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Surgical and oncological outcomes after complete mesocolic excision in right-sided colon cancer compared with conventional surgery: a retrospective, single-institution study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

A Correction to this article was published on 07 December 2017

This article has been updated

Abstract

Purpose

The aim of the study was whether complete mesocolic excision (CME) with central vascular ligation (CVL) is associated with a survival benefit compared with traditional procedure in right-sided colon cancer.

Methods

Overall, 251 consecutive patients underwent surgery for right colon cancer between 2007 and 2012. After exclusion, 95 subjects received non-CME surgery before 2010, and 97 subjects received CME surgery after January 2010, when we started to perform CME systematically. The number of lymph nodes, morbidity, and mortality was analyzed. Overall survival (OS) and disease-specific survival (DSS) were investigated.

Results

The median number of examined lymph nodes was 33.28 in the CME group and 26.92 in the non-CME group, p < 0.001. Postoperative complications were 21.6% in the CME group and 17.8% in the non-CME group, without significant difference. One out of 192 patients died. Three-year OS was 88% in the CME group and 71% in the non-CME group (p = 0.003). In stage II, 3-year DSS was 97% in the CME group and 86% in the non-CME group. In stage III, the 3-year DSSs in the CME and in the non-CME groups were 86 and 67%, respectively (p < 0.001). Cox’s regression showed that CME (p = 0.0012), the number of lymph nodes (p = 0.029), and TNM stage (p < 0.001) were significant independent predictors of DSS at 3 years.

Conclusion

Surgical standardization of CME with CVL for right-sided colon cancer is associated with better staging and prognosis, particularly in UICC stage II and III. This study shows that CME is safe and reproducible with acceptable morbidity.

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Change history

  • 07 December 2017

    The publisher regrets that some errors were introduced during the production process. The errors are now presented correctly in this article.

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Acknowledgements

The authors would like to thank very much Professor Werner Hohenberger (Erlangen) for the special review and the precious support during the writing of the work.

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Authors and Affiliations

  1. Department of General Surgery, Hospital of Busto Arsizio (Va), Piazzale Solaro 3, 21052, Busto Arsizio, Italy

    Tommaso Zurleni, Alberto Cassiano, Elson Gjoni, Andrea Ballabio & Francesco Zurleni

  2. Department of Anatomical Pathology, Hospital of Busto Arsizio, Busto Arsizio, Italy

    Giovanni Serio

  3. Department of Medical Physics, Hospital of Busto Arsizio, Busto Arsizio, Italy

    Luca Marzoli

Authors
  1. Tommaso Zurleni
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  2. Alberto Cassiano
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  7. Francesco Zurleni
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Contributions

Study conception and design: T. Zurleni, F. Zurleni

Acquisition of data: T. Zurleni, A. Cassiano, E. Gjoni, A. Ballabio, G. Serio

Analysis and interpretation of data: T. Zurleni, F. Zurleni, A. Cassiano, E. Gjoni, A. Ballabio, G. Serio, L. Marzoli

Writing the manuscript: T. Zurleni, F. Zurleni

Corresponding author

Correspondence to Tommaso Zurleni.

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Conflicts of interest

The authors declare that they have no conflicts of interest.

Additional information

The original version of this article was revised: Modifications have been made to the Figure 3 images, Figures 3 and 4 captions and also to the entries of Tables 1 and 3. Full information regarding corrections made can be found in the erratum/correction article for this article.

A correction to this article is available online at https://doi.org/10.1007/s00384-017-2936-z.

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Zurleni, T., Cassiano, A., Gjoni, E. et al. Surgical and oncological outcomes after complete mesocolic excision in right-sided colon cancer compared with conventional surgery: a retrospective, single-institution study. Int J Colorectal Dis 33, 1–8 (2018). https://doi.org/10.1007/s00384-017-2917-2

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