Prognostic impact of primary tumor location in patients undergoing curative resection for colon cancer

Aim: Tumor sidedness is a well-established prognostic and predictive factor in metastatic colon cancer. However, its prognostic significance in patients undergoing curative surgical resection remains unclear. This study aimed to evaluate the impact of primary tumor location on oncologic outcomes in patients treated with curative-intent surgery for colon cancer.

Materials and Methods: This retrospective cohort study included 179 patients who underwent curative surgical resection between 2014 and 2025. Clinicopathological characteristics and tumor location were analyzed. Progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan – Meier analysis and Cox proportional hazards models.

Results: Tumor location was significantly associated with progression (p = 0.023). Patients with left-sided and rectosigmoid tumors demonstrated higher progression risk compared with right-sided tumors. In multivariate analysis, tumor location remained independently associated with progression risk. Tumor location was also associated with overall survival in univariate analysis; however, this finding did not remain significant after adjustment. Age was the only independent predictor of overall survival.

Conclusion: Primary tumor location may be independently associated with disease progression in patients undergoing curative-intent resection for colon cancer. Tumor location may provide additional prognostic value in non-metastatic disease.