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Recurrence and Long-Term Survival Following Segmental Colectomy for Right-Sided Colon Cancer in 813 Patients: a Single-Institution Study

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Controversy exists regarding optimal surgical approach to right-sided colon cancer due to increasing complete mesocolic excision outcome data; yet, scarce long-term surgical and oncologic outcome data from high-volume centers following right segmental resections without complete mesocolic excision make comparisons difficult to interpret. We report long-term outcomes following standard mesocolic excision for right-sided colon adenocarcinoma.

Methods

A retrospective review of a prospective database was conducted of all consecutive adult patients undergoing surgery for a right-sided colon adenocarcinoma between 2000 and 2007. Demographics, oncologic, operative, and pathologic details are reported. Primary endpoints consisted of overall survival and recurrence. Patients with stage IV and recurrent disease were excluded.

Results

Eight hundred thirteen patients were identified. Majority of tumors were stage II (n = 318, 39%). Adjuvant chemotherapy was administered to 228 patients (28%). Recurrence was observed in 97 patients (12%), at median 1.3 years. Recurrence was most commonly distant (n = 73, 9%). At median follow-up 7.3 years, 5- and 10-year overall survival was 72.4%, and 48.6%, respectively. Five- and 10-year disease-free survival was 67% and 45.8%, respectively. Multivariable analysis demonstrated that TNM stage was a significant predictor of recurrence. For disease-free survival, T stage, and N stage were significant on multivariate analysis. Multivariable predictors of overall survival included age, number of lymph nodes removed, N stage, and adjuvant chemotherapy use.

Conclusions

Excellent long-term outcomes from a large cohort of patients with non-metastatic, right colon adenocarcinoma treated by segmental colectomy without complete mesocolic excision are reported. The majority of recurrences were distant.

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Authors and Affiliations

  1. Department of Surgery, Mayo Clinic, Jacksonville, FL, USA

    Alexandra W. Elias

  2. Division of Colon & Rectal Surgery, Mayo Clinic, Jacksonville, FL, USA

    Amit Merchea & Dorin T. Colibaseanu

  3. Division of Colon & Rectal Surgery, Mayo Clinic, Rochester, MN, USA

    Sara Moncrief, Eric J. Dozois & Kellie L. Mathis

  4. Department of Surgery, Mayo Clinic, Rochester, MN, USA

    Kevin B. Wise

  5. Division of Colon & Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Kellie L. Mathis

Authors
  1. Alexandra W. Elias
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  2. Amit Merchea
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  3. Sara Moncrief
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  4. Kevin B. Wise
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  5. Dorin T. Colibaseanu
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  6. Eric J. Dozois
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  7. Kellie L. Mathis
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Contributions

Alexandra W. Elias: Substantial contributions to the conception and design of the work, drafting, final approval, agreement for all aspects of the work.

Amit Merchea: Substantial contributions to the conception and design of the work, drafting, final approval, agreement for all aspects of the work.

Sara Moncrief: Substantial contributions to the conception and design of the work, drafting, final approval, agreement for all aspects of the work.

Kevin B. Wise: Substantial contributions to the conception and design of the work, drafting, final Approval, agreement for all aspects of the work.

Dorin T. Colibaseanu: Substantial contributions to the conception and design of the work, drafting, final approval, agreement for all aspects of the work.

Eric J. Dozois: Substantial contributions to the conception and design of the work, drafting, final approval, agreement for all aspects of the work.

Kellie L. Mathis: Substantial contributions to the conception and design of the work, drafting, final approval, agreement for all aspects of the work.

Corresponding author

Correspondence to Kellie L. Mathis.

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Presentations: The manuscript was presented as a poster at ASCRS Annual Meeting, Seattle, WA, June 10–14, 2017.

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Elias, A.W., Merchea, A., Moncrief, S. et al. Recurrence and Long-Term Survival Following Segmental Colectomy for Right-Sided Colon Cancer in 813 Patients: a Single-Institution Study. J Gastrointest Surg 24, 1648–1654 (2020). https://doi.org/10.1007/s11605-019-04271-4

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  • DOI: https://doi.org/10.1007/s11605-019-04271-4

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