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Jimba M, Nakajima K, Momiyama M, Morikawa T, Satou S. Pathologic Complete Response and Long-Term Survival After Preoperative Chemotherapy for Transverse Colon Cancer With Para-Aortic Lymph Node Metastases. Cureus 2024; 16:e59363. [PMID: 38689672 PMCID: PMC11060184 DOI: 10.7759/cureus.59363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 05/02/2024] Open
Abstract
A 52-year-old male patient was diagnosed with transverse colon cancer and synchronous stage IVA para-aortic lymph node (PALN) metastases (cT3N1bM1a of the lymph node). Six courses of mFOLFOX6 plus bevacizumab were administered as neoadjuvant chemotherapy. Computed tomography showed shrinkage of the primary tumor and PALN metastases. Extended right hemicolectomy, D3 lymph node dissection, and PALN dissection were performed. A pathologic examination indicated that the tumor had completely changed and comprised necrotic tissue with no viable cells. Therefore, it was considered that mFOLFOX6 plus bevacizumab resulted in a pathologic complete response. Postoperatively, six courses of mFOLFOX6 were administered. Six years postoperatively, the patient did not exhibit any signs of recurrence. There have been few reports of pathologic complete response after neoadjuvant therapy and resection for colon cancer with synchronous PALN metastases. This report describes a unique case involving a pathologic complete response with long-term survival after mFOLFOX6 plus bevacizumab and radical resection, including PALN dissection. Preoperative mFOLFOX6 plus bevacizumab followed by radical resection and adjuvant mFOLFOX6 therapy was safe and resulted in a good outcome. This regimen should be considered for advanced colon cancer with PALN metastases.
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Xie F, Lu P, Chen Y, Liu X, Zou Z, Gan J. Laparoscopic radical surgery for locally advanced T4 transverse colon cancer and prognostic factors analysis: Evidence from multi-center databases. Medicine (Baltimore) 2023; 102:e36242. [PMID: 38050292 PMCID: PMC10695505 DOI: 10.1097/md.0000000000036242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/31/2023] [Indexed: 12/06/2023] Open
Abstract
The safety and efficacies of laparoscopic radical procedures are still controversial for locally advanced pathological T4 (pT4) TCC (transverse colon cancer). Therefore, the aim of this study is to evaluate the oncologic and perioperative outcomes and to recognize the prognostic factors in radical resection for pT4 TCC derived from multi-center databases. 314 patients with TCC who underwent radical resection between January 2004 and May 2017, including 139 laparoscopic resections and 175 open resections, were extracted from multicenter databases. Oncological as well as perioperative outcomes were investigated. The baseline characteristics of the 2 groups did not differ significantly. Nevertheless, the laparoscopic technique was found to be linked with a significantly longer duration of surgery (208.96 vs 172.89 minutes, P = .044) and a significantly shorter postoperative hospital stay (12.23 vs 14.48 days, P = .014) when compared to the conventional open approach. In terms of oncological outcomes, lymph node resection (16.10 vs 13.66, P = .886), 5-year overall survival (84.7% vs 82.7%, P = .393), and disease-free survival (82.7% vs 83.9%, P = .803) were similar between the 2 approaches. Based on multivariate analysis, it was determined that differentiation and N classification were both independent prognostic factors for overall survival. However, it was found that only N classification was an independent prognostic factor for disease-free survival. These findings underscore the significance of differentiation and N classification as key determinants of patient outcomes in this context. Overall, the laparoscopic approach may offer advantages in terms of shorter hospital stays, while maintaining comparable oncological outcomes. Laparoscopic radical procedure can gain a couple of short-term benefits without reducing long-term oncological survival for patients with pT4 TCC.
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Affiliation(s)
- Feng Xie
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Jiangxi, People’s Republic of China
| | - Pingfan Lu
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Jiangxi, People’s Republic of China
| | - Yuming Chen
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Jiangxi, People’s Republic of China
| | - Xiangjun Liu
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Jiangxi, People’s Republic of China
| | - Zhenhong Zou
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Jiangxi, People’s Republic of China
| | - Jinheng Gan
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Jiangxi, People’s Republic of China
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3
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Lv J, Chen H, Guan X, Zhao Z, Quan J, Zhang X, Liu Z, Jiang Z, Zheng Z, Wang X. Laparoscopic radical transverse colectomy with transrectal specimen extraction: A novel natural orifice specimen extraction procedure: A case report. J Minim Access Surg 2023; 19:440-442. [PMID: 37282427 PMCID: PMC10449054 DOI: 10.4103/jmas.jmas_13_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/13/2022] [Accepted: 06/28/2022] [Indexed: 06/08/2023] Open
Abstract
Transverse colon cancer accounts for about 10% of all colonic cancers. The resection of cancers in the transverse colon is technically more challenging, compared with other cancer locations in the colon because the variable anatomy of the middle colic vessels demands excellent surgical skills and the anatomical location of the transverse colon is related to major organs. We report a novel laparoscopic technique for the first time used in surgery of transverse colon cancer which combines a total intracorporeal anastomosis with natural orifice specimen extraction to solve the problems of traditional laparoscopic surgery. A 48-year-old male patient, whose diagnosis was transverse colon adenocarcinoma, was admitted to the hospital. The surgery was performed in accordance with the procedure of totally laparoscopic right hemicolectomy and the specimen was extracted by opening the rectum. Natural orifice specimen extraction surgery has many advantages, including less pain, better cosmesis and minimising risks of complications and also has comparable long-term outcomes compared to conventional laparoscopic surgery.
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Affiliation(s)
- Jingfang Lv
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haipeng Chen
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xu Guan
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhixun Zhao
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jichuan Quan
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoqian Zhang
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zheng Liu
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zheng Jiang
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhaoxu Zheng
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xishan Wang
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Klein J, Avin N, Gandhi S. Adenocarcinoma of the Transverse Colon Presenting as Anterior Abdominal Wall Abscess. HCA Healthc J Med 2023; 4:253-256. [PMID: 37434904 PMCID: PMC10332377 DOI: 10.36518/2689-0216.1482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
Introduction Locally invasive colon carcinoma comprises a small fraction of the incidence of colon carcinoma. Complications, such as perforation and obstruction, can occur in less than 0.5% of cases and often present differently based on location. Case Presentation We present a case of an 85-year-old woman who presented with an acute abdominal wall abscess which was caused by perforation of transverse colon carcinoma. Conclusion En-bloc resection increases 5-year survival, and adjuvant chemotherapy reduces the risk of recurrence in patients with stage II resectable colon carcinoma.
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Affiliation(s)
- Jenn Klein
- HCA Healthcare/USF Morsani College of Medicine GME Consortium
- HCA Florida Citrus Hospital, Inverness, FL
| | - Nima Avin
- HCA Healthcare/USF Morsani College of Medicine GME Consortium
- HCA Florida Citrus Hospital, Inverness, FL
| | - Sunil Gandhi
- HCA Healthcare/USF Morsani College of Medicine GME Consortium
- HCA Florida Citrus Hospital, Inverness, FL
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Liu XJ, Lang ZQ, Zhang W, Zhang XQ, Lu PF, Xie F, Liang B, Huang ZP, Zou ZH. Clinical and survival outcomes of colectomy for transverse colon cancer in elderly patients. Medicine (Baltimore) 2023; 102:e33046. [PMID: 36862857 PMCID: PMC9981399 DOI: 10.1097/md.0000000000033046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
It remains controversial whether elderly patients with transverse colon cancer present worse prognoses. Our study utilized evidence from multi-center databases to evaluate the perioperative and oncology outcomes of radical resection of colon cancer in elderly and nonelderly patients. In this study, we analyzed 416 patients with transverse colon cancer who underwent radical surgery from January 2004 to May 2017, including 151 elderly (aged ≥ 65 years) and 265 nonelderly (aged < 65 years) patients. We retrospectively compared the perioperative and oncological outcomes between these 2 groups. The median follow-up in the elderly and nonelderly groups was 52 and 64 months, respectively. There were no significant differences in the overall survival (OS) (P = .300) and disease-free survival (DFS) (P = .380) between the elderly and nonelderly groups. However, the elderly group had longer hospital stays (P < .001), a higher complication rate (P = .027), and fewer lymph nodes harvested (P = .002). The N classification and differentiation were significantly associated with OS based on univariate analysis, and the N classification was an independent prognostic factor for OS based on multivariate analysis (P < .05). Similarly, the N classification and differentiation were significantly correlated with the DFS based on univariate analysis. However, multivariate analysis indicated that the N classification was an independent prognostic factor for DFS (P < .05). In conclusion, the survival and surgical outcomes in elderly patients were similar to nonelderly patients. The N classification was an independent factor for OS and DFS. Even though elderly patients with transverse colon cancer present a higher surgical risk than nonelderly patients, performing radical resection in elderly patients can be an appropriate choice for treatment.
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Affiliation(s)
- Xiang-Jun Liu
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Jiangxi, People’s Republic of China
| | - Zhi-Quan Lang
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Jiangxi, People’s Republic of China
- Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, Wuhan, Hubei, People’s Republic of China
| | - Wei Zhang
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Jiangxi, People’s Republic of China
| | - Xiao-Qing Zhang
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Jiangxi, People’s Republic of China
| | - Ping-Fan Lu
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Jiangxi, People’s Republic of China
| | - Feng Xie
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Jiangxi, People’s Republic of China
| | - Bo Liang
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Jiangxi, People’s Republic of China
| | - Zhi-Ping Huang
- Departments of Hepatobiliary Surgery, General Hospital of Southern Theatre Command, Guangzhou, People’s Republic of China
- * Correspondence: Zhi-Ping Huang, Department of Hepatobiliary Surgery, General Hospital of Southern Theatre Command, Guangzhou 510010, China (e-mail: )
| | - Zhen-Hong Zou
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Jiangxi, People’s Republic of China
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Xu YX, Huang Y, Wang XJ, Ye DX, Chi P. Clinical significance of 206 station lymph node in transverse colon cancer. Cancer Med 2022; 11:2366-2376. [PMID: 35437894 PMCID: PMC9189469 DOI: 10.1002/cam4.4626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 12/30/2021] [Accepted: 01/20/2022] [Indexed: 11/15/2022] Open
Abstract
Background Lymph node (LN) metastasis is crucial in determining the prognosis and treatment options for colon cancer patients. Our work was to study whether the lymph nodes beyond D3 station in transverse colon cancer, especially 206 LN, should be dissected. Methods A total of 225 patients within our department were reviewed. The primary and secondary endpoints were overall survival (OS) and disease‐free survival (DFS). We employed Propensity score weighting (PSW) for weighing participants to balance observed confounders between the 206D+ group and the 206D− group. Results The rate of metastasis in station 206 was 9.3%. Only T stage (OR, 3.009; 95% CI, 1.018–8.892), N stage (OR, 9.818; 95% CI, 1.158–83.227), and M stage (OR, 26.126; 95% CI, 1.274–535.945) were an independent risk factor for 206 station metastasis in multivariate logistic analysis. The 206D+ group had a similarly survival than the 206D− group (3‐year DFS, 89.6% v 85.9%; p = 0.389; 3‐year OS, 94.6% v 85.3% p = 0.989). PSW further verified it. Metastasis of 206 station LN is not an independent prognostic factor, but a predictive factor of DFS. Conclusion Station 206 LN positive is a predictive factor for DFS. Only the patient with T1‐3, N+ who is at a high risk of 206 station LN metastases should consider dissecting 206 station LN.
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Affiliation(s)
- Yu Xin Xu
- Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Ying Huang
- Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Xiao Jie Wang
- Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Dao Xiong Ye
- Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Fuzhou, People's Republic of China
| | - Pan Chi
- Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Fuzhou, People's Republic of China
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Hojo D, Kawai K, Murono K, Nozawa H, Hata K, Tanaka T, Nishikawa T, Shuno Y, Kaneko M, Sasaki K, Emoto S, Ishii H, Sonoda H, Ishihara S. Establishment of deformable three-dimensional printed models for laparoscopic right hemicolectomy in transverse colon cancer. ANZ J Surg 2021; 91:E493-E499. [PMID: 33634953 DOI: 10.1111/ans.16659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Applications of three-dimensional (3-D) printed solid organ models for navigation and simulation were previously reported for abdominal surgeries, and their usefulness was shown by subjective evaluation. However, thus far, no study has examined the effect of intraoperative movements for tissue handling. Novel, deformable 3-D printed models of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) were created to optimize laparoscopic right hemicolectomy. The aim of this study was to establish a method using these individualized models for use in surgical practice. METHODS Deformable 3-D models for laparoscopic right hemicolectomy were created using a 3-D printing flexible filamentous material (thermoplastic polyurethane). Five patients with transverse colon cancer who underwent laparoscopic right hemicolectomy with D3 lymphadenectomy between April 2017 and September 2019 were enrolled in this study. Then, the created patient-specific models were compared with the previously recorded intraoperative video views. RESULTS Transverse colon mobilization changed the spatial arrangement of the branches of the SMA and SMV. The 3-D models reproduced the intraoperative view, although approaches to the dominant vessels to complete D3 lymphadenectomy may vary. CONCLUSIONS Deformable 3-D models of the SMA and SMV with added branches may aid in optimizing laparoscopic right hemicolectomy operations.
