Complete mesocolic excision (CME) impacts survival only for Stage III right-sided colon cancer: a systematic review and meta-analysis.

IF 1.7 4区医学 Q2 SURGERY

Minimally Invasive Therapy & Allied Technologies Pub Date : 2024-09-25 DOI:10.1080/13645706.2024.2405544

Kengo Hayashi, Roberto Passera, Chiara Meroni, Rebecca Dallorto, Chiara Marafante, Carlo Alberto Ammirati, Alberto Arezzo

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引用次数: 0

Abstract

Introduction: Complete mesocolic excision (CME) is widely adopted for its assumed superior oncological outcome. However, it's unclear if all right-sided colon cancer patients benefit from CME. The aim of this systematic review is to investigate whether CME contributes to postoperative outcomes and to determine the surgical indications for CME.

Material and methods: We searched eligible articles about CME versus non-CME procedures for right-sided colon cancer in the OVID Medline, Embase, and Cochrane CENTRAL databases, and a meta-analysis was conducted.

Results: Twenty-two articles and seven abstracts involving 8088 patients were included in this study. Among them, 3803 underwent CME and 4285 non-CME procedures. The analysis showed that CME was favoured for three-year disease-free survival (DFS) and overall survival (OS), for local, systemic, and total recurrence, and for hospital stay durations. However, increased vascular injury and longer surgery time were observed in CME. Regarding the three-year OS, the superiority of CME was observed only in Stage III. Additionally, no significant differences were observed between CME and non-CME groups regarding overall complications, 30-day readmission rates, reoperation, or postoperative mortality rates.

Conclusions: CME for right-sided colon cancer should be considered, particularly in Stage III patients, to contribute to improved oncological outcomes. However, careful attention must be paid to the increased risk of vascular injury.

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完全结肠系膜切除术 (CME) 仅影响 III 期右侧结肠癌患者的生存率：系统综述和荟萃分析。

导言：结肠系膜完全切除术（CME）因其假定的优越肿瘤治疗效果而被广泛采用。然而，尚不清楚是否所有右侧结肠癌患者都能从 CME 中获益。本系统性综述旨在研究 CME 是否有助于术后效果，并确定 CME 的手术适应症：我们在 OVID Medline、Embase 和 Cochrane CENTRAL 数据库中检索了符合条件的关于右侧结肠癌 CME 与非 CME 手术的文章，并进行了荟萃分析：本研究共收录了22篇文章和7篇摘要，涉及8088名患者。其中，3803 例接受了 CME，4285 例未接受 CME。分析结果表明，在三年无病生存率（DFS）和总生存率（OS）、局部复发、全身复发和总复发率以及住院时间方面，CME 更受青睐。不过，CME的血管损伤增加，手术时间延长。在三年生存率方面，仅在III期观察到CME的优越性。此外，在总体并发症、30天再入院率、再次手术率或术后死亡率方面，CME组和非CME组之间没有观察到明显差异：结论：应考虑对右侧结肠癌进行 CME 治疗，尤其是对 III 期患者，以改善肿瘤治疗效果。结论：应考虑对右侧结肠癌患者进行 CME 治疗，尤其是 III 期患者，这有助于改善肿瘤治疗效果，但必须注意血管损伤风险的增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Minimally Invasive Therapy & Allied Technologies 医学-外科

CiteScore

3.80

自引率

5.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Minimally Invasive Therapy and Allied Technologies (MITAT) is an international forum for endoscopic surgeons, interventional radiologists and industrial instrument manufacturers. It is the official journal of the Society for Medical Innovation and Technology (SMIT) whose membership includes representatives from a broad spectrum of medical specialities, instrument manufacturing and research. The journal brings the latest developments and innovations in minimally invasive therapy to its readers. What makes Minimally Invasive Therapy and Allied Technologies unique is that we publish one or two special issues each year, which are devoted to a specific theme. Key topics covered by the journal include: interventional radiology, endoscopic surgery, imaging technology, manipulators and robotics for surgery and education and training for MIS.