{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T13:42:03Z","timestamp":1783690923955,"version":"3.55.0"},"reference-count":75,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T00:00:00Z","timestamp":1716940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The purpose of the study was to analyze the relationships among several clinical factors and also the tumor topography and surgical strategies used in patients with colorectal cancer. Materials and Methods: We designed an analytical, observational, retrospective study that included patients admitted to our emergency surgical department and diagnosed with colorectal cancer. The study group inclusion criteria were: patients admitted during 2020\u20132022; patients diagnosed with colorectal cancer (including the ileocecal valve); patients who benefited from a surgical procedure, either emergency or elective. Results: In our study group, consisting of 153 patients, we accounted for 56.9% male patients and 43.1% female patients. The most common clinical manifestations were pain (73.2% of the study group), followed by abdominal distension (69.3% of the study group) and absence of intestinal transit (38.6% of the study group). A total of 69 patients had emergency surgery (45.1%), while 84 patients (54.9%) benefited from elective surgery. The most frequent topography of the tumor was the sigmoid colon, with 19.60% of the patients, followed by the colorectal junction, with 15.68% of the patients, and superior rectum and inferior rectum, with 11.11% of the patients in each subcategory. The most frequent type of procedure was right hemicolectomy (21.6% of the study group), followed by rectosigmoid resection (20.9% of the study group). The surgical procedure was finished by performing an anastomosis in 49% of the patients, and an ostomy in 43.1% of the patients, while for 7.8% of the patients, a tumoral biopsy was performed. Conclusions: Colorectal cancer remains one of the most frequent cancers in the world, with a heavy burden that involves high mortality, alterations in the quality of life of patients and their families, and also the financial costs of the medical systems.<\/jats:p>","DOI":"10.3390\/medicina60060898","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T03:38:30Z","timestamp":1716953910000},"page":"898","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Emergency and Elective Colorectal Cancer\u2014Relationship between Clinical Factors, Tumor Topography and Surgical Strategies: A Cohort Study"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0535-7100","authenticated-orcid":false,"given":"Ionu\u0163 Simion","family":"Coman","sequence":"first","affiliation":[{"name":"10th Clinical Department\u2014General Surgery, Discipline of General Surgery\u2014\u201cBagdasar-Arseni\u201d Clinical Emergency Hospital, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"General Surgery Department, \u201cBagdasar-Arseni\u201d Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluca Cristina","family":"Vital","sequence":"additional","affiliation":[{"name":"General Surgery Department, \u201cBagdasar-Arseni\u201d Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Violeta Elena","family":"Coman","sequence":"additional","affiliation":[{"name":"10th Clinical Department\u2014General Surgery, Discipline of General Surgery\u2014\u201cBagdasar-Arseni\u201d Clinical Emergency Hospital, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"General Surgery Department, \u201cBagdasar-Arseni\u201d Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosmin","family":"Burleanu","sequence":"additional","affiliation":[{"name":"General Surgery Department, \u201cBagdasar-Arseni\u201d Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6022-2236","authenticated-orcid":false,"given":"Mircea","family":"Li\u0163escu","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery and General Anesthesia, Discipline of Surgery and General Anesthesia\u2014\u201cSf. Ioan\u201d Clinical Emergency Hospital, Faculty of Dental Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"General Surgery Department, \u201cSf. Ioan\u201d Clinical Emergency Hospital, 13 Vitan-B\u00e2rze\u015fti Road, 042122 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1664-0291","authenticated-orcid":false,"given":"Costin George","family":"Florea","sequence":"additional","affiliation":[{"name":"General Surgery