title: Standard versus limited colon resection for high risk T1 colon cancer. A matched case-control study.
abstract: The National Comprehensive Cancer Network (NCCN) recommends a colectomy in presence of high risk T1 colon polyps considering the risk of incomplete lymph node dissection or presence of residual disease. We evaluated the outcomes of segmental versus standard colon resection for high risk T1 colon cancers, in order to demonstrate if segmental colectomy (SegCR) allows same short-term and oncological results compared to standard radical colectomy (StaCR). METHODS. A matched case-control study on patients who had undergone segmental versus standard colon resection was performed. One-hundred and two patients with high risk T1 colon cancer after endoscopic polypectomy, divided in 2 homogeneous groups of 51 cases, were analyzed and intra-operative, post-operative and oncological data were compared. RESULTS. Segmental colectomy allowed less operative time and intra-operative blood loss compared to StaCR (p < 0.001). Hospital stay after SegCR was shorter compared to StaCR (p < 0.001). No differences were found in terms of overall morbidity and mortality rates. Five-year actuarial overall, disease-free and disease-specific survival after StaCR were similar to SegCR (87%, 96% and 95% vs. 88%, 97% and 94%, respectively, p = 0.51, p=0.33, p=0.78). CONCLUSIONS. According to our findings, SegCR can be a valid alternative to StaCR for high risk T1 colon polyps. Segmental colectomy allows better peri-operative outcomes compared to StaCR ensuring the same oncological long-term outcomes.
authors.affiliation: Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, Rome, Italy. marco.latorre@uniroma1.it.
authors.forename: Marco
authors.initials: M
authors.lastname: La Torre
authors.affiliation: Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nigri
authors.affiliation: Department of Clinical Oncology, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome La Sapienza Rome, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Mazzuca
authors.affiliation: Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Ferri
authors.affiliation: Department of Clinical Oncology, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome La Sapienza Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Botticelli
authors.affiliation: Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Lorenzon
authors.affiliation: Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, Rome, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Pilozzi
authors.affiliation: Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ziparo
mesh_terms: D016063:Blood Loss, Surgical / Q000517:prevention & control; D003082:Colectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003111:Colonic Polyps / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000009:adverse effects / Q000401:mortality; D009367:Neoplasm Staging; D061646:Operative Time; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome