Right-sided vs. left-sided obstructing colonic cancer: results of a multicenter study of the French Surgical Association in 2325 patients and ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-04-02

AUTHORS

Diane Mege, Gilles Manceau, Laura Beyer, Valérie Bridoux, Zaher Lakkis, Aurélien Venara, Thibault Voron, Nicolas de’Angelis, Solafah Abdalla, Igor Sielezneff, Mehdi Karoui, On behalf of the AFC (French Surgical Association) Working Group

ABSTRACT

PURPOSE: Few studies compared management and outcomes of obstructing colonic cancer (OCC), according to the tumor site. Our aim was to compare patient and tumor characteristics, postoperative and pathological results, and oncological outcomes after emergency management of right-sided vs. left-sided OCC. METHODS: A national cohort study including all consecutive patients managed for OCC from 2000 to 2015 in French surgical centers members of the French National Surgical Association (AFC). RESULTS: During the study period, 2325 patients with OCC were divided in right-sided (n = 819, 35%) and left-sided (n = 1506, 65%) locations. Patients with right-sided OCC were older, more frequently females, and associated with comorbidities, history of cancer, or previous laparotomy. Surgical management was more frequently performed for right-sided than left-sided OCC (99 vs. 96%, p < 0.0001). Tumor resection was more frequently performed in right-sided OCC (95 vs. 90%, p < 0.0001). Among the resected patients, primary anastomosis was more frequently performed in case of right-sided OCC (86 vs. 62%, p < 0.0001). Definitive stoma rate was lower in right-sided location (17 vs. 46%, p < 0.0001). There was no significant difference between locations in terms of cumulative morbidity, anastomotic leak, unplanned reoperation, and mortality. Five-year overall and disease-free survival rates were significantly lower in right-sided OCC (43 and 36%) than in left-sided OCC (53 and 46%, p < 0.0001 and p = 0.001, respectively). CONCLUSIONS: Although patients with right-sided OCC are frailer than left-sided OCC, tumor resection and anastomosis are more frequently performed, without difference in surgical results. However, right-sided OCC is associated with worse prognosis than distal location. More... »

PAGES

1-12

References to SciGraph publications

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  • Identifiers

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    http://scigraph.springernature.com/pub.10.1007/s00384-019-03286-2

    DOI

    http://dx.doi.org/10.1007/s00384-019-03286-2

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1113179918

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30941568


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