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Pancreatic or duodenal resection or both for advanced carcinoma of the right colon

Is it justified?

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: The role of extended resections for locally advanced carcinomas of the right colon infiltrating duodenum and pancreas remains unclear. This investigation was undertaken to review our experience with pancreatic head or duodenal resections for advanced right-sided colon cancer. METHODS: The clinical, pathologic, and follow-up details of eight patients with bulky primary carcinomas of the right colon infiltrating the duodenum (n=4) or pancreatic head (n=4) surgically managed at Memorial Sloan-Kettering Cancer Center between 1986 and 1998 were reviewed. RESULTS: Six patients presented with anemia, and one patient each with epigastric pain and an abdominal mass. All patients had T4 lesions, whereas five had lymph node metastases at presentation. All patients were resected with clear pathologic margins either by right colectomy anden bloc duodenectomy (n=4), oren bloc pancreaticoduodenectomy (n=4). The 30-day mortality rate was zero. Six patients remained alive and free of disease at a median follow-up of 26 months, and there was one long-term survivor who was alive and free of disease at 84 months after resection. CONCLUSION: Extended resection for localized primary colonic carcinoma invading pancreas or duodenum can be undertaken safely and is associated with prolonged survival time.

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Authors and Affiliations

  1. Gastric and Mixed Tumor Services, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York

    Kevin Conlon M.D.

  2. Colorectal Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, 10021, New York, New York

    Jonathan B. Koea M.D., Philip B. Paty M.D., Jose G. Guillem M.D. &  Alfred M. Cohen M.D. (Chief)

Authors
  1. Jonathan B. Koea M.D.
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  2. Kevin Conlon M.D.
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  3. Philip B. Paty M.D.
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  4. Jose G. Guillem M.D.
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  5. Alfred M. Cohen M.D.
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Additional information

Dr. Koea is supported by the Eru Pomare Fellowship from the Health Research Council of New Zealand.

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Koea, J.B., Conlon, K., Paty, P.B. et al. Pancreatic or duodenal resection or both for advanced carcinoma of the right colon. Dis Colon Rectum 43, 460–465 (2000). https://doi.org/10.1007/BF02237187

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