Comparison of conventional resection to D3 lymphadenectomy in right-sided colon cancer: A retrospective cohort study.
Colon cancer
D3
Lymphadenectomy
Right colectomy
Survival
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
20 Aug 2024
20 Aug 2024
Historique:
received:
06
07
2024
revised:
08
08
2024
accepted:
19
08
2024
medline:
24
8
2024
pubmed:
24
8
2024
entrez:
23
8
2024
Statut:
aheadofprint
Résumé
Lymphadenectomy during right hemicolectomy for colon cancer varies between the U.S. and Japan. Patients undergoing right hemicolectomy for non-metastatic right-sided colon cancer between 2010 and 2019 at U.S. and Japanese institutions were compared. Outcomes included survival, pathologic findings, and postoperative complications. 319 American patients (57 % female, mean age 70 years) underwent conventional resection and 308 Japanese patients (52 % female, mean age 70 years) underwent extended dissection. The conventional group underwent more laparotomies (26.6 % vs. 8.4 %, p < 0.001), had more poorly differentiated histology (31.7 % vs. 11.0 %, p < 0.01), lower lymph node yield (M = 27 ± 11 vs. M = 32 ± 14, p < 0.001), and more 30-day readmissions (31 vs. 5, p < 0.001). Adjusting for demographics, pathology, perioperative outcomes, and adjuvant chemotherapy, extended lymphadenectomy improved disease-free survival (HR 0.50; 95 % CI, 0.31-0.80; p = 0.004), but not overall survival (HR 0.98; 95 % CI, 0.95-1.02; p = 0.14). Extended lymphadenectomy for right sided-colon cancer improves disease-free, but not overall, survival among Japanese patients.
Sections du résumé
BACKGROUND
BACKGROUND
Lymphadenectomy during right hemicolectomy for colon cancer varies between the U.S. and Japan.
METHODS
METHODS
Patients undergoing right hemicolectomy for non-metastatic right-sided colon cancer between 2010 and 2019 at U.S. and Japanese institutions were compared. Outcomes included survival, pathologic findings, and postoperative complications.
RESULTS
RESULTS
319 American patients (57 % female, mean age 70 years) underwent conventional resection and 308 Japanese patients (52 % female, mean age 70 years) underwent extended dissection. The conventional group underwent more laparotomies (26.6 % vs. 8.4 %, p < 0.001), had more poorly differentiated histology (31.7 % vs. 11.0 %, p < 0.01), lower lymph node yield (M = 27 ± 11 vs. M = 32 ± 14, p < 0.001), and more 30-day readmissions (31 vs. 5, p < 0.001). Adjusting for demographics, pathology, perioperative outcomes, and adjuvant chemotherapy, extended lymphadenectomy improved disease-free survival (HR 0.50; 95 % CI, 0.31-0.80; p = 0.004), but not overall survival (HR 0.98; 95 % CI, 0.95-1.02; p = 0.14).
CONCLUSIONS
CONCLUSIONS
Extended lymphadenectomy for right sided-colon cancer improves disease-free, but not overall, survival among Japanese patients.
Identifiants
pubmed: 39178599
pii: S0002-9610(24)00463-X
doi: 10.1016/j.amjsurg.2024.115911
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
115911Informations de copyright
Copyright © 2024 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors confirm that this manuscript has not been published elsewhere and is not under consideration by another journal.