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Metastasis to lymph nodes around the vascular tie worsens long-term oncological outcomes following complete mesocolic excision and conventional colectomy for right-sided colon cancer

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Abstract

Background

Oncologic outcomes after complete mesocolic excision (CME) in colon cancer are under investigation. The aim of our study was to compare CME and conventional colectomy (CC) in terms of pathological and oncological outcomes for right colon cancer and to evaluate the impact of lymph node metastasis around the vascular tie on survival.

Methods

Consecutive patients with right colon cancer who had CME or CC between January 2011 and August 2018 at two specialized centers in Turkey were included. Statistical analyses were performed with respect to demographic characteristics, operative and pathologic outcomes, harvested and metastatic lymph nodes around the vascular tie (LNVT), recurrences, and survival.

Results

There were 91 patients in the CME group (58 males, mean age 64 ± 16 years) and 192 patients in the CC group (96 males, mean age 66 ± 14 years). The mean number of harvested lymph nodes (CME: 42 ± 15 vs CC: 34 ± 13, p = 0.01) and LNVT were higher in the CME group (CME: 3.2 ± 2.2 vs CC: 2.4 ± 1.6, p = 0.001). LNVT metastases were 7.7% and 8.3% in the CME and CC groups, respectively (p = 0.85). Three-year overall and disease-free survival rates were 96.4% and 90.9% in the CME group and 90.4% and 87.6% in the CC group in stage I–III patients (p > 0.05). In stage III patients, the 3-year overall survival (92.5% vs 63.5%, p = 0.03) and disease-free survival (85.6% vs 52.1%, p = 0.008) were significantly better in LNVT-negative patients than in LNVT-positive patients.

Conclusion

LNVT metastasis seems to be the key factor associated with poor disease-free and overall survival in right colon cancer regardless of the radicality of surgery.

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Availability of data and material

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of General Surgery, VKF American Hospital, Guzelbahce Street, No: 20, Sisli, Istanbul, Turkey

    Serkan Zenger, Bulent Gurbuz & Dursun Bugra

  2. Department of General Surgery, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey

    Erman Aytac, Volkan Ozben, Bilgi Baca, Ismail Hamzaoglu & Tayfun Karahasanoglu

  3. Department of General Surgery, School of Medicine, Koc University, Istanbul, Turkey

    Emre Ozoran, Emre Balik & Dursun Bugra

Authors
  1. Serkan Zenger
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  2. Erman Aytac
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Contributions

All the authors contributed to the study conception. SZ conceived the idea and designed this study. SZ, EA, BG, VO, and EO performed data collection and analysis. SZ wrote the first draft of the manuscript. SZ, BB, EB, IH, TK, and DB supervised the entire study. SZ, EA, and DB revised the manuscript for intellectual content. All the authors reviewed and approved the final version of the manuscript.

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Correspondence to Serkan Zenger.

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The authors declare that they have no conflict of interest.

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The study protocol was approved by the Institutional Review Board (Reference number: 2019.249.IRB1.046).

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Informed consent was obtained from all individual participants included in the study.

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Zenger, S., Aytac, E., Gurbuz, B. et al. Metastasis to lymph nodes around the vascular tie worsens long-term oncological outcomes following complete mesocolic excision and conventional colectomy for right-sided colon cancer. Tech Coloproctol 25, 309–317 (2021). https://doi.org/10.1007/s10151-020-02378-4

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