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Affiliation(s)
- Daisuke Hojo
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazushige Kawai
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Koji Murono
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroaki Nozawa
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keisuke Hata
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Toshiaki Tanaka
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takeshi Nishikawa
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasutaka Shuno
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Manabu Kaneko
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhito Sasaki
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shigenobu Emoto
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroaki Ishii
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hirofumi Sonoda
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Soichiro Ishihara
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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8
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Jiang Y, Zou Z, Zhang Z, Zhang Y, Sun Y, Liang B. Long-Term Outcomes of Radical Surgery for Transverse Colon Cancer Staged from I to IIIC. Cancer Manag Res 2020; 12:13043-13049. [PMID: 33376398 PMCID: PMC7765749 DOI: 10.2147/cmar.s244777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 10/28/2020] [Indexed: 11/23/2022] Open
Abstract
Background No study has reported the risk factors associated with the prognosis of patients with transverse colon cancer. Therefore, we aimed to demonstrate the long-term outcomes of transverse colon cancer patients undergoing radical surgery and explore the prognostic factors. Materials and Methods The clinical data of a total of 366 patients with transverse colon cancer staged from I to IIIC undergoing radical surgery from February 1992 to May 2017 were retrospectively analyzed. Clinicopathological features were recorded, and univariate and multivariate analyses were conducted to evaluate the association between the factors and overall survival (OS) as well as disease-free survival (DFS). Kaplan–Meier curves were generated to assess the association between TNM stage and OS and DFS, respectively. Results The median follow-up time was 62 months, and the 5-year OS and DFS rates were 87.5% and 86.5%, respectively. In addition, a significant difference was also found in the OS and DFS curves according to TNM stage. The N classification, vascular invasion, differentiation, preoperative CA199, preoperative CA125 and preoperative AFP were significantly associated with OS according to univariate analysis, while N classification and differentiation were independent prognostic factors for OS according to multivariate analysis (both P < 0.05). Similarly, N classification, vascular invasion, differentiation, preoperative CA199, preoperative CA125, and preoperative AFP were statistically correlated with DFS according to univariate analysis, while N classification and preoperative CA199 were independent prognostic factors for DFS according to multivariate analysis (both P < 0.05). Conclusion N classification was an independent factor for both OS and DFS, while differentiation and CA199 were independent prognostic factors only for OS and DFS, respectively.
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Affiliation(s)
- Yaofei Jiang
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China.,Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital, Wuhan University, Wuhan, Hubei Province, People's Republic of China
| | - Zhenhong Zou
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Zulei Zhang
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China.,Department of Cardiac Surgery, Ganzhou People's Hospital, Ganzhou, Jiangxi, People's Republic of China
| | - Yi Zhang
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Yuting Sun
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Bo Liang
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
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9
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Cremolini C, Benelli M, Fontana E, Pagani F, Rossini D, Fucà G, Busico A, Conca E, Di Donato S, Loupakis F, Schirripa M, Lonardi S, Borelli B, Ongaro E, Eason K, Morano F, Casagrande M, Fassan M, Sadanandam A, de Braud F, Falcone A, Pietrantonio F. Benefit from anti-EGFRs in RAS and BRAF wild-type metastatic transverse colon cancer: a clinical and molecular proof of concept study. ESMO Open 2019; 4:e000489. [PMID: 30962964 PMCID: PMC6435314 DOI: 10.1136/esmoopen-2019-000489] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/05/2019] [Accepted: 02/06/2019] [Indexed: 12/22/2022] Open
Abstract
Objective Primary tumour location is regarded as a reliable surrogate of colorectal cancer biology. Sensitivity to anti-EGFRs (Epidermal Growth Factor Receptor) of metastatic transverse colon cancers (mTCCs) has usually been assumed similar to right-sided tumours; however, evidence about the clinical behaviour of mTCC is limited. Thus, to verify sensitivity of mTCC to anti-EGFRs we conducted the present study. Methods Patients with RAS/BRAF wild-type microsatellite stable (MSS) mTCC receiving anti-EGFR monotherapy, or in combination with irinotecan if clearly irinotecan-refractory, were included. Hypothesising an overall response rate (ORR) of 35%, 11 patients, of whom at least 3 were responders, were necessary to be able to reject the null hypothesis of an ORR of 5%, with α and β errors of 0.05 and 0.20. PRESSING panel and consensus molecular subtypes (CMS) were assessed on tumour samples, whereas in-silico data were obtained from TCGA dataset. Results Among nine eligible patients, four and three achieved response and disease stabilisation (ORR 44%). At a median follow-up of 23.1 months, median progression-free survival and overall survival were 7.3 (95% CI 3.9 to NA) and 15.0 months (95% CI 10.0 to NA), respectively. A MET amplification and an ERBB4 S303F substitution were detected in patients with rapid disease progression, while others had PRESSING panel-negative tumours with CMS2 or CMS4 subtypes. Conclusions RAS/BRAF wild-type MSS mTCCs may be sensitive to anti-EGFRs, as confirmed by molecular analyses.
