Abstract
Purpose: Complete mesocolic excision for right sided colon cancer is a complex operation that might offer a survival benefit. However, studies comparing CME to standard surgery have not been published so far. Methods: One-hundred-seven patients were operated at the discretion of the surgeon either according to principles of complete mesocolic excision (CME-group, n=69) or received a standard right hemicolectomy (non-CME group, n=38). The type of surgery was prospectively recorded. Results: Patients in the non-CME group were significantly older (67,9 vs.78,1 p<0,001) and had fewer adjuvant chemotherapies in stage III (94,7 vs. 60,0% p=0,02). For the combined analysis of stages I-III actuarial 5-year overall-, recurrence free- and tumor specific survival was significantly better for the CME group (OS 89,4% vs. 71,5%, p=0,011; RFS 83,8% vs. 70,3% p=0,035; TSS 93,8% vs. 78,0% p=0,049). Conclusion: The data suggest a survival benefit for complete mesocolic excision in the treatment of right sided colon cancer. However, the data needs to be interpreted with caution because of the uneven distribution of age and number chemotherapies. The results of the large multicentre trial which is currently going on among German certified cancer is expected to further clarify this issue.
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