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A Transverse Colectomy is as Safe as an Extended Right or Left Colectomy for Mid-Transverse Colon Cancer

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Abstract

Background

Although extended colectomy is often chosen for patients with transverse colon cancer, the optimal surgical approach for mid-transverse colon cancer has not been established.

Methods

We identified patients who underwent a transverse (TC) or an extended colectomy (EC) for mid-transverse colon cancer between 2004 and 2014. To adjust for potential selection bias between the groups, a propensity score matching analysis was performed.

Results

A total of 103 patients were included, of whom 63% underwent EC (right 47%, left 17%) and 37% TC. EC patients tend to have worse short-term outcomes. Although fewer lymph nodes were harvested after TC, 5-year overall (OS) ad disease-free survival (DFS) was comparable between the groups. When comparing long-term outcomes stage-by-stage, worse OS and DFS were seen in stage-II. All stage-II patients died of a non-cancer-related cause and recurrence occurred in pT4 TC patients who did not receive adjuvant therapy. The propensity-matched cohort demonstrated similar postoperative morbidity, but more laparoscopic procedures in EC. Additionally, TC tumors were correlated with poorer histopathological features and disease recurrence was only seen after TC.

Conclusion

Our study underlines the oncological safety of a transverse colectomy for mid-transverse colon cancer. Although TC tumors were associated with poorer histopathological features, survival rates were comparable.

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Abbreviations

AJCC:

American Joint Committee on Cancer

ASA:

American Society of Anesthesiologists

BMI:

Body mass index (kg/m2)

DFS:

Disease-free survival

EC:

Extended colectomy

EMVI:

Extramural vascular invasion

MSI-H:

High microsatellite instability

OS:

Overall survival

PSM:

Propensity score matching

pT:

Pathological T-staging

TC:

Transverse colectomy

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Funding

LL received a grant from the Prins Bernhard Cultuurfonds and Hendrik Muller’s Fonds.

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Authors and Affiliations

  1. Department of General and Gastrointestinal Surgery, Massachusetts General Hospital, Harvard Medical School, 15 Parkman Street, Boston, MA, 02114, USA

    Lieve G. J. Leijssen, Anne M. Dinaux, Ramzi Amri, Hiroko Kunitake, Liliana G. Bordeianou & David L. Berger

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  1. Lieve G. J. Leijssen
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  2. Anne M. Dinaux
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  3. Ramzi Amri
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  4. Hiroko Kunitake
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  5. Liliana G. Bordeianou
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  6. David L. Berger
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Corresponding author

Correspondence to David L. Berger.

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The authors have no conflict of interest, or financial ties to disclose.

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Leijssen, L.G.J., Dinaux, A.M., Amri, R. et al. A Transverse Colectomy is as Safe as an Extended Right or Left Colectomy for Mid-Transverse Colon Cancer. World J Surg 42, 3381–3389 (2018). https://doi.org/10.1007/s00268-018-4582-1

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  • DOI: https://doi.org/10.1007/s00268-018-4582-1

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