Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Recurrence after complete mesocolic excision for right-sided colon cancer: post hoc sensitivity analyses-early recurrence, surgery by specialist and dissection in the mesocolic plane

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Collaboration in colorectal surgical research

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Predicting life with a permanent end colostomy: A prospective study on function, bother and acceptance

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Stoma-related complications: a report from the Stoma-Const randomized controlled trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Short-term outcomes after transanal total mesorectal excision for rectal cancer in Denmark - a prospective multicentre study

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Accuracy of preoperative staging with multidetector computed tomography in colon cancer

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Changes in Incidence and Management of Acute Appendicitis in Children-A Population-Based Study in the Period 2000-2015

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Accuracy of preoperative staging with multidetector computed tomography in colon cancer

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Optimal peripheral nerve block after minimally invasive colon surgery - a study protocol for a randomised trial

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

AIM: The aim was to investigate whether the previously reported causal treatment effect of complete mesocolic excision on the risk of recurrence was biased by inclusion of patients with potentially undiagnosed disseminated disease at the time of surgery, by non-specialist surgery, or caused by mesocolic plane dissection.

METHOD: A population of 1069 patients, 813 undergoing conventional resection and 256 complete mesocolic excision for colon cancer during the period 2008-2013, was stepwise reduced in the following order by excluding patients with recurrence diagnosed within 6 months of the resection, having surgery performed by a non-specialist without supervision, and specimens assessed as not being mesocolic plane dissection. The primary outcome measure was risk of recurrence after 5.2 years using competing risk analyses.

RESULTS: The absolute risk reduction of complete mesocolic excision was 6.0% (95% CI 1.8-10.2; P = 0.0049) after excluding patients with recurrence within 6 months of resection, 6.1% (95% CI 1.9-10.4; P = 0.0045) after excluding non-specialist surgery, and 7.5% (95% CI 2.9-12.0; P = 0.0013) after the exclusion of patients whose specimens were assessed as dissections not being performed in the mesocolic plane.

CONCLUSION: The absolute risk reduction of recurrence after complete mesocolic excision for right-sided colon cancer in our previous study was not biased by potentially undiagnosed disseminated disease at the time of surgery or non-specialist surgery, and was not solely caused by dissection in the mesocolic plane. Central vascular dissection with central lymphadenectomy seems a major factor for better oncological results.

Original languageEnglish
JournalColorectal Disease
Volume23
Issue number8
Pages (from-to)1971-1981
Number of pages11
ISSN1462-8910
DOIs
Publication statusPublished - Aug 2021

    Research areas

  • Colon cancer, complete mesocolic excision, mesocolic plane, recurrence, right-sided

ID: 67015318