Department, \u201cBagdasar-Arseni\u201d Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Alin","family":"Cristian","sequence":"additional","affiliation":[{"name":"10th Clinical Department\u2014General Surgery, Discipline of General Surgery\u2014\u201cCol\u0163ea\u201d Clinical Hospital, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"General Surgery Department, \u201cCol\u0163ea\u201d Clinical Hospital, 1 Ion C. Br\u0103tianu Boulevard, 030167 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5340-8929","authenticated-orcid":false,"given":"Gabriel-Petre","family":"Gorecki","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cTitu Maiorescu\u201d University, 67A Gheorghe Petra\u015fcu Street, 031593 Bucharest, Romania"},{"name":"Department of Anesthesia and Intensive Care, CF2 Clinical Hospital, 63 M\u0103r\u0103\u015fti Boulevard, 011464 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4006-5397","authenticated-orcid":false,"given":"Petru Adrian","family":"Radu","sequence":"additional","affiliation":[{"name":"10th Clinical Department\u2014General Surgery, Discipline of General Surgery\u2014\u201cDr. Carol Davila\u201d Clinical Nephrology Hospital, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"General Surgery Department, \u201cDr. Carol Davila\u201d Clinical Nephrology Hospital, 4 Grivi\u0163ei Road, 010731 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iancu Emil","family":"Ple\u015fea","sequence":"additional","affiliation":[{"name":"Pathology Department, \u201cBagdasar-Arseni\u201d Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anwar","family":"Erchid","sequence":"additional","affiliation":[{"name":"General Surgery Department, \u201cBagdasar-Arseni\u201d Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentin Titus","family":"Grigorean","sequence":"additional","affiliation":[{"name":"10th Clinical Department\u2014General Surgery, Discipline of General Surgery\u2014\u201cBagdasar-Arseni\u201d Clinical Emergency Hospital, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"General Surgery Department, \u201cBagdasar-Arseni\u201d Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"609","DOI":"10.21037\/atm.2019.07.91","article-title":"Concise update on colorectal cancer epidemiology","volume":"7","author":"Mattiuzzi","year":"2019","journal-title":"Ann. Transl. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"998","DOI":"10.2174\/18735592MTEx9NTk2y","article-title":"Colorectal Cancer Epidemiology: Recent Trends and Impact on Outcomes","volume":"22","author":"Baidoun","year":"2021","journal-title":"Curr. Drug Targets"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1136\/gutjnl-2022-327736","article-title":"Global burden of colorectal cancer in 2020 and 2040: Incidence and mortality estimates from GLOBOCAN","volume":"72","author":"Morgan","year":"2023","journal-title":"Gut"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Sawicki, T., Ruszkowska, M., Danielewicz, A., Nied\u017awiedzka, E., Ar\u0142ukowicz, T., and Przyby\u0142owicz, K.E. (2021). A Review of Colorectal Cancer in Terms of Epidemiology, Risk Factors, Development, Symptoms and Diagnosis. Cancers, 13.","DOI":"10.3390\/cancers13092025"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/gastro\/got041","article-title":"Colorectal polyps and polyposis syndromes","volume":"2","author":"Shussman","year":"2014","journal-title":"Gastroenterol. Rep."},{"key":"ref_6","first-page":"335","article-title":"Physical status is the principal determinant of outcome after emergency admission of patients with colorectal cancer","volume":"75","author":"Kingston","year":"1993","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.ajem.2010.11.029","article-title":"Cancer diagnosis and outcomes in Michigan EDs vs other settings","volume":"30","author":"Sikka","year":"2012","journal-title":"Am. J. Emerg. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"4366","DOI":"10.1038\/s41598-022-08447-y","article-title":"Determinants of emergency presentation in patients with colorectal cancer: A systematic review and meta-analysis","volume":"12","author":"Golder","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1016\/j.surg.2018.06.044","article-title":"Obstruction predicts worse long-term outcomes in stage III colon cancer: A secondary analysis of the N0147 trial","volume":"164","author":"Dandaleh","year":"2018","journal-title":"Surgery"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3109\/0284186X.2014.975839","article-title":"Risk of recurrence in patients with colon cancer stage II and III: A systematic review and meta-analysis of recent literature","volume":"54","author":"Engelmann","year":"2015","journal-title":"Acta Oncol."