title: En bloc pancreaticoduodenectomy and right colectomy in the treatment of locally advanced colon cancer.
abstract: BACKGROUND
  Carcinoma of the right colon invading the pancreas or duodenum is rare. Evidence of the indication, operative morbidity, and survival of en bloc pancreaticoduodenectomy and right colectomy for right colon cancer invading adjacent organs is limited.
  
  
  OBJECTIVE
  : The goal of this study was to investigate the feasibility, safety, indication, and long-term results of en bloc pancreaticoduodenectomy and right colectomy in the treatment of locally advanced right-sided colon cancer.
  
  
  METHODS
  : This was a retrospective analysis of all inpatients undergoing en bloc pancreaticoduodenectomy and right colectomy. Detailed data of these patients were assessed by a thorough review of medical charts.
  
  
  METHODS
  The study was conducted using a hospital database.
  
  
  METHODS
  Fourteen patients who underwent en bloc pancreaticoduodenectomy and right colectomy from January 1989 through December 2011 were included in the study.
  
  
  METHODS
  In-hospital complications, mortality, and survival were the primary outcomes measured.
  
  
  RESULTS
  Major postoperative complications included delayed gastric empting (n = 7), class B pancreatic fistula (n = 3), and bile leakage (n = 1). Postoperative death occurred in 2 patients. The median hospital stay was 22.5 days (range, 17.0-57.0 days). Inflammatory adhesion was confirmed by pathologic examination in only 1 patient. Eight patients (57%) did not have lymph node metastasis. The median follow-up time was 21 months (range, 4-276 months). Ten patients were alive at the time of their last scheduled follow-up. The overall survival rates were 72% at 1 year and 60% at 2 years. No patient was lost to follow-up. Three patients developed tumor recurrence. The outcomes are no worse than those of the stage-matched patients without adjacent organ involvement and are much better than those of the stage-matched patients who underwent bypass surgery and chemotherapy.
  
  
  CONCLUSIONS
  The number of patients in current studies is limited.
  
  
  CONCLUSIONS
  En bloc pancreaticoduodenectomy and right colectomy can be performed safely with an acceptable morbidity and mortality rate in selected patients with locally advanced right-side colon cancer. The long-term results are promising.
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Hepato-Pancreatic Biliary Surgery, Beijing Cancer Hospital, Peking University Cancer Hospital & Institute, Beijing, China.
authors.forename: Ji
authors.initials: J
authors.lastname: Zhang
authors.forename: Jia-hua
authors.initials: JH
authors.lastname: Leng
authors.forename: Hong-gang
authors.initials: HG
authors.lastname: Qian
authors.forename: Hui
authors.initials: H
authors.lastname: Qiu
authors.forename: Jian-hui
authors.initials: JH
authors.lastname: Wu
authors.forename: Bo-nan
authors.initials: BN
authors.lastname: Liu
authors.forename: Cheng-peng
authors.initials: CP
authors.lastname: Li
authors.forename: Chun-yi
authors.initials: CY
authors.lastname: Hao
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome