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Title

More Than Lymph Node Dissection Has an Effect on Overall Survival For Right Colon Cancer

Authors
Ignjatovic, Dejan
Published in Diseases of the colon & rectum. 2022, vol. 65, no. 1, e27
Abstract We are impressed with the work presented by Zhou et al. There have been some recent retrospective publications stating the similar results, namely that time to recurrence was significantly longer after more extensive lymph node dissection (D3) compared to less extensive lymph node dissection; however, the extent of lymph node dissection alone did not have a significant impact on 5-year overall survival (OS). Moreover, it was noticed that vascular invasion and a high lymph node ratio significantly reduced the OS. This could also imply that the prognosis for subgroups of Stage III colon cancer patients can be good also without chemotherapy, which in turn bears a significant risk of morbidity and mortality. This also includes the patient's anatomy as stated by Ishyama et al, when the ileocolic artery crosses posterior to the superior mesenteric vein. Another point we wish to address is the occurrence and prevention of chylous ascites. When the ongoing trial “Safe Radical D3 Right Hemi-colectomy for Cancer through Preoperative Biphasic Multi-Detector Computed Tomography (MDCT) Angiography” introduced a standardized personalized approach with central vessel ligation in the central mesentery both anterior and posterior to the superior mesenteric vessels a higher occurrence of chylous ascites was also noticed. The solution for this problem was a simple fat free diet administered in the first three postoperative days, and has very effectively neutralized the issue. We agree that intraoperative complications are somewhat higher in this D3 patient group.
Identifiers
PMID: 34636787
Note Comment on: The Medial Border of Laparoscopic D3 Lymphadenectomy for Right Colon Cancer
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Other version: https://journals.lww.com/10.1097/DCR.0000000000002313
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IGNJATOVIC, Dejan, STIMEC, Bojan. More Than Lymph Node Dissection Has an Effect on Overall Survival For Right Colon Cancer. In: Diseases of the colon & rectum, 2022, vol. 65, n° 1, p. e27. doi: 10.1097/DCR.0000000000002313 https://archive-ouverte.unige.ch/unige:157248

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Deposited on : 2021-12-15

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