},{"key":"ref_11","unstructured":"Bluegrass Coalition for Colorectal Screening, and KMA Cancer Committee (2005). Colorectal cancer facts. J. Ky. Med. Assoc., 103, 118."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"5167","DOI":"10.3748\/wjg.v21.i17.5167","article-title":"Sex- and gender-specific disparities in colorectal cancer risk","volume":"21","author":"Kim","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s00423-019-01850-6","article-title":"Gender comparison of clinical, histopathological, therapeutic and outcome factors in 185,967 colon cancer patients","volume":"405","author":"Schmuck","year":"2020","journal-title":"Langenbeck\u2019s Arch. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1038\/s41575-019-0189-8","article-title":"Global burden of colorectal cancer: Emerging trends, risk factors and prevention strategies","volume":"16","author":"Keum","year":"2019","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1055\/s-2005-916274","article-title":"Colorectal cancer: Epidemiology, risk factors, and health services","volume":"18","author":"Amersi","year":"2005","journal-title":"Clin. Colon Rectal Surg."},{"key":"ref_16","unstructured":"Th\u00e9lin, C., Sikka, S., Th\u00e9lin, C., and Sikka, S. (2015). Screening for Colorectal Cancer with Colonoscopy, IntechOpen Limited."},{"key":"ref_17","first-page":"89","article-title":"Epidemiology of colorectal cancer: Incidence, mortality, survival, and risk factors","volume":"14","author":"Rawla","year":"2019","journal-title":"Prz. Gastroenterol."},{"key":"ref_18","first-page":"8","article-title":"Worldwide Incidence and Mortality of Colorectal Cancer and Human Development Index (HDI): An Ecological Study","volume":"6","author":"Goodarzi","year":"2019","journal-title":"World Cancer Res. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2964","DOI":"10.1002\/cncr.31543","article-title":"The impact of the rising colorectal cancer incidence in young adults on the optimal age to start screening: Microsimulation analysis I to inform the American Cancer Society colorectal cancer screening guideline","volume":"124","author":"Peterse","year":"2018","journal-title":"Cancer"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1820","DOI":"10.1136\/gutjnl-2018-317592","article-title":"Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years","volume":"68","author":"Vuik","year":"2019","journal-title":"Gut"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"967","DOI":"10.2147\/CIA.S109285","article-title":"Colorectal cancer development and advances in screening","volume":"11","author":"Simon","year":"2016","journal-title":"Clin. Interv. Aging"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"30","DOI":"10.7812\/tpp\/11-128","article-title":"Early detection of colon cancer\u2014The kaiser permanente northwest 30-year history: How do we measure success? Is it the test, the number of tests, the stage, or the percentage of screen-detected patients?","volume":"15","author":"Moiel","year":"2011","journal-title":"Perm. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.clcc.2015.07.004","article-title":"Colorectal Cancer Initial Diagnosis: Screening Colonoscopy, Diagnostic Colonoscopy, or Emergent Surgery, and Tumor Stage and Size at Initial Presentation","volume":"15","author":"Moreno","year":"2016","journal-title":"Clin. Color. Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1002\/bjs.10573","article-title":"Clinical assessment to determine the risk of bowel cancer using Symptoms, Age, Mass and Iron deficiency anaemia (SAMI)","volume":"104","author":"Thompson","year":"2017","journal-title":"Br. J. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1111\/apt.12519","article-title":"Bleeding-related symptoms in colorectal cancer: A 4-year nationwide population-based study","volume":"39","author":"Hreinsson","year":"2014","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1850","DOI":"10.4251\/wjgo.v13.i12.1850","article-title":"Management of obstructive colon cancer: Current status, obstacles, and future directions","volume":"13","author":"Yoo","year":"2021","journal-title":"World J. Gastrointest. