TY - JOUR

T1 - Association between plane of mesocolic dissection and recurrence after complete mesocolic excision for right-sided colon cancer

T2 - a cohort study

AU - Bertelsen, Claus Anders

AU - Gundestrup, Anders Kierkegaard

AU - Olsen, Anna Sofie Friis

AU - Bols, Birgitte

AU - Ingeholm, Peter

AU - Kleif, Jakob

N1 - Publisher Copyright: © 2023 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.

PY - 2023

Y1 - 2023

N2 - Aim: 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.

AB - Aim: 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.

KW - colon cancer

KW - mesocolic dissection plane

KW - recurrence

KW - right colon

KW - survival

U2 - 10.1111/codi.16551

DO - 10.1111/codi.16551

M3 - Journal article

C2 - 37020396

AN - SCOPUS:85152052939

VL - 25

SP - 1392

EP - 1402

JO - Colorectal Disease

JF - Colorectal Disease

SN - 1462-8910

IS - 7

ER -