Long-Term Oncological Outcomes After Complete Mesocolic Excision Versus Standard Resection for Right-Sided Colon Cancer: A Propensity Score Matching Analysis.

IF 1.6 Q4 ONCOLOGY

Journal of Gastrointestinal Cancer Pub Date : 2025-05-31 DOI:10.1007/s12029-025-01248-2

Federica Del Coco, Pietro Achilli, Pietro Carnevali, Irene Giusti, Alessandro Giani, Camillo Leonardo Bertoglio, Carmelo Magistro, Matteo Origi, Michele Mazzola, Giovanni Ferrari

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引用次数: 0

Abstract

Background: Complete mesocolic excision (CME) has not gained wide diffusion, mainly due to its technical complexity and unclear oncological benefits. We investigated the long-term outcomes of patients with right-sided colon cancer who underwent CME surgery compared to those treated with conventional surgery (NCME).

Methods: Prospectively collected data of patients who underwent surgery between 2010 and 2018 were retrospectively analysed. Propensity score matching (PSM) was used to balance baseline characteristics of CME and NCME patients. The primary endpoints of the study were overall and disease-free survival (OS and DFS), distant and local recurrence-free survival (DRFS and LRFS).

Results: Out of the 444 patients included in the study, 254 were correctly matched after PSM, 127 in each group. The median follow-up was 70 months (IQR 54-81). Conversion rate, complications, and 90-day mortality were comparable in both groups. Five-year LRFS rates for CME patients was 100% and 95% for NCME (log-rank p = 0.044). At 5 years, there were no differences between the two groups in terms of overall survival and disease-free survival.

Conclusions: Laparoscopic CME for RCC is associated with a significant decrease in terms of LRFS. No benefit on long-term disease-free survival and overall survival was obtained.

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右侧结肠癌结肠肠系膜完全切除与标准切除后的长期肿瘤预后：倾向评分匹配分析。

背景：完全肠系膜切除（CME）尚未得到广泛推广，主要是由于其技术复杂性和不明确的肿瘤益处。我们调查了右侧结肠癌患者接受CME手术与常规手术（NCME）治疗的长期结果。方法：回顾性分析前瞻性收集的2010 - 2018年手术患者资料。倾向评分匹配（PSM）用于平衡CME和NCME患者的基线特征。研究的主要终点是总生存期和无病生存期（OS和DFS），远处和局部无复发生存期（DRFS和LRFS）。结果：在纳入研究的444例患者中，254例PSM后匹配正确，每组127例。中位随访为70个月（IQR 54-81）。两组的转换率、并发症和90天死亡率具有可比性。CME患者的5年LRFS为100%，NCME患者为95% （log-rank p = 0.044）。在5年时，两组在总生存期和无病生存期方面没有差异。结论：腹腔镜下肾细胞癌CME与LRFS显著降低相关。对长期无病生存期和总生存期没有获益。

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

Journal of Gastrointestinal Cancer ONCOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

121

期刊介绍： The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.