The role of lymph node dissection in the management of right-sided colon cancer remains controversial.
The aim of this study was to investigate the surgical treatment of curable right-sided colon cancer by using D3 lymphadenectomy with a no-touch isolation technique and to determine the extent of lymph node dissection optimal for the prognosis of right-sided colon cancer.
This research is a retrospective cohort study from a prospectively collected database.
The investigation took place in a specialized colorectal surgery department.
Data on 370 consecutive patients who underwent D3 lymph node dissection for right-sided colon cancer with a no-touch isolation technique were identified.
The survival of patients with involvement of main nodes at the roots of colonic arterial trunks along superior mesenteric vessels through intermediate nodes in the right mesocolon was determined.
The 5-year overall survival of patients with stage I (n = 73, 19.7%), II (n = 155, 41.9%), and III (n = 142, 38.4%) cancer were 94.5%, 87.6%, and 79.2%. The 5-year disease-specific survival of patients with stages I, II, and III cancer were 100.0%, 94.5%, and 85.0%. Eleven patients (3.0%) had metastatic involvement of main lymph nodes, whereas 49 (13.2%) had metastases to intermediate lymph nodes. The 5-year overall survival and disease-specific survival of patients with metastases to main lymph nodes were 36.4% for both, and 5-year overall survival and disease-specific survival of patients with metastases to intermediate lymph nodes were 77.6% and 83.5%.
This study was limited by its nonrandomized retrospective design.
D3 lymphadenectomy with a no-touch isolation technique allows curative resection and long-term survival in a cohort of patients with cancer of the right colon.
See related Editorial on p. 805
1 Department of Gastroenterological Surgery, Aichi Cancer Center, Nagoya, Japan
2 Department of Surgery, Kamiiida Daiichi General Hospital, Nagoya, Japan
Financial Disclosures: None reported.
Presented at a meeting of the Japan Surgical Association, Tokyo, Japan, November 17 to 19, 2011.
Correspondence: Yukihide Kanemitsu, M.D., Colorectal Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. E-mail: firstname.lastname@example.org