00306-2"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.30.1366"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032709"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1713709"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30527-1"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32347"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED-D-11-00434"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2012.61"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31818afd6b"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.5754\/hge10849"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-013-1750-5"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.11540"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/00008469-199912001-00002"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-019-0253-4"},{"issue":"5","key":"e_1_2_9_50_1","first-page":"381","article-title":"The growing challenge of young adults with colorectal cancer","volume":"31","author":"Weinberg BA","year":"2017","journal-title":"Oncology (Williston Park)"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2018-0117"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.3757","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cam4.3757","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.3757","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T19:33:39Z","timestamp":1693596819000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.3757"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,2]]},"references-count":50,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1002\/cam4.3757"],"URL":"https:\/\/doi.org\/10.1002\/cam4.3757","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,2]]},"assertion":[{"value":"2020-10-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}