Complete mesocolic excision and D3 lymphadenectomy with central vascular ligation in right-sided colon cancer: a systematic review of postoperative outcomes, tumor recurrence and overall survival

Mazzarella, Gennaro; Muttillo, Edoardo Maria; Picardi, Biagio; Rossi, Stefano; Muttillo, Irnerio Angelo

doi:10.1007/s00464-021-08529-4

Cited by 36 publications

(27 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In particular, and in line with the described pattern of recurrence, comparing 3-year survival of our series to the OS of CME-D3 reported by the most recent study [1,21,22] on the subject, no significant improvement was confirmed.…”

Section: Discussionsupporting

confidence: 90%

“…In recent years, many studies have compared different techniques (open, laparoscopic, or robotic) RC-D2 versus CME-D3, and some authors advocate the latter as possible gold standard in RCC [12][13][14][15][16][17][18][19][20][21][22]. To date, however, CME-D3 has not been widely accepted as a standard of care, also due to the technically challenging nature of the procedure, which is associated with higher intra-operative complications and postoperative morbidity [23].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pattern of recurrence and survival after D2 right colectomy for cancer: is there place for a routine more extended lymphadenectomy?

et al. 2022

View full text Add to dashboard Cite

Background Conventional Right Colectomy with D2 lymphadenectomy (RC-D2) currently represent the most common surgical treatment of right-sided colon cancer (RCC). However, whether it should be still considered a standard of care, or replaced by a routine more extended D3 lymphadenectomy remains unclear. In the present study, we aim to critically review the patterns of relapse and the survival outcomes obtained from our 11-year experience of RC-D2. Methods Clinical data of 489 patients who underwent RC-D2 for RCC at two centres, from January 2009 to January 2020, were retrospectively reviewed. Patients with synchronous distant metastases and/or widespread nodal involvement at diagnosis were excluded. Post-operative clinical–pathological characteristics and survival outcomes were evaluated including the pattern of disease relapse. Results We enrolled a total of 400 patients with information follow-up. Postoperative morbidity was 14%. The median follow-up was 62 months. Cancer recurrence was observed in 55 patients (13.8%). Among them, 40 patients (72.7%) developed systemic metastases, and lymph-node involvement was found in 7 cases (12.8%). None developed isolated central lymph-node metastasis (CLM), in the D3 site. The estimated 3- and 5-year relapse-free survival were 86.1% and 84.4%, respectively. The estimated 3- and 5-year cancer-specific OS were 94.5% and 92.2%, respectively. Conclusions The absence of isolated CLM, as well as the cancer-specific OS reported in our series, support the routine use of RC-D2 for RCC. However, D3 lymphadenectomy may be recommended in selected patients, such as those with pre-operatively known CLM, or with lymph-node metastases close to the origin of the ileocolic vessels.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Pattern of recurrence and survival after D2 right colectomy for cancer: is there place for a routine more extended lymphadenectomy?

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Different surgical methods and surgical ranges for right colon cancer have been used, and these have led to different incidences of postoperative complications, including complete mesocolic excision (CME) and D3 lymph node dissection, standard operation and extended right colectomy, and differences in the medial boundary of lymph node dissection [9][10][11]. Currently, few studies on risk factors for EPSBO after right hemicolectomy have been reported, especially to establish predictive models.…”

Section: Introductionmentioning

confidence: 99%

Novel nomogram for predicting risk of early postoperative small bowel obstruction after right colectomy for cancer

et al. 2022

View full text Add to dashboard Cite

Background Early postoperative small bowel obstruction (EPSBO) is a common complication after colorectal cancer surgery. Few studies have specifically studied risk factors for early small bowel obstruction after right colectomy, especially in establishing predictive models. The purpose of the current study was to establish an effective nomogram to predict the incidence of EPSBO after right colectomy. Methods The current study retrospectively analyzed data from a total of 424 patients who underwent right colectomy in a local hospital from January 2014 to March 2021. A logistic regression model was used to identify potential risk factors for EPSBO after right colectomy. A nomogram was established by independent risk factors, and the prediction performance of the model was evaluated using an area under the receiver operating characteristic (ROC) curve and calibration chart. Results A total of 45 patients (10.6%) developed early small bowel obstruction after right colectomy. Male sex, emergency operation, history of abdominal surgery, open surgery, long operative time, anastomotic leakage, and preoperative albumin were closely related to EPSBO. Analysis of postoperative rehabilitation indices showed that EPSBO remarkably slowed the postoperative rehabilitation speed of patients. Multivariate logistic regression analysis showed that male sex, open surgery, operative time, and anastomotic leakage were independent risk factors (P < 0.05), and the operation time had the greatest impact on EPSBO. On the basis of multivariate logistic regression, a nomogram was constructed, which showed moderate accuracy in predicting EPSBO, with a C-statistic of 0.716. The calibration chart showed good consistency between the predicted probability and ideal probability. Conclusion The current study constructed a nomogram based on the clinical data of patients who underwent right colectomy, which had moderate predictability and could provide reference value for clinicians to evaluate the risk of EPSBO.

show abstract

“…The authors have no conflicts of interest or financial ties to disclose. Gennaro Mazzarella 1,2 Edoardo Maria Muttillo 1,3…”

Section: Co N Fli C T O F I Nte R E S T Smentioning

confidence: 99%

Need to define right mesocolectomy and complete mesocolic excision concept: How, when and why?

Mazzarella

Muttillo

2021

Colorectal Disease

Self Cite

View full text Add to dashboard Cite

Complete mesocolic excision and D3 lymphadenectomy with central vascular ligation in right-sided colon cancer: a systematic review of postoperative outcomes, tumor recurrence and overall survival

Cited by 36 publications

References 56 publications

Pattern of recurrence and survival after D2 right colectomy for cancer: is there place for a routine more extended lymphadenectomy?

Pattern of recurrence and survival after D2 right colectomy for cancer: is there place for a routine more extended lymphadenectomy?

Novel nomogram for predicting risk of early postoperative small bowel obstruction after right colectomy for cancer

Need to define right mesocolectomy and complete mesocolic excision concept: How, when and why?

Contact Info

Product

Resources

About