Schabl L, Duraes L C, Erozkan K, Alipouriani A, Steele S R, Kessler H
Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave, A30, Cleveland, OH, 44122, USA.
Department of General, Visceral and Thoracic Surgery, University Hospital of Salzburg, Salzburg, Austria.
Langenbecks Arch Surg. 2025 May 9;410(1):156. doi: 10.1007/s00423-025-03665-0.
Transverse colon carcinomas are often treated as a single entity in medical literature, despite differences in embryology, anatomy, physiology, genetics, and surgical treatment. We hypothesized that tumor sublocation affects demographics, oncological, surgical and quality of life outcomes.
A retrospective analysis of patients who underwent surgery for transverse colon carcinomas between 2000 and 2018 was conducted. Tumor localization was determined by operative, pathological and imaging reports, and procedures were defined by the extent of vascular resection.
The study included 273 patients aged 69 years (SD 12.3), of whom 44% were female. The BMI was 28.8 kg/m (SD 6.2), and 61% were ASA class 3. Carcinomas were in the proximal (22%), the mid (42%), and the distal transverse colon (36%). Mid-transverse carcinomas exhibited the highest prevalence among female patients (53% vs. 35% proximal vs. 39% distal, p < 0.03). Proximal transverse carcinomas presented with a higher proportion of pathological stage II than mid and distal transverse carcinomas (68.3% vs. proximal vs. 44.3% mid-vs. 49% distal, p = 0.006). On multivariate analysis, anemia was more likely in mid than proximal (p = 0.009) and distal (p = 0.002) transverse colon cancers. Obstruction occurred more often in proximal than mid (p = 0.003), and hematochezia in distal than in mid (p < 0.001) and proximal (p = 0.014) transverse colon carcinomas. The 30-day mortality and morbidity and 5-year overall and disease-free survival rates were similar between the tumor sublocations.
Sublocations of the transverse colon carcinomas affect the symptoms of patients. Tumor sublocation does not impact the intraoperative, postoperative, or oncological outcomes and quality of life.
在医学文献中，横结肠癌常被视为一个单一的实体，尽管其在胚胎学、解剖学、生理学、遗传学及手术治疗方面存在差异。我们推测肿瘤的亚部位会影响人口统计学特征、肿瘤学、手术及生活质量结局。
对2000年至2018年间接受横结肠癌手术的患者进行回顾性分析。通过手术、病理及影像学报告确定肿瘤定位，并根据血管切除范围定义手术方式。
该研究纳入了273例年龄为69岁（标准差12.3）的患者，其中44%为女性。体重指数为28.8kg/m（标准差6.2），61%为美国麻醉医师协会（ASA）3级。癌肿位于近端横结肠（22%）、中段横结肠（42%）及远端横结肠（36%）。中段横结肠癌在女性患者中的患病率最高（53%，近端为35%，远端为39%，p<0.03）。近端横结肠癌的病理II期比例高于中段和远端横结肠癌（68.3%，近端vs.中段44.3% vs.远端49%，p=0.006）。多因素分析显示，中段横结肠癌患者贫血的可能性高于近端（p=0.009）和远端（p=0.002）横结肠癌患者。梗阻在近端横结肠癌中比中段更常见（p=0.003），便血在远端横结肠癌中比中段（p<0.001）和近端（p=0.014）更常见。肿瘤亚部位之间的30天死亡率和发病率以及5年总生存率和无病生存率相似。
横结肠癌的亚部位会影响患者的症状。肿瘤亚部位不影响术中、术后、肿瘤学结局及生活质量。