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Affiliation(s)
- Chiara Cremolini
- Unit of Medical Oncology 2, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.,Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Matteo Benelli
- Bioinformatics Unit, Oncology Department, Hospital of Prato, Prato, Italy
| | - Elisa Fontana
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK.,Centre for Molecular Pathology, Royal Marsden NHS Foundation Trust, London, UK
| | - Filippo Pagani
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Daniele Rossini
- Unit of Medical Oncology 2, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.,Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giovanni Fucà
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Adele Busico
- Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Elena Conca
- Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Samantha Di Donato
- Medical Oncology Unit, Oncology Department, Hospital of Prato, Prato, Italy
| | - Fotios Loupakis
- Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, IRCCS Istituto Oncologico Veneto, Padova, Italy
| | - Marta Schirripa
- Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, IRCCS Istituto Oncologico Veneto, Padova, Italy
| | - Sara Lonardi
- Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, IRCCS Istituto Oncologico Veneto, Padova, Italy
| | - Beatrice Borelli
- Unit of Medical Oncology 2, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.,Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Elena Ongaro
- Unit of Medical Oncology 2, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.,Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.,Department of Oncology, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Katherine Eason
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK
| | - Federica Morano
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Mariaelena Casagrande
- Department of Oncology, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Matteo Fassan
- Unit of Surgical Pathology, Department of Medicine, University of Padova, Padova, Italy
| | - Anguraj Sadanandam
- Division of Molecular Pathology, The Institute of Cancer Research, London, UK.,Centre for Molecular Pathology, Royal Marsden NHS Foundation Trust, London, UK
| | - Filippo de Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Alfredo Falcone
- Unit of Medical Oncology 2, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.,Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Filippo Pietrantonio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
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10
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Ozben V, de Muijnck C, Esen E, Aytac E, Baca B, Karahasanoglu T, Hamzaoglu I. Is Robotic Complete Mesocolic Excision Feasible for Transverse Colon Cancer? J Laparoendosc Adv Surg Tech A 2018; 28:1443-1450. [PMID: 29878855 DOI: 10.1089/lap.2018.0239] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction: Laparoscopic complete mesocolic excision (CME) for transverse colon cancer is technically challenging. Robotic technology has been developed to reduce technical limitations of laparoscopy. Yet, no data are available on the role of robotic approach for CME of transverse colon cancer. The aim of this study is to evaluate the feasibility and short-term outcomes of robotic CME in this subset of colon cancer. Methods: A retrospective review of a prospectively maintained database of 29 consecutive patients undergoing robotic CME for transverse colon adenocarcinoma between December 2014 and December 2017 was performed. Data on demographics, tumor characteristics, postoperative 30-day complications, and oncologic outcomes were analyzed. Results: There were 21 (72%) men and 8 women with a mean age of 62.9 ± 15.6 years and a body mass index of 26.4 ± 4.8 kg/m2. Of the 29 robotic CME procedures, 12 patients underwent extended right colectomy, 10 extended left colectomy, 6 subtotal colectomy, and 1 total colectomy. The mean operative time was 321.7 ± 111.3 minutes and estimated blood loss was 106.9 ± 110.9 mL (median, 50; range, 10-400 mL). The intra- and postoperative complication rates were 7% and 24%, respectively. There were no conversions. The mean time to first bowel movement was 3.5 ± 1.3 and length of hospital stay was 7.1 ± 3.0 days. All the resections were R0. The mean number of harvested lymph nodes in extended and subtotal/total colectomy procedures was 36.6 ± 13.1 and 71.0 ± 30.3, respectively. The rate of mesocolic plane surgery was 79%. There were no statistically significant differences between the mesocolic and the intramesocolic/muscularis propria plane resections with respect to clinical characteristics, operative outcomes, and pathology results (P > .05). Conclusions: Robotic CME for transverse colon cancer is feasible and can be a procedure of choice to achieve a good surgical quality.
