Abstract
Background
Right-sided colon cancers that invade the adjacent organs are often missed on preoperative imaging. These patients are often considered unresectable at laparotomy as the surgeon is not prepared for en bloc resections. A few centers have reported extended survival after en bloc resection in such tumors. We therefore decided to evaluate the outcome of our patients after en bloc right hemicolectomy.
Patients and methods
The records of all patients who underwent en bloc resection of adjacent organs for right colon cancers were analyzed.
Results
Between 1992 and 2004, 11 patients had an en bloc right hemicolectomy for right-sided colon cancer. There were ten males and one female with a mean age of 44 years (35–80 years). All patients had anaemia at presentation and most had weight loss and a fixed palpable lump. Preoperative CT scan was able to detect adjacent organ infiltration in nine patients. Six patients had an en bloc pancreaticoduodenectomy, three patients had en bloc local excision of duodenal wall, one patient had en bloc resection of segments 5 and 6 of the liver and one patient had en bloc distal gastrectomy. There was one operative mortality after an en bloc pancreaticoduodenectomy. The median disease-free survival was 54 months.
Conclusion
Right-sided colon cancers that invade adjacent organs in the absence of distant spread may be a subset of tumors that behave in a locally aggressive manner without causing hematogenous spread. En bloc resection of these tumors is possible, in select centers, with low mortality and morbidity and extended survival.
Similar content being viewed by others
References
Staniunas RJ, Schoetz DJ (1993) Extended resection for carcinoma of the colon and rectum. Surg Clin North Am 73:117–129
McGlone TP, Bemie WA, Elliot DW (1982) Survival following extended operations for extracolonic invasion by colon cancer. Arch Surg 117:595–599
Eldar S, Kemeny MM, Terz JJ (1985) Extended resections for the carcinoma of the colon and rectum. Surg Gynecol Obstet 161:319–322
Gall FP, Tonak J, Altendorf A (1987) Mutivisceral resections in colorectal cancers. Dis Colon Rectum 30:337–341
Hunter JA, Ryan JA Jr, Schultz P (1987) En bloc resection of colon cancer adherent to other organs. Am J Surg 154:67–71
Heslov SF, Frost DB (1988) Extended resection for primary colorectal carcinoma involving adjacent organs or structures. Cancer 62:1637–1640
Turner GG (1929) Cancer of the colon. Lancet 1:1017–1023
Van Prohaska J, Govostis MC, Wasick M (1956) Multiple resection for advanced carcinoma of the colon and rectum. Surg Gynecol Obstet 97:177–182
Yeo CJ, Cameron JL (1999) Improving results of pancreaticoduodenectomy for pancreatic cancer. World J Surg 23:907–912
Polk HC (1972) Extended resection for selected adenocarcinoma of the large bowel. Ann Surg 175:892–899
Kroneman H, Castelin A, Jeckel J (1991) En bloc resection of colon carcinoma adherent to other organs: an efficacious treatment? Dis Colon Rectum 34:780–783
Koea JB, Conlon K, Paty PB, Guillem JG, Cohen AM (2000) Pancreatic or duodenal resection or both for advanced carcinoma of the right colon: is it justified? Dis Colon Rectum 43:460–465
Berrospi F, Celis J, Ruiz E, Payet E (2002) En bloc pancreaticoduodenectomy for right colon cancer invading adjacent organs. J Surg Oncol 79:194–197
Ellis H, Morgan MN, Wastell C (1972) Curative surgery in carcinoma of the colon involving duodenum. A report of 6 cases. Br J Surg 59:932–935
Curley SA, Evans DB, Ames FC (1994) Resection for cure of carcinoma of the colon directly invading the duodenum or pancreatic head. J Am Coll Surg 179:587–592
Curley SA, Carlson GW, Shumate CR, Wishnow KI, Ames FC (1992) Extended resection for locally advanced colorectal carcinoma. Am J Surg 163:553–559
Charnsangavej C, Whitley NO (1993) Metastases to the pancreas and peripancreatic lymph nodes from carcinoma of the right side of the colon: CT findings in 12 patients. Am J Roentgenol 160:49–52
Davies GC, Ellis H (1975) Radical surgery in locally advanced cancer of the large bowel. Clin Oncol 1:21–26
Fielding LP, Phillips RK, Fry JS, Hittinger R (1986) Prediction of outcome after curative resection for large bowel cancer. Lancet 2:904–907
Kama NA, Reis E, Doganay M, Gozalan U, Yasti C (2001) Radical surgery of colon cancers directly invading the duodenum, pancreas and liver. Hepatogastroenterology 48:114–117
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kapoor, S., Das, B., Pal, S. et al. En bloc resection of right-sided colonic adenocarcinoma with adjacent organ invasion. Int J Colorectal Dis 21, 265–268 (2006). https://doi.org/10.1007/s00384-005-0756-z
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00384-005-0756-z