Interactions of occult tumor spread and surgical technique on overall and disease-free survival in patients operated for stage I and II right-sided colon cancer

Purpose To determine if “medial to lateral” (ML) dissection with devascularization first is superior to “lateral to medial” (LM) dissection regarding numbers of lymph node micro metastases (MM) and isolated tumor cells (ITC) as well as 5-year disease-free (5YDFS) and 5-year overall survival (5YOS) i...

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Bibliographic Details
Published in:Journal of cancer research and clinical oncology 2021-12, Vol.147 (12), p.3535-3543
Main Authors: Banipal, G. S., Stimec, B. V., Andersen, S. N., Faerden, A. E., Edwin, B., Baral, J., Benth, J. Šaltytė, Ignjatovic, D.
Format: Article
Language:English
Subjects:
Aged
Angiography
Cancer Research
Colectomy - adverse effects
Colectomy - methods
Colon cancer
Colonic Neoplasms - pathology
Colonic Neoplasms - surgery
Colorectal cancer
Computed tomography
Disease-Free Survival
Female
Hematology
Humans
Internal Medicine
Laparotomy - adverse effects
Laparotomy - methods
Lymph nodes
Lymphatic Metastasis - pathology
Lymphatic system
Male
Medicine
Medicine & Public Health
Metastases
Middle Aged
Monoclonal antibodies
NCT
NCT01351714
Oncology
Original Article – Cancer Research
Original – Cancer Research
Patients
Surgical techniques
Tumor cells
Tumors
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Summary:Purpose To determine if “medial to lateral” (ML) dissection with devascularization first is superior to “lateral to medial” (LM) dissection regarding numbers of lymph node micro metastases (MM) and isolated tumor cells (ITC) as well as 5-year disease-free (5YDFS) and 5-year overall survival (5YOS) in stage I/II right-sided colon cancer. Methods Two datasets are used. ML group consists of consecutive stage I/II patients from a prospective trial. LM group is the original dataset from a previous publication. All harvested lymph nodes are examined with monoclonal antibody CAM 5.2 (immunohistochemically). Lymph node harvest and 5YOS/5YDFS were compared between ML/LM groups, stage I/II tumors and MM/ITC presence/absence. Results 117 patients included ML:51, LM:66. MM/ITC positive in ML 37.3% (19/51), LM 31.8% (21/66) p  = 0.54. The 5YDFS for patients in ML 70.6% and LM 69.7%, p  = 0.99, 5YOS: 74.5% ML and 71.2% LM ( p  = 0.73). No difference in 5YDFS/5YOS between groups for Stage I/II tumors; however, LM group had an excess of early tumors (16) when compared to ML group, while lymph node harvest was significantly higher in ML group ( p  
ISSN:0171-5216
1432-1335
DOI:10.1007/s00432-021-03773-6