Does transverse colon cancer spread to the extramesocolic lymph node stations?

Yüksel, Bülent Cavit; Er, Sadettin; Çetinkaya, Erdinç; Aşlar, Ahmet Keşşaf

doi:10.1080/00015458.2019.1689642

Cited by 11 publications

(20 citation statements)

References 19 publications

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“…Extra‐mesocolic nodes have been observed in the gastro‐epiploic, infra‐pyloric and pancreatic areas [29]. Studies investigating complete mesocolic excision have suggested routine dissection of the infra‐pancreatic lymph node regions and gastro‐epiploic arcade [31,32]. It is possible that oncological outcomes for transverse colon tumours are not different based on the extent of mesocolic excision because lymphatic spread is into all three embryological planes.…”

Section: Discussionmentioning

confidence: 99%

“…routine dissection of the infra-pancreatic lymph node regions and gastro-epiploic arcade [31,32]. It is possible that oncological outcomes for transverse colon tumours are not different based on the extent of mesocolic excision because lymphatic spread is into all three embryological planes.…”

Section: Studies Investigating Complete Mesocolic Excision Have Sugge...mentioning

confidence: 99%

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Segmental versus extended colectomy for tumours of the transverse colon: a systematic review and meta‐analysis

et al. 2020

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There is no consensus on the appropriate extent of oncological resection for tumours of the transverse colon. Concerns regarding tumour factors such as pattern of lymph node spread and technical factors such as anastomotic perfusion lead to a variety of procedures being performed. Operations such as sub-total colectomy, extended right hemicolectomy, left hemicolectomy, transverse colectomy and segmental resection are all frequently performed for tumours of similar location [1-5].

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Section: Discussionmentioning

confidence: 99%

Section: Studies Investigating Complete Mesocolic Excision Have Sugge...mentioning

confidence: 99%

Segmental versus extended colectomy for tumours of the transverse colon: a systematic review and meta‐analysis

et al. 2020

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“…The exclusion criteria were: (1) non-elective case; (2) cases with locoregional invasion/metastases in other organs; (3) any cancer personal history; (4) neoadjuvant therapy. Patients in the T1 stage were not included in the study because it was considered that a cancer in this stage does not have locoregional tumor involvement or metastases at the level of other organs, and the excision of the GCL cannot be taken into account [ 8 , 9 ].…”

Section: Methodsmentioning

confidence: 99%

Extended Lymphadenectomy for Proximal Transverse Colon Cancer: Is There a Place for Standardization?

et al. 2022

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Background and Objectives: Complete mesocolon excision and high vascular ligation have become a standard procedure in the treatment of colon cancer. The transverse colon has certain embryological and anatomical particularities which require special attention in case of oncological surgeries. Proximal transverse colon cancer (TCC) can metastasize to the lymph nodes in the gastrocolic ligament. The aim of this study is to assess the tumor involvement of these lymph nodes and to determine the applicability of gastrocolic ligament lymph nodes dissection as the standard approach for proximal transverse colon cancer. Materials and Methods: this study analyzes the cases of patients admitted to the Surgery Department, diagnosed with proximal transverse colon cancer, with tumor invasion ≥ T2 and for which complete mesocolon excision with high vascular ligation and lymphadenectomy of the gastrocolic ligament (No. 204, 206, 214v) were performed. Results: A total of 43 cases operated during 2015–2020 were included in the study. The median total number of retrieved central lymph nodes was 23 (range, 12–38), that had tumor involvement in 22 cases (51.2%). Gastrocolic ligament tumor involvement was found in 5 cases (11.6%). The median operation time was 180 min, while the median blood loss was 115 mL (range 0–210). The median time of hospitalization was 6 days (range, 5–11). Grade IIIA in the Clavien-Dindo classification was noticed in 3 patients, with no mortality. Upon Kaplan–Meier analysis, tumors > T3 (p < 0.016) and lymph node ratio < 0.05 (p < 0.025) were statistically significant. Conclusions: lymph node dissection of the gastrocolic ligament in patients with advanced proximal transverse colon cancer may improve the oncological outcome in T3/T4 tumors, and therefore standardization could be feasible

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“…There is no recommendation in current guidelines about IGLN routine dissection for hepatic flexure/transverse colon tumours. Few authors have reported IGLN metastases rates from colonic tumours (range 0.7%-22.0%) [4][5][6][7][8][9][10][11]. Routine IGLN dissection could increase morbidity and mortality [5].…”

Section: Laparoscopic Complete Mesocolic Excision With Extended D3 Ly...mentioning

confidence: 99%

Laparoscopic complete mesocolic excision with extended D3 lymphadenectomy for advanced hepatic flexure cancer: Addressing infrapyloric node dissection – A video vignette

et al. 2021

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to the splenic flexure is challenging so a mixed approach can be used to overcome the technical difficulties. Obese patients have a higher risk of surgical site infection and they often present with preoperative skin conditions such as intertrigo in body folds, which can affect the decision about the site of the mini-laparotomy. Indocyanine green angiography is a useful tool to ensure vascularization of the anastomosis, considering the higher risk of anastomotic leakage.Lastly, obese patients have higher conversion rates, longer operative times and higher postoperative morbidity, especially lower respiratory tract infections, which are the main cause of prolongation of hospital stay and increased costs.

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Does transverse colon cancer spread to the extramesocolic lymph node stations?

Cited by 11 publications

References 19 publications

Segmental versus extended colectomy for tumours of the transverse colon: a systematic review and meta‐analysis

Segmental versus extended colectomy for tumours of the transverse colon: a systematic review and meta‐analysis

Extended Lymphadenectomy for Proximal Transverse Colon Cancer: Is There a Place for Standardization?

Laparoscopic complete mesocolic excision with extended D3 lymphadenectomy for advanced hepatic flexure cancer: Addressing infrapyloric node dissection – A video vignette

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