Long-term results of treatment of right-sided colon cancer with mesocolic excision and D3-lymph node dissection

Aim of investigation. To estimate efficacy of D3-lymph node dissection with mesocolic excision in comparison to standard surgical technique of right hemicolectomy for right colon cancer in long-term terms.Methods. Comparative analysis of the long-term results of treatment of right colon cancer at I–...

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Main Authors: S. K. Efetov, I. A. Tulina, A. Yu. Kravchenko, D. N. Fedorov, S. V. Efetov, P. V. Tsarkov
Format: Article
Language:Russian
Published: Gastro LLC 2014-07-01
Series:Российский журнал гастроэнтерологии, гепатологии, колопроктологии
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Online Access:https://www.gastro-j.ru/jour/article/view/1092
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author S. K. Efetov
I. A. Tulina
A. Yu. Kravchenko
D. N. Fedorov
S. V. Efetov
P. V. Tsarkov
author_facet S. K. Efetov
I. A. Tulina
A. Yu. Kravchenko
D. N. Fedorov
S. V. Efetov
P. V. Tsarkov
author_sort S. K. Efetov
collection DOAJ
description Aim of investigation. To estimate efficacy of D3-lymph node dissection with mesocolic excision in comparison to standard surgical technique of right hemicolectomy for right colon cancer in long-term terms.Methods. Comparative analysis of the long-term results of treatment of right colon cancer at I–III stages with D2- and D3-lymph node dissections was carried out. Traditional right hemicolectomy with D2-lymph node dissection was applied in 132 patients (control group). Patients after right hemicolectomy with D3-lymph node dissection, mesocolic excision with «notouch» principles have been included to the main group (n=64). Groups were comparable by demographic and clinical features, and also by stage of local neoplastic spread.Results. Significant differences in general cumulative 5-years survival rate (69 and 86% respectively, р=0,043) and 5-years cancer-specific survival rate (91 and 71% respectively, р=0,014) have been revealed between control and main groups. Among patients with involved lymph nodes (III stage) overall 5-years survival rate after standard surgery (58%) was worse, than after right hemicolectomy with D3-lymph node dissection (83%, p=0,042). In patients with D2-lymph node dissection the involvement of regional lymph nodes was significant prognostic factor deteriorating overall 5-years survival rate (p=0,039) while at D3-lymph node dissection this factor had no effect on the prognosis (p=0,535).Conclusion. At right colon cancer of I–III stages D3-lymph node dissection is the major factor significantly improving overall 5-years survival rate. Extended lymph node dissection is the factor levelling negative prognostic effect of metastatic lymph node involvement which can be accomplished by prevention of local lymphogenic relapse of tumor.
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spelling doaj-art-1d00f6446bf3434d8e2c7ca3fdc074612025-02-10T16:14:33ZrusGastro LLCРоссийский журнал гастроэнтерологии, гепатологии, колопроктологии1382-43762658-66732014-07-012416270693Long-term results of treatment of right-sided colon cancer with mesocolic excision and D3-lymph node dissectionS. K. Efetov0I. A. Tulina1A. Yu. Kravchenko2D. N. Fedorov3S. V. Efetov4P. V. Tsarkov5State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university», Ministry of Healthcare of the Russian FederationState educational government-financed institution of higher professional education «Sechenov First Moscow state medical university», Ministry of Healthcare of the Russian FederationState educational government-financed institution of higher professional education «Sechenov First Moscow state medical university», Ministry of Healthcare of the Russian FederationPetrovsky National Research Center of Surgery of Russian Academy of Medical Science«Oncologic clinical dispensary n. a. V.M. Efetov»State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university», Ministry of Healthcare of the Russian FederationAim of investigation. To estimate efficacy of D3-lymph node dissection with mesocolic excision in comparison to standard surgical technique of right hemicolectomy for right colon cancer in long-term terms.Methods. Comparative analysis of the long-term results of treatment of right colon cancer at I–III stages with D2- and D3-lymph node dissections was carried out. Traditional right hemicolectomy with D2-lymph node dissection was applied in 132 patients (control group). Patients after right hemicolectomy with D3-lymph node dissection, mesocolic excision with «notouch» principles have been included to the main group (n=64). Groups were comparable by demographic and clinical features, and also by stage of local neoplastic spread.Results. Significant differences in general cumulative 5-years survival rate (69 and 86% respectively, р=0,043) and 5-years cancer-specific survival rate (91 and 71% respectively, р=0,014) have been revealed between control and main groups. Among patients with involved lymph nodes (III stage) overall 5-years survival rate after standard surgery (58%) was worse, than after right hemicolectomy with D3-lymph node dissection (83%, p=0,042). In patients with D2-lymph node dissection the involvement of regional lymph nodes was significant prognostic factor deteriorating overall 5-years survival rate (p=0,039) while at D3-lymph node dissection this factor had no effect on the prognosis (p=0,535).Conclusion. At right colon cancer of I–III stages D3-lymph node dissection is the major factor significantly improving overall 5-years survival rate. Extended lymph node dissection is the factor levelling negative prognostic effect of metastatic lymph node involvement which can be accomplished by prevention of local lymphogenic relapse of tumor.https://www.gastro-j.ru/jour/article/view/1092colon cancermesocolic excisiond3-lymph node dissectionlong-term results
spellingShingle S. K. Efetov
I. A. Tulina
A. Yu. Kravchenko
D. N. Fedorov
S. V. Efetov
P. V. Tsarkov
Long-term results of treatment of right-sided colon cancer with mesocolic excision and D3-lymph node dissection
Российский журнал гастроэнтерологии, гепатологии, колопроктологии
colon cancer
mesocolic excision
d3-lymph node dissection
long-term results
title Long-term results of treatment of right-sided colon cancer with mesocolic excision and D3-lymph node dissection
title_full Long-term results of treatment of right-sided colon cancer with mesocolic excision and D3-lymph node dissection
title_fullStr Long-term results of treatment of right-sided colon cancer with mesocolic excision and D3-lymph node dissection
title_full_unstemmed Long-term results of treatment of right-sided colon cancer with mesocolic excision and D3-lymph node dissection
title_short Long-term results of treatment of right-sided colon cancer with mesocolic excision and D3-lymph node dissection
title_sort long term results of treatment of right sided colon cancer with mesocolic excision and d3 lymph node dissection
topic colon cancer
mesocolic excision
d3-lymph node dissection
long-term results
url https://www.gastro-j.ru/jour/article/view/1092
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AT ayukravchenko longtermresultsoftreatmentofrightsidedcoloncancerwithmesocolicexcisionandd3lymphnodedissection
AT dnfedorov longtermresultsoftreatmentofrightsidedcoloncancerwithmesocolicexcisionandd3lymphnodedissection
AT svefetov longtermresultsoftreatmentofrightsidedcoloncancerwithmesocolicexcisionandd3lymphnodedissection
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