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Ann Surg. 2018 Aug 24. doi: 10.1097/SLA.0000000000003012. [Epub ahead of print]

Efficacy and Safety of Complete Mesocolic Excision in Patients With Colon Cancer: Three-year Results From a Prospective, Nonrandomized, Double-blind, Controlled Trial.

Author information

1
Department of Gastrointestinal Surgery, Peking University People's Hospital, Beijing, China.
2
Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Beijing, China.
3
Laboratory of Surgical Oncology, Peking University People's Hospital, Beijing, China.
4
Department of Pathology, Peking University People's Hospital, Beijing, China.
5
Department of Radiology, Peking University People's Hospital, Beijing, China.
6
Department of Epidemiology, Peking University Health Science Center, Beijing, China.

Abstract

OBJECTIVE:

The aim of the study was to evaluate the oncological outcomes of complete mesocolic excision (CME) in colon cancer patients.

SUMMARY BACKGROUND DATA:

CME is considered a standard procedure for colon cancer patients. However, previous evidence regarding the effect of CME on prognosis has fundamental limitations that prevent it from being fully accepted.

METHODS:

Patients who underwent radical resection for colon cancer were enrolled between November 2012 and March 2016. According to the principles of CME, patients were stratified into 2 groups based on intraoperative surgical fields and specimen photographs. The primary outcome was local recurrence-free survival (LRFS). The clinicopathological data and follow-up information were collected and recorded. The final follow-up date was April 2016. The trial was registered in ClinicalTrials.gov (identifier: NCT01724775).

RESULTS:

There were 220 patients in the CME group and 110 patients in the noncomplete mesocolic excision (NCME) group. Baseline characteristics were well balanced. Compared with NCME, CME was associated with a greater number of total lymph nodes (24 vs 20, P = 0.002). Postoperative complications did not differ between the 2 groups. CME had a positive effect on LRFS compared with NCME (100.0% vs 90.2%, log-rank P < 0.001). Mesocolic dissection (100.0% vs 87.9%, log-rank P < 0.001) and nontumor deposits (97.2% vs 91.6%, log-rank P < 0.022) were also associated with improved LRFS.

CONCLUSIONS:

Our findings demonstrate that, compared with NCME, CME improves 3-year LRFS without increasing surgical risks.

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