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1055\/s-0041-1729922","article-title":"Bowel Obstructions: Malignant Large Bowel Obstruction","volume":"34","author":"Muldoon","year":"2021","journal-title":"Clin. Colon Rectal Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.suc.2017.01.004","article-title":"Emergency Presentations of Colorectal Cancer","volume":"97","author":"Baer","year":"2017","journal-title":"Surg. Clin. N. Am."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1007\/s12029-012-9468-0","article-title":"Colorectal Cancer Emergencies","volume":"44","author":"Barnett","year":"2013","journal-title":"J. Gastrointest. Cancer"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1111\/j.1463-1318.2010.02270.x","article-title":"Emergency presentation of colon cancer is most frequent during summer","volume":"13","author":"Gunnarsson","year":"2011","journal-title":"Color. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.amsu.2020.04.033","article-title":"Emergency curative resection of colorectal cancer, do it with caution. A comparative case series","volume":"55","author":"Elmessiry","year":"2020","journal-title":"Ann. Med. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1080\/00015458.2008.11680207","article-title":"Does emergency surgery affect resectability of colorectal cancer?","volume":"108","author":"Pavlidis","year":"2008","journal-title":"Acta Chir. Belg."},{"key":"ref_33","first-page":"565","article-title":"Emergency colonic surgery: Analysis of risk factors predicting morbidity and mortality","volume":"61","author":"Costa","year":"2009","journal-title":"Chir. Ital."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1111\/j.1463-1318.2008.01613.x","article-title":"Short term outcome after emergency and elective surgery for colon cancer","volume":"11","author":"Sjo","year":"2009","journal-title":"Color. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"011","DOI":"10.5152\/UCD.2015.2969","article-title":"An evaluation of treatment results of surgery in emergency versus elective colorectal cancer patients","volume":"32","author":"Bayar","year":"2016","journal-title":"Turk. J. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.amjsurg.2005.01.045","article-title":"Presentation, treatment, and multivariate analysis of risk factors for obstructive and perforative colorectal carcinoma","volume":"190","author":"Alvarez","year":"2005","journal-title":"Am. J. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1007\/DCR.0b013e3181a1d8c9","article-title":"Emergency first presentation of colorectal cancer predicts significantly poorer outcomes: A review of 356 consecutive Irish patients","volume":"52","author":"Bass","year":"2009","journal-title":"Dis. Colon Rectum"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/S0009-739X(07)71674-3","article-title":"Long-term results of emergency surgery for colon cancer compared with elective surgery","volume":"82","author":"Biondo","year":"2007","journal-title":"Cir. Esp."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Marano, L., Carbone, L., Poto, G.E., Calomino, N., Neri, A., Piagnerelli, R., Fontani, A., Verre, L., Savelli, V., and Roviello, F. (2022). Antimicrobial Prophylaxis Reduces the Rate of Surgical Site Infection in Upper Gastrointestinal Surgery: A Systematic Review. Antibiotics, 11.","DOI":"10.3390\/antibiotics11020230"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"779","DOI":"10.7326\/0003-4819-113-10-779","article-title":"Colorectal cancer: Evidence for distinct genetic categories based on proximal or distal tumor location","volume":"113","author":"Bufill","year":"1990","journal-title":"Ann. Intern. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1002\/jso.20156","article-title":"Two colons-two cancers: Paradigm shift and clinical implications","volume":"88","author":"Gervaz","year":"2004","journal-title":"J. Surg. Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1002\/ijc.10635","article-title":"Are there two sides to colorectal cancer?","volume":"101","author":"Iacopetta","year":"2002","journal-title":"Int. J. Cancer"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.ejca.2017.07.016","article-title":"Understanding the role of primary tumour localisation in colorectal cancer treatment and outcomes","volume":"84","author":"Stintzing","year":"2017","journal-title":"Eur. J. Cancer"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"19","DOI":"10.5152\/eurasianjmed.2018.17092","article-title":"Eighteen Years\u2019 Retrospective Review of Colorectal Cancer Cases in Eastern Population","volume":"50","author":"Timuroglu","year":"2018","journal-title":"Eurasian J. