<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2020-0032_s_006_w2aab3b7b2b1b6b1aab1c16b1Aa"><h3>Background</h3><p>Management of locally advanced colon cancer (LACC) is challenging. Surgery is the mainstay of the treatment, yet its outcomes remain unclear, especially in the setting of multivisceral resections. The aim of the study was to examine the outcomes of standard and multivisceral colectomy in patients with LACC.</p></sec><sec id="j_raon-2020-0032_s_007_w2aab3b7b2b1b6b1aab1c16b2Aa"><h3>Patients and methods</h3><p>Patients demographics, clinical and perioperative data of patients operated within study period 2004–2018 were collected. LACC was defined as stage T4 colon cancer including tumor invasion either through the visceral peritoneum or to the adjacent organs/structures. Accordingly, either standard or multivisceral colectomy (SC and MVC) was performed.</p></sec><sec id="j_raon-2020-0032_s_008_w2aab3b7b2b1b6b1aab1c16b3Aa"><h3>Results</h3><p>Two hundred and three patients underwent colectomy for LACC. Of those, 112 had SC (55.2%) and 91 (44.8%) had MVC. Severe morbidity and mortality rates were 5.9% and 2.5%, respectively. MVC was associated with an increased blood loss (200 ml <italic>vs</italic>. 100 ml, p = 0.01), blood transfusion (22% <italic>vs</italic>. 8.9%, p = 0.01), longer operative time (180 minutes <italic>vs</italic>. 140 minutes, p &lt; 0.01) and postoperative hospital stay (11 days <italic>vs</italic>. 10 days, p &lt; 0.01) compared with SC. The complication-associated parameters were similar. Male gender, presence of ≥ 3 comorbidities, tumor location in the left colon and perioperative blood transfusion were associated with complications in the univariable analysis. In the multivariable model, the presence of ≥ 3 comorbidities was the only independent predictor of complications.</p></sec><sec id="j_raon-2020-0032_s_009_w2aab3b7b2b1b6b1aab1c16b4Aa"><h3>Conclusions</h3><p>Colectomy with or without multivisceral resection is a safe procedure in LACC. In experienced hands, the postoperative outcomes are similar for SC and MVC. Given the complexity of the latter, these procedures should be reserved to qualified expert centers.</p></sec></abstract>

BackgroundManagement of locally advanced colon cancer (LACC) is challenging. Surgery is the mainstay of the treatment, yet its outcomes remain unclear, especially in the setting of multivisceral resections. The aim of the study was to examine the outcomes of standard and multivisceral colectomy in patients with LACC.Patients and methodsPatients demographics, clinical and perioperative data of patients operated within study period 2004–2018 were collected. LACC was defined as stage T4 colon cancer including tumor invasion either through the visceral peritoneum or to the adjacent organs/structures. Accordingly, either standard or multivisceral colectomy (SC and MVC) was performed.ResultsTwo hundred and three patients underwent colectomy for LACC. Of those, 112 had SC (55.2%) and 91 (44.8%) had MVC. Severe morbidity and mortality rates were 5.9% and 2.5%, respectively. MVC was associated with an increased blood loss (200 ml vs. 100 ml, p = 0.01), blood transfusion (22% vs. 8.9%, p = 0.01), longer operative time (180 minutes vs. 140 minutes, p < 0.01) and postoperative hospital stay (11 days vs. 10 days, p < 0.01) compared with SC. The complication-associated parameters were similar. Male gender, presence of ≥ 3 comorbidities, tumor location in the left colon and perioperative blood transfusion were associated with complications in the univariable analysis. In the multivariable model, the presence of ≥ 3 comorbidities was the only independent predictor of complications.ConclusionsColectomy with or without multivisceral resection is a safe procedure in LACC. In experienced hands, the postoperative outcomes are similar for SC and MVC. Given the complexity of the latter, these procedures should be reserved to qualified expert centers.

Standard and multivisceral colectomy in locally advanced colon cancer

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

{"article-title":"Standard and multivisceral colectomy in locally advanced colon cancer"}

BackgroundManagement of locally advanced colon cancer (LACC) is challenging. Surgery is the mainstay of the treatment, yet its outcomes remain unclear,...

Standard and multivisceral colectomy in locally advanced colon cancer

Article Category: Research Article

Pubblicato online: 28 mag 2020

Pagine: 341 - 346

Ricevuto: 21 feb 2020

Accettato: 30 apr 2020

DOI: https://doi.org/10.2478/raon-2020-0032

© 2020 Artur M. Sahakyan, Andranik Aleksanyan, Hovhannes Batikyan, Hmayak Petrosyan, Mushegh А. Sahakyan, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.