Association between plane of mesocolic dissection and recurrence after complete mesocolic excision for right-sided colon cancer: a cohort study
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Dissection in the mesocolic plane is considered by some medical professionals to be crucial in complete mesocolic excision. We aimed to assess whether intramesocolic plane dissection is associated with a risk of recurrence after complete mesocolic excision for right-sided colon cancer.
Method
This is a single-centre study based on prospectively registered data on patients undergoing resection for Union for International Cancer Control Stage I–III right-sided colon adenocarcinoma during the period 2010–2017. Patients were stratified in an intramesocolic plane group or a mesocolic plane group based on a prospective assessment of fresh specimens by a pathologist. Primary outcome was the 4.2 year risk of recurrence after inverse probability treatment weighting and competing risk analyses.
Results
Of 383 patients, 4 (1%) were excluded as the specimen was assessed as muscularis propria plane, 347 (91.6%) specimens were deemed as mesocolic and 32 (8.4%) as intramesocolic. The 4.2 year cumulative incidence of recurrence after inverse probability treatment weighting was 9.1% (95% CI 6.0%–12.1%) in the mesocolic group compared with 14.0% (3.6%–24.5%) in the intramesocolic group with an absolute risk difference in favour of mesocolic plane dissection of 4.9% (−5.7 to 15.6, p = 0.37). No difference was observed in the risk of local recurrence, death before recurrence or overall survival after 4.2 years between the two groups.
Conclusion
Mesocolic plane dissection can be achieved in more than 90% of patients. The classification seems to be a guide for good surgical practice and not to be used for research purposes.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Colorectal Disease |
| Vol/bind | 25 |
| Udgave nummer | 7 |
| Sider (fra-til) | 1392-1402 |
| Antal sider | 11 |
| ISSN | 1462-8910 |
| DOI | |
| Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:
This study was funded by the Tvergaard Fond, the Helen Rude Fond, the Edgar & Hustru Gilberte Schnohrs Fond, the K&V Fond, the Olga Bryde Nielsen Fond, the Else & Mogens Wedell‐Wedellsborg Fond and the Inger & Hakon Fabricius Fond. CAB is funded by a research grant from Copenhagen University Hospital – Nordsjællands Hospital.The funding sources had no role in study design, in the collection, analysis and interpretation of data, in the writing of the report or in the decision to submit the paper for publication. CAB had access to all data, and as corresponding author had the final responsibility to submit for publication.
Funding Information:
This study was funded by the Tvergaard Fond, the Helen Rude Fond, the Edgar & Hustru Gilberte Schnohrs Fond, the K&V Fond, the Olga Bryde Nielsen Fond, the Else & Mogens Wedell-Wedellsborg Fond and the Inger & Hakon Fabricius Fond. CAB is funded by a research grant from Copenhagen University Hospital – Nordsjællands Hospital.The funding sources had no role in study design, in the collection, analysis and interpretation of data, in the writing of the report or in the decision to submit the paper for publication. CAB had access to all data, and as corresponding author had the final responsibility to submit for publication.
Publisher Copyright:
© 2023 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.
ID: 363396264