Recurrence and Long-Term Survival Following Segmental Colectomy for Right-Sided Colon Cancer in 813 Patients: a Single-Institution Study

Alexandra W. Elias, Amit Merchea, Sara Moncrief, Kevin B. Wise, Dorin T. Colibaseanu, Eric Dozois, Kellie L. Mathis

Research output: Contribution to journalArticle

Abstract

Background: Controversy exists regarding optimal surgical approach to right-sided colon cancer due to increasing complete mesocolic excision outcome data; yet, scarce long-term surgical and oncologic outcome data from high-volume centers following right segmental resections without complete mesocolic excision make comparisons difficult to interpret. We report long-term outcomes following standard mesocolic excision for right-sided colon adenocarcinoma. Methods: A retrospective review of a prospective database was conducted of all consecutive adult patients undergoing surgery for a right-sided colon adenocarcinoma between 2000 and 2007. Demographics, oncologic, operative, and pathologic details are reported. Primary endpoints consisted of overall survival and recurrence. Patients with stage IV and recurrent disease were excluded. Results: Eight hundred thirteen patients were identified. Majority of tumors were stage II (n = 318, 39%). Adjuvant chemotherapy was administered to 228 patients (28%). Recurrence was observed in 97 patients (12%), at median 1.3 years. Recurrence was most commonly distant (n = 73, 9%). At median follow-up 7.3 years, 5- and 10-year overall survival was 72.4%, and 48.6%, respectively. Five- and 10-year disease-free survival was 67% and 45.8%, respectively. Multivariable analysis demonstrated that TNM stage was a significant predictor of recurrence. For disease-free survival, T stage, and N stage were significant on multivariate analysis. Multivariable predictors of overall survival included age, number of lymph nodes removed, N stage, and adjuvant chemotherapy use. Conclusions: Excellent long-term outcomes from a large cohort of patients with non-metastatic, right colon adenocarcinoma treated by segmental colectomy without complete mesocolic excision are reported. The majority of recurrences were distant.

Original languageEnglish (US)
JournalJournal of Gastrointestinal Surgery
DOIs
StatePublished - Jan 1 2019

Fingerprint

Colectomy
Colonic Neoplasms
Recurrence
Survival
Colon
Adenocarcinoma
Adjuvant Chemotherapy
Disease-Free Survival
Multivariate Analysis
Lymph Nodes
Demography
Databases
Neoplasms

Keywords

  • Adenocarcinoma
  • Colon cancer
  • Mesocolic excision
  • Right colectomy

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Recurrence and Long-Term Survival Following Segmental Colectomy for Right-Sided Colon Cancer in 813 Patients : a Single-Institution Study. / Elias, Alexandra W.; Merchea, Amit; Moncrief, Sara; Wise, Kevin B.; Colibaseanu, Dorin T.; Dozois, Eric; Mathis, Kellie L.

In: Journal of Gastrointestinal Surgery, 01.01.2019.

Research output: Contribution to journalArticle

Elias, Alexandra W. ; Merchea, Amit ; Moncrief, Sara ; Wise, Kevin B. ; Colibaseanu, Dorin T. ; Dozois, Eric ; Mathis, Kellie L. / Recurrence and Long-Term Survival Following Segmental Colectomy for Right-Sided Colon Cancer in 813 Patients : a Single-Institution Study. In: Journal of Gastrointestinal Surgery. 2019.
@article{30b92f3b751a45158011e34a20554dda,
title = "Recurrence and Long-Term Survival Following Segmental Colectomy for Right-Sided Colon Cancer in 813 Patients: a Single-Institution Study",
abstract = "Background: Controversy exists regarding optimal surgical approach to right-sided colon cancer due to increasing complete mesocolic excision outcome data; yet, scarce long-term surgical and oncologic outcome data from high-volume centers following right segmental resections without complete mesocolic excision make comparisons difficult to interpret. We report long-term outcomes following standard mesocolic excision for right-sided colon adenocarcinoma. Methods: A retrospective review of a prospective database was conducted of all consecutive adult patients undergoing surgery for a right-sided colon adenocarcinoma between 2000 and 2007. Demographics, oncologic, operative, and pathologic details are reported. Primary endpoints consisted of overall survival and recurrence. Patients with stage IV and recurrent disease were excluded. Results: Eight hundred thirteen patients were identified. Majority of tumors were stage II (n = 318, 39{\%}). Adjuvant chemotherapy was administered to 228 patients (28{\%}). Recurrence was observed in 97 patients (12{\%}), at median 1.3 years. Recurrence was most commonly distant (n = 73, 9{\%}). At median follow-up 7.3 years, 5- and 10-year overall survival was 72.4{\%}, and 48.6{\%}, respectively. Five- and 10-year disease-free survival was 67{\%} and 45.8{\%}, respectively. Multivariable analysis demonstrated that TNM stage was a significant predictor of recurrence. For disease-free survival, T stage, and N stage were significant on multivariate analysis. Multivariable predictors of overall survival included age, number of lymph nodes removed, N stage, and adjuvant chemotherapy use. Conclusions: Excellent long-term outcomes from a large cohort of patients with non-metastatic, right colon adenocarcinoma treated by segmental colectomy without complete mesocolic excision are reported. The majority of recurrences were distant.",
keywords = "Adenocarcinoma, Colon cancer, Mesocolic excision, Right colectomy",
author = "Elias, {Alexandra W.} and Amit Merchea and Sara Moncrief and Wise, {Kevin B.} and Colibaseanu, {Dorin T.} and Eric Dozois and Mathis, {Kellie L.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s11605-019-04271-4",
language = "English (US)",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
publisher = "Springer New York",