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"365","DOI":"10.7326\/0003-4819-146-5-200703060-00010","article-title":"The use of aspirin for primary prevention of colorectal cancer: A systematic review prepared for the U.S. Preventive Services Task Force","volume":"146","author":"Rostom","year":"2007","journal-title":"Ann. Intern. Med."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Gao, Z., Guo, B., Gao, R., Zhu, Q., and Qin, H. (2015). Microbiota disbiosis is associated with colorectal cancer. Front. Microbiol., 6.","DOI":"10.3389\/fmicb.2015.00020"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Kohoutova, D., Smajs, D., Moravkova, P., Cyrany, J., Moravkova, M., Forstlova, M., Cihak, M., Rejchrt, S., and Bures, J. (2014). Escherichia coli strains of phylogenetic group B2 and D and bacteriocin production are associated with advanced colorectal neoplasia. BMC Infect. Dis., 14.","DOI":"10.1186\/s12879-014-0733-7"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1093\/aje\/kwr331","article-title":"Helicobacter pylori Infection and Colorectal Cancer Risk: Evidence From a Large Population-based Case-Control Study in Germany","volume":"175","author":"Zhang","year":"2012","journal-title":"Am. J. Epidemiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1136\/gutjnl-2015-309595","article-title":"Tumour-associated and non-tumour-associated microbiota in colorectal cancer","volume":"66","author":"Flemer","year":"2017","journal-title":"Gut"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1159\/000443644","article-title":"Right Sided Colon Cancer as a Distinct Histopathological Subtype with Reduced Prognosis","volume":"33","author":"Nitsche","year":"2016","journal-title":"Dig. Surg."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"5294","DOI":"10.1158\/1078-0432.CCR-15-0527","article-title":"Analysis of molecular markers by anatomic tumor site in stage III colon carcinomas from adjuvant chemotherapy trial NCCTG N0147 (Alliance)","volume":"21","author":"Sinicrope","year":"2015","journal-title":"Clin. Cancer Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"3238","DOI":"10.1158\/0008-5472.CAN-14-0013","article-title":"Colorectal cancer cell lines are representative models of the main molecular subtypes of primary cancer","volume":"74","author":"Mouradov","year":"2014","journal-title":"Cancer Res."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1002\/1097-0215(20001115)88:4<614::AID-IJC15>3.0.CO;2-0","article-title":"Genetic alterations in DNA diploid, aneuploid and multiploid colorectal carcinomas identified by the crypt isolation technique","volume":"88","author":"Sugai","year":"2000","journal-title":"Int. J. Cancer"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1093\/annonc\/mdu275","article-title":"Distal and proximal colon cancers differ in terms of molecular, pathological, and clinical features","volume":"25","author":"Missiaglia","year":"2014","journal-title":"Ann. Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"6470","DOI":"10.3748\/wjg.v21.i21.6470","article-title":"Different treatment strategies and molecular features between right-sided and left-sided colon cancers","volume":"21","author":"Shen","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"250","DOI":"10.22543\/7674.72.P250256","article-title":"Immunohistochemical pattern\u2013A prognostic factor for synchronous gastrointestinal cancer","volume":"7","author":"Alius","year":"2020","journal-title":"J. Mind Med. Sci."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Hemminki, K., Santi, I., Weires, M., Thomsen, H., Sundquist, J., and Bermejo, J.L. (2010). Tumor location and patient characteristics of colon and rectal adenocarcinomas in relation to survival and TNM classes. BMC Cancer, 10.","DOI":"10.1186\/1471-2407-10-688"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"dju247","DOI":"10.1093\/jnci\/dju427","article-title":"Primary tumor location as a prognostic factor in metastatic colorectal cancer","volume":"107","author":"Loupakis","year":"2015","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"4401","DOI":"10.1200\/JCO.2011.36.4414","article-title":"Mortality by stage for right-versus left-sided colon cancer: Analysis of surveillance, epidemiology, and end results\u2014Medicare data","volume":"29","author":"Weiss","year":"2011","journal-title":"J. Clin. Oncol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1200\/JCO.22.01690","article-title":"Treatment of Metastatic Colorectal Cancer: ASCO Guideline","volume":"41","author":"Morris","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1093\/bjs\/znad095","article-title":"Colorectal cancer: Current management and future perspectives","volume":"110","author":"Dohrn","year":"2023","journal-title":"Br. J. Surg."