Clinicopathologic characteristics, surgical treatment and outcomes for splenic flexure colon cancer.
OBJECTIVE
This current study examined the clinicopathologic characteristics of patients with splenic flexure (SF) colon cancer and the association with the surgical outcomes to find the optimal procedure to treat this malady.


METHODS
A total of 167 operated patients with SF colon cancer were consecutively recruited between 1993 and 2003. The clinicopathological, operative and survival data was reviewed and analyzed.


RESULTS
For the SF colon cancer patients, the proportion of males was higher than that for the right-sided colon patients or the sigmoid-descending junction & sigmoid (SD & S) colon patients (p≤=0.05, respectively) and the age at the time of diagnosis was younger (p≤=0.05). Obstruction was more frequent in the patients with SF colon cancer than that for the patients with colon cancer at other sites (p≤=0.001). The incidence of mucinous adenocarcinoma for the SF patients was similar to that for the patients with right-sided colon cancer, but it was higher than that for the patients with SD & S colon cancer (11.4% vs. 6.5%, p=0.248 or 2.5%, respectively, p=0.001). Disease-free and overall survival did not differ between the patients who underwent a left hemicolectomy and extended surgery such as combined splenectomy or subtotal colectomy. Multivariate analysis showed that old age (≥=60 years) and a N1-2 and M1 status were the independent risk factors for overall survival.


CONCLUSIONS
The SF colon cancers exhibited exclusively different characteristics as compared to colon cancers at other site colon cancers. It appears that left hemicolectomy was generally sufficient for a satisfactory oncological outcome, obviating concurrent splenectomy.
Kim
Chan Wook
CW
Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
Shin
Ui Sup
US
Yu
Chang Sik
CS
Kim
Jin Cheon
JC