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Affiliation(s)
- Volkan Ozben
- 1 Department of General Surgery, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Cansu de Muijnck
- 2 Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Eren Esen
- 2 Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Erman Aytac
- 1 Department of General Surgery, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Bilgi Baca
- 1 Department of General Surgery, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Tayfun Karahasanoglu
- 1 Department of General Surgery, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Ismail Hamzaoglu
- 1 Department of General Surgery, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
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11
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Guan X, Zhao Z, Yang M, Chen H, Chen W, Liu Z, Jiang Z, Chen Y, Wang G, Wang X. Whether partial colectomy is oncologically safe for patients with transverse colon cancer: a large population-based study. Oncotarget 2017; 8:93236-93244. [PMID: 29190993 PMCID: PMC5696259 DOI: 10.18632/oncotarget.21275] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 09/09/2017] [Indexed: 12/14/2022] Open
Abstract
Due to special tumor location and technical difficulty of transverse colon cancer (TCC), partial colectomy (PC) is being widely applied in selected TCC patients, instead of extended hemicolectomy (HC). However, the oncological safety of this less aggressive surgical approach is not well studied. Here, we identified 10344 TCC patients from Surveillance, Epidemiology, and End-Results (SEER) database. The surgical treatment for those patients included PC and HC. Firstly, we compared lymph nodes evaluations between patients treated with HC and PC, including median number of nodes, the rate of nodes ≥ 12 and the rate of node positivity. Then, 5-year cancer specific survival (CSS) was obtained. Kaplan-Meier methods and Cox regression models were performed to assess the correlations between prognostic factors and long-term survival. Despite of less node examined by PC, the rate of node positivity was equal between PC and HC, suggesting node retrieval under PC was adequate to tumor stage. In addition, the 5-year CSS for patients who underwent PC were 67.5%, which was similar to patients who received HC (66.5%). The result after propensity score matching also confirmed the equivalent survival outcome between HC and PC. However, subgroup analyses showed that patients with tumor size ≥ 5 cm could not obtain survival benefit from PC. Furthermore, surgical approach was not considered as independent prognostic factor for TCC patients. Therefore, although PC is a less aggressive surgical approach, it should be a safe and feasible option for selected TCC patients.
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Affiliation(s)
- Xu Guan
- Department of Colorectal Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhixun Zhao
- Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ming Yang
- Department of Colorectal Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haipeng Chen
- Department of Surgical Oncology, The First Affiliated Clinical Hospital of Qiqihaer Medical University, Qiqihaer, China
| | - Wei Chen
- Follow Up Center, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zheng Liu
- Department of Colorectal Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zheng Jiang
- Department of Colorectal Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yinggang Chen
- Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Guiyu Wang
- Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xishan Wang
- Department of Colorectal Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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12
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Yamaguchi S, Tashiro J, Araki R, Okuda J, Hanai T, Otsuka K, Saito S, Watanabe M, Sugihara K. Laparoscopic versus open resection for transverse and descending colon cancer: Short-term and long-term outcomes of a multicenter retrospective study of 1830 patients. Asian J Endosc Surg 2017; 10:268-275. [PMID: 28387060 DOI: 10.1111/ases.12373] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 02/13/2017] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Previous randomized controlled trials demonstrated similar oncological outcomes between laparoscopic and open colectomies, except for cases involving transverse colon and splenic flexure colon cancer. The objective of this study was to confirm the oncological safety and advantages of the short-term results of laparoscopic surgery for transverse and descending colon cancer in comparison with open surgery. METHODS The study data were retrospectively collected from the databases of 45 hospitals. Patients with transverse or descending colon cancer who underwent laparoscopic or open R0 resection were registered. The primary end-points were the 3-year overall survival and relapse-free survival rates according to pathological stage. The secondary end-points were the short-term results, including blood loss, operative time, diet intake, hospital stay, and postoperative complications. RESULTS Of the 1830 eligible patients, 872 underwent open colectomy and 958 underwent laparoscopic colectomy. The median follow-up period was 38.4 months. The conversion rate to open resection was 4.5%. The 3-year overall survival rate of the laparoscopic group was significantly higher than that of the open group for stage I patients (96.2% vs 99.2%; P = 0.04); it was also higher for stage II (94.0% vs 95.5%) and stage III (87.4% vs 90.2%) patients, but there were no significant differences. The 3-year relapse-free survival rate of the laparoscopic group was significantly higher than that of the open group for stage I patients; there were no differences between the open and laparoscopic groups among the stage II and III patients. In the multivariate analyses, laparoscopic resection was a significant factor in relapse-free survival. Laparoscopic patients had significantly lower blood loss and a significantly longer operative time than the open groups. Also, postoperative hospital stay was significantly shorter and postoperative morbidity was significantly lower in the laparoscopic group. CONCLUSION Although this retrospective study has limitations, we can conclude that laparoscopic surgery for transverse and descending colon cancer is oncologically safe and yields better short-term results than open surgery.