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1097\/DCR.0000000000001762","article-title":"The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Rectal Cancer","volume":"63","author":"You","year":"2020","journal-title":"Dis. Colon Rectum"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1097\/DCR.0000000000002323","article-title":"The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Colon Cancer","volume":"65","author":"Vogel","year":"2022","journal-title":"Dis. Colon Rectum"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1111\/j.1463-1318.2008.01735.x","article-title":"Standardized surgery for colonic cancer: Complete mesocolic excision and central ligation--technical notes and outcome","volume":"11","author":"Hohenberger","year":"2009","journal-title":"Color. Dis."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1016\/S0140-6736(86)91510-2","article-title":"Recurrence and survival after total mesorectal excision for rectal cancer","volume":"327","author":"Heald","year":"1986","journal-title":"Lancet"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"382","DOI":"10.26574\/maedica.2021.16.3.382","article-title":"Short-Course Radiotherapy versus Long-Course Radio-Chemotherapy as Neoadjuvant Treatment for Locally Advanced Rectal Cancer: Meta-Analysis from a Toxicity Perspective","volume":"16","author":"Liscu","year":"2021","journal-title":"Maedica"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"411","DOI":"10.47162\/RJME.62.2.07","article-title":"Assessment of clinical and pathological complete response after neoadjuvant chemoradiotherapy in rectal adenocarcinoma and its therapeutic implications","volume":"62","author":"Alexandrescu","year":"2021","journal-title":"Rom. J. Morphol. Embryol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1200\/JCO.22.00046","article-title":"Preoperative Chemotherapy for Operable Colon Cancer: Mature Results of an International Randomized Controlled Trial","volume":"41","author":"Morton","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1200\/JCO.21.02538","article-title":"Adjuvant Therapy for Stage II Colon Cancer: ASCO Guideline Update","volume":"40","author":"Baxter","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Liscu, H.D., Liscu, B.R., Mitre, R., Anghel, I.V., Antone-Iordache, I.L., Balan, A., Coniac, S., Miron, A.-I., and Halcu, G. (2023). The Conditioning of Adjuvant Chemotherapy for Stage II and III Rectal Cancer Determined by Postoperative Pathological Characteristics in Romania. Medicina, 59.","DOI":"10.3390\/medicina59071224"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1038\/s41591-020-0805-8","article-title":"Neoadjuvant immunotherapy leads to pathological responses in MMR-proficient and MMR-deficient early-stage colon cancers","volume":"26","author":"Chalabi","year":"2020","journal-title":"Nat. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"2363","DOI":"10.1056\/NEJMoa2201445","article-title":"PD-1 Blockade in Mismatch Repair-Deficient, Locally Advanced Rectal Cancer","volume":"386","author":"Cercek","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1200\/JCO.21.02691","article-title":"Mismatch Repair-Deficient Colorectal Cancer: Building on Checkpoint Blockade","volume":"40","author":"Jin","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer J. Clin."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/j.cgh.2020.02.026","article-title":"Differences in Incidence and Mortality Trends of Colorectal Cancer Worldwide Based on Sex, Age, and Anatomic Location","volume":"19","author":"Wong","year":"2021","journal-title":"Clin. Gastroenterol. Hepatol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/6\/898\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:49:54Z","timestamp":1760107794000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/6\/898"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,29]]},"references-count":75,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["medicina60060898"],"URL":"https:\/\/doi.org\/10.3390\/medicina60060898","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,29]]}}}