Right hemicolectomy plus pancreaticoduodenectomy vs partial duodenectomy in treatment of locally advanced right colon cancer invading pancreas and/or only duodenum

En Bloc Pancreaticoduodenectomy for Locally Advanced Right Colon Cancers

“…In the literature, it was published that 8 patients underwent R0 en bloc colectomy and PD for locally advanced colon carcinoma and survived nearly or more than ten years (Saiura et al, five patients [6]; Praderi et al, two patients [34]; and Berrospi et al, one patient [23]). The reported 5-year survival after R0, en bloc RC + PD, is 52% [35]; on the other hand, 5-year survival is 0−23% [3, 20, 22, 36] in patients who underwent surgery by separation of adhesions to adjacent organs. Median survival was 42 months in our series; in one extreme case that had two recurrences after RC and PD, she underwent major surgeries for local recurrences (pelvic exenteration and CRS and HIPEC).…”

Increased morbidity and mortality of a concomitant colectomy during a pancreaticoduodenectomy: an NSQIP propensity-score matched analysis

“…The key finding in the current study was that even adjusting for those independent risk factors, including neoadjuvant chemotherapy or radiation, CR significantly increased the risk of MM and mortality. 7,10,16,22,23 One reason CR may increase MM and mortality is its inherent potential risk for anastomotic leak, infected fluid collection and/or an abscess. We also determined that even in the propensity-matched group, OSI is almost two times higher in the PD+CR group when compared with PD alone (22.4% versus 11.1%, P < 0.001).…”

“…Despite improvements in neoadjuvant and adjuvant therapies, and surgical techniques, only 15% to 20% of patients are candidates for a resection owing to the presence of a distant tumour outside the confines of a resection, or because of locally advanced disease. Select patients with peri‐ampullary cancers require a multi‐organ resection during a PD to achieve margin‐negative resections. A margin‐negative, or R0, resection is critical as better oncological outcomes are associated with a successful R0 resection.…”

“…[2][3][4][5][6] Select patients with peri-ampullary cancers require a multi-organ resection during a PD to achieve marginnegative resections. [7][8][9][10][11][12] A margin-negative, or R0, resection is critical as better oncological outcomes are associated with a successful R0 resection. 4,[13][14][15] However, this aggressive approach with a multivisceral resection with PD may result in an increase in major morbidity and/or mortality, leading to delays in adjuvant therapy and even a decreased survival.…”

Advanced transverse colon cancer highly indicative of invasion to the duodenum and pancreas

“…On laparotomy, the tumor showed neither lymph node metastasis nor duodenal or pancreatic invasion. Thus, a radical right hemicolectomy alone was performed curatively . Locally advanced right‐sided colon cancer may directly invade the duodenum or pancreatic head.…”