title: Long-term results following an anatomically based surgical technique for resection of colon cancer: a comparison with results from complete mesocolic excision.
abstract: OBJECTIVE
  Complete mesocolic excision (CME) has been advocated as likely to improve the long-term oncological outcome of colon cancer resection, although there is a paucity of long-term results in the literature. The aim of this study was to supplement our previously published results on colon cancer resection based on a standardized technique of precise dissection along anatomical planes with high vascular ligation and to compare our long-term results with those of recent European studies of CME.
  
  
  METHODS
  Data were drawn from a prospective hospital registry of consecutive resections for colon cancer between 1996 and 2007, including follow-up to the end of 2012. The principal outcomes from potentially curative resections were 5-year Kaplan-Meier rates of local recurrence, systemic recurrence, overall survival and cancer-specific survival. Secondary outcomes for all resections were postoperative complications, number of lymph nodes retrieved and R0 status.
  
  
  RESULTS
  For 779 potentially curative resections the local recurrence rate was 2.1% (95% CI 1.3-3.4), the systemic recurrence rate was 10.2% (95% CI 8.1-12.7), the 5-year overall survival rate was 76.2% (95% CI 73.0-79.0) and the cancer-specific survival rate was 89.8% (95% CI 87.3-91.9). For all 905 resections, rates of 14 surgical complications were low and not dissimilar to those in a comparable study. The median lymph node count was 15 (range 0-113). R0 status was confirmed in 883/905 patients (97.6%; 95% CI 96.4-98.5).
  
  
  CONCLUSIONS
  For colon cancer, meticulous dissection along anatomical planes together with high vascular ligation results in few complications, a high R0 rate, low recurrence and high survival.
authors.affiliation: Department of Surgery, Liverpool Hospital, Sydney, New South Wales, Australia.|School of Medicine, University of Western Sydney, Sydney, New South Wales, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Bokey
authors.affiliation: Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia.|Discipline of Surgery, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: P H
authors.initials: PH
authors.lastname: Chapuis
authors.affiliation: Division of Anatomical Pathology, Concord Hospital, Sydney, New South Wales, Australia.|Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Chan
authors.affiliation: Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Stewart
authors.affiliation: Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia.
authors.forename: M J F X
authors.initials: MJ
authors.lastname: Rickard
authors.affiliation: Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia.|Discipline of Surgery, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Keshava
authors.affiliation: Department of Surgery, Liverpool Hospital, Sydney, New South Wales, Australia.|School of Medicine, University of Western Sydney, Sydney, New South Wales, Australia.|Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia.|Discipline of Surgery, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: O F
authors.initials: OF
authors.lastname: Dent
mesh_terms: D000328:Adult; D000368:Aged; D003082:Colectomy / Q000379:methods*; D003106:Colon / Q000033:anatomy & histology / Q000601:surgery; D003110:Colonic Neoplasms / Q000601:surgery*; D003131:Combined Modality Therapy; D004210:Dissection / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008026:Ligation / Q000379:methods*; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008198:Lymph Nodes / Q000601:surgery; D008297:Male; D008646:Mesocolon / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012042:Registries; D015996:Survival Rate; D013995:Time; D016896:Treatment Outcome; D055815:Young Adult
keywords: Complete mesocolic excision; recurrence; survival