}

TY - JOUR

T1 - Recurrence and Long-Term Survival Following Segmental Colectomy for Right-Sided Colon Cancer in 813 Patients

T2 - a Single-Institution Study

AU - Elias, Alexandra W.

AU - Merchea, Amit

AU - Moncrief, Sara

AU - Wise, Kevin B.

AU - Colibaseanu, Dorin T.

AU - Dozois, Eric

AU - Mathis, Kellie L.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Controversy exists regarding optimal surgical approach to right-sided colon cancer due to increasing complete mesocolic excision outcome data; yet, scarce long-term surgical and oncologic outcome data from high-volume centers following right segmental resections without complete mesocolic excision make comparisons difficult to interpret. We report long-term outcomes following standard mesocolic excision for right-sided colon adenocarcinoma. Methods: A retrospective review of a prospective database was conducted of all consecutive adult patients undergoing surgery for a right-sided colon adenocarcinoma between 2000 and 2007. Demographics, oncologic, operative, and pathologic details are reported. Primary endpoints consisted of overall survival and recurrence. Patients with stage IV and recurrent disease were excluded. Results: Eight hundred thirteen patients were identified. Majority of tumors were stage II (n = 318, 39%). Adjuvant chemotherapy was administered to 228 patients (28%). Recurrence was observed in 97 patients (12%), at median 1.3 years. Recurrence was most commonly distant (n = 73, 9%). At median follow-up 7.3 years, 5- and 10-year overall survival was 72.4%, and 48.6%, respectively. Five- and 10-year disease-free survival was 67% and 45.8%, respectively. Multivariable analysis demonstrated that TNM stage was a significant predictor of recurrence. For disease-free survival, T stage, and N stage were significant on multivariate analysis. Multivariable predictors of overall survival included age, number of lymph nodes removed, N stage, and adjuvant chemotherapy use. Conclusions: Excellent long-term outcomes from a large cohort of patients with non-metastatic, right colon adenocarcinoma treated by segmental colectomy without complete mesocolic excision are reported. The majority of recurrences were distant.

AB - Background: Controversy exists regarding optimal surgical approach to right-sided colon cancer due to increasing complete mesocolic excision outcome data; yet, scarce long-term surgical and oncologic outcome data from high-volume centers following right segmental resections without complete mesocolic excision make comparisons difficult to interpret. We report long-term outcomes following standard mesocolic excision for right-sided colon adenocarcinoma. Methods: A retrospective review of a prospective database was conducted of all consecutive adult patients undergoing surgery for a right-sided colon adenocarcinoma between 2000 and 2007. Demographics, oncologic, operative, and pathologic details are reported. Primary endpoints consisted of overall survival and recurrence. Patients with stage IV and recurrent disease were excluded. Results: Eight hundred thirteen patients were identified. Majority of tumors were stage II (n = 318, 39%). Adjuvant chemotherapy was administered to 228 patients (28%). Recurrence was observed in 97 patients (12%), at median 1.3 years. Recurrence was most commonly distant (n = 73, 9%). At median follow-up 7.3 years, 5- and 10-year overall survival was 72.4%, and 48.6%, respectively. Five- and 10-year disease-free survival was 67% and 45.8%, respectively. Multivariable analysis demonstrated that TNM stage was a significant predictor of recurrence. For disease-free survival, T stage, and N stage were significant on multivariate analysis. Multivariable predictors of overall survival included age, number of lymph nodes removed, N stage, and adjuvant chemotherapy use. Conclusions: Excellent long-term outcomes from a large cohort of patients with non-metastatic, right colon adenocarcinoma treated by segmental colectomy without complete mesocolic excision are reported. The majority of recurrences were distant.

KW - Adenocarcinoma

KW - Colon cancer

KW - Mesocolic excision

KW - Right colectomy

UR - http://www.scopus.com/inward/record.url?scp=85068823585&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85068823585&partnerID=8YFLogxK

U2 - 10.1007/s11605-019-04271-4

DO - 10.1007/s11605-019-04271-4

M3 - Article

AN - SCOPUS:85068823585

JO - Journal of Gastrointestinal Surgery

JF - Journal of Gastrointestinal Surgery

SN - 1091-255X

ER -