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Affiliation(s)
- Shigeki Yamaguchi
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Jo Tashiro
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Ryuichiro Araki
- Community Health Science Center, Saitama Medical University, Moroyama, Japan
| | - Junji Okuda
- Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki, Japan
| | - Tsunekazu Hanai
- Department of Colorectal Surgery, Fujita Health University, Toyoake, Japan
| | - Koki Otsuka
- Department of Surgery, Iwate Medical University, Morioka, Japan
| | - Shuji Saito
- Department of Surgery, National Hospital Organization Yokohama Medical Center, Yokohama, Japan.,Department of Surgery, Yokohama Shin-Midori General Hospital, Yokohama, Japan
| | - Masahiko Watanabe
- Department of Surgery, Kitasato University Hospital, Sagamihara, Japan
| | - Kenichi Sugihara
- Department of Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan
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13
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Wu Q, Wei M, Ye Z, Bi L, Zheng E, Hu T, Gu C, Wang Z. Laparoscopic Colectomy Versus Open Colectomy for Treatment of Transverse Colon Cancer: A Systematic Review and Meta-Analysis. J Laparoendosc Adv Surg Tech A 2017; 27:1038-1050. [PMID: 28355104 DOI: 10.1089/lap.2017.0031] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The surgical management of transverse colon cancer (TCC) is still not standardized. The aim of this meta-analysis was to evaluate the effect of laparoscopic colectomy (LC) for treatment of TCC in terms of short-term and long-term outcomes compared with open colectomy. METHOD A systematic literature search with no limits was performed in PubMed and Embase. The last search was performed on September 15, 2016. The short-term outcomes included intraoperative outcomes, postoperative outcomes, and oncological surgical quality. The long-term outcomes included overall survival (OS) and disease-free survival (DFS). RESULTS Thirteen articles and one conference abstract published between 2010 and 2016 with a total of 1728 patients were enrolled in this meta-analysis. LC was associated with significant less estimated blood loss, fewer total postoperative complications, and shorter time to first flatus, time to liquid diet, length of hospital stay, and length of postoperative hospital stay. However, longer operative time was needed in LC. There was no statistically significant difference between the groups concerning the intraoperative complications, mortality, ileus, anastomotic leakage, bleeding, wound infection, abdominal infection, lymph nodes harvested, proximal resection margin, distal resection margin, OS, or DFS. CONCLUSION Our meta-analysis suggests that LC is a safe and feasible technique for TCC associated with less estimated blood loss, fewer total postoperative complications, quicker recovery of intestinal function, shorter length of hospital stay, and equivalent long-term outcomes. Furthermore, a large-scaled, prospective randomized controlled study is warranted to verify those results.
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Affiliation(s)
- Qingbin Wu
- 1 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University , Chengdu, China .,2 West China School of Medicine, Sichuan University , Chengdu, China
| | - Mingtian Wei
- 1 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University , Chengdu, China .,3 State Key Laboratory of Biotherapy and Cancer Center/Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University , Chengdu, China
| | - Zengpanpan Ye
- 2 West China School of Medicine, Sichuan University , Chengdu, China
| | - Liang Bi
- 1 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University , Chengdu, China .,2 West China School of Medicine, Sichuan University , Chengdu, China
| | - Erliang Zheng
- 1 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University , Chengdu, China .,2 West China School of Medicine, Sichuan University , Chengdu, China
| | - Tao Hu
- 1 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University , Chengdu, China .,2 West China School of Medicine, Sichuan University , Chengdu, China
| | - Chaoyang Gu
- 1 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University , Chengdu, China .,2 West China School of Medicine, Sichuan University , Chengdu, China
| | - Ziqiang Wang
- 1 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University , Chengdu, China
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14
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Wang Y, Zhang C, Feng YF, Fu Z, Sun YM. Comparison of short-term outcomes between laparoscopic-assisted and open complete mesocolic excision (CME) for the treatment of transverse colon cancer. Chin Clin Oncol 2017; 6:6. [PMID: 28285536 DOI: 10.21037/cco.2017.01.01] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 12/21/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) is the third most common cancer worldwide. Although laparoscopic-assisted complete mesocolic excision (LCME) is a superior treatment, there are few studies available on it owe to the low incidence and technical difficulty of LCME in transverse colon cancer. METHODS The clinical data of 78 patients with transverse colon cancer who were treated by LCME and open complete mesocolic excision (OCME) were retrospectively analyzed. A total of 39 cases had been treated by LCME, compared with 39 cases treated by OCME. The patient characteristics and short-term outcomes including operation time, intra-operative blood loss, length of incision, time to first flatus, first postoperative ambulation, postoperative hospitalization time, number of harvested lymph nodes, length of resected specimen and incidence of complications were evaluated. RESULTS There was no case converted to OCME in LCME group. LCME had significantly shorter length of incision, shorter operation time, less intra-operative blood loss, shorter postoperative hospitalization time (P<0.05). The length of resected specimen and the numbers of harvested lymph nodes were (26.5±5.4 cm) and (16.2±3.1) in LCME group, and (24.8±4.9 cm) and (15.1±3.5) in OCME group, with no differences between two groups. The incidence of wound infection was lower while the incidence of lymphatic leakage, anastomotic leakage, urinary tract infection and wound dehiscence had no significant differences between two groups. None of patients in these two groups developed urinary retention, anastomotic bleeding and postoperative intestinal obstruction. CONCLUSIONS Our findings suggested that LCME is a safe, feasible and effective treatment method for the treatment of transverse colon cancer due to it can provide superior short-term outcomes including less intra-operative blood loss, faster recovery and lower incidence of wound infection.
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Affiliation(s)
- Yong Wang
- Department of Colorectal Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Chuan Zhang
- Department of Colorectal Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yi-Fei Feng
- Department of Colorectal Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zan Fu
- Department of Colorectal Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yue-Ming Sun
- Department of Colorectal Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
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15
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Sheng W, Zhang B, Chen W, Gu D, Gao W. Laparoscopic colectomy for transverse colon cancer: comparative analysis of short- and long-term outcomes. Int J Clin Exp Med 2015; 8:16029-16035. [PMID: 26629108 PMCID: PMC4658997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 06/21/2015] [Indexed: 06/05/2023]
Abstract
This study evaluated the short- and long-term outcomes of laparoscopic colectomy compared with open colectomy for patients with transverse colon cancer by matched-pair analysis. This study enrolled 59 patients who underwent laparoscopic colectomy and compared them with 59 matched patients who underwent open colectomy for transverse colon cancer. The following parameters were matched: clinical stage and type of resection. Both short- and long-term outcomes of laparoscopic colectomy were compared with those of open colectomy. No difference was observed between the two groups in terms of age, gender, ASA score, comorbidity, clinical stage and operative procedures. Regarding short-term outcomes, blood loss, time to first flatus, time to liquid diet and postoperative stay were significantly shorter in the laparoscopy group than in the open group, while operation time was significantly longer in the laparoscopy group than in the open group. Postoperative complication was similar between the two groups. With respect to long-term outcomes, the two groups did not differ significantly in terms of 5-year overall and disease-free survival. In summary, laparoscopic colectomy is a safe and feasible option for selected patients with transverse colon cancer. The short- and long-term outcomes of laparoscopic colectomy are considered to be acceptable.
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Affiliation(s)
- Weizheng Sheng
- Department of General Surgery, Zhongshan Hospital, Fudan University 180 Feng Lin Road, Shanghai 200032, People's Republic of China
| | - Bo Zhang
- Department of General Surgery, Zhongshan Hospital, Fudan University 180 Feng Lin Road, Shanghai 200032, People's Republic of China
| | - Weifeng Chen
- Department of General Surgery, Zhongshan Hospital, Fudan University 180 Feng Lin Road, Shanghai 200032, People's Republic of China
| | - Dayong Gu
- Department of General Surgery, Zhongshan Hospital, Fudan University 180 Feng Lin Road, Shanghai 200032, People's Republic of China
| | - Weidong Gao
- Department of General Surgery, Zhongshan Hospital, Fudan University 180 Feng Lin Road, Shanghai 200032, People's Republic of China
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Matsuda T, Fujita H, Kunimoto Y, Kimura T, Hayashi T, Maeda T, Yamakawa J, Mizumoto T, Ogino K. Clinical outcomes of laparoscopic surgery for transverse and descending colon cancers in a community setting. Asian J Endosc Surg 2013; 6:186-91. [PMID: 23323722 DOI: 10.1111/ases.12017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 11/01/2012] [Accepted: 12/09/2012] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The feasibility, safety and oncological outcomes of laparoscopic surgery for transverse and descending colon cancers in a community hospital setting were evaluated. METHODS Twenty-six patients with transverse or descending colon cancers who underwent laparoscopic surgery at our hospital were included in this retrospective analysis (group A). Their outcomes were compared with those of 71 patients who underwent laparoscopic surgery for colon cancer at other tumor sites (group B). RESULTS There were no significant differences between the two groups in terms of operative time, estimated blood loss, postoperative hospital stay and morbidity rate. Extended lymphadenectomy was performed more frequently and the number of harvested lymph nodes was significantly higher in group B than in group A. However, no recurrence developed in group A, while recurrence occurred in four patients from group B. The 3-year disease-free survival rates were 100% for group A and 93.5% for group B. The 3-year overall survival rates were 100% for group A and 91.6% for group B. CONCLUSIONS Laparoscopic surgery for transverse and descending colon cancers can be performed safely with oncological validity in a community hospital setting, provided there is careful selection of the patients and adequate lymphadenectomy considering the clinical stage of their disease.
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Affiliation(s)
- Takeru Matsuda
- Department of Surgery, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
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