Long-Term Oncological Outcomes After Complete Mesocolic Excision Versus Standard Resection for Right-Sided Colon Cancer: A Propensity Score Matching Analysis.

BACKGROUND

Complete mesocolic excision (CME) has not gained wide diffusion, mainly due to its technical complexity and unclear oncological benefits. We investigated the long-term outcomes of patients with right-sided colon cancer who underwent CME surgery compared to those treated with conventional surgery (NCME).

METHODS

Prospectively collected data of patients who underwent surgery between 2010 and 2018 were retrospectively analysed. Propensity score matching (PSM) was used to balance baseline characteristics of CME and NCME patients. The primary endpoints of the study were overall and disease-free survival (OS and DFS), distant and local recurrence-free survival (DRFS and LRFS).

RESULTS

Out of the 444 patients included in the study, 254 were correctly matched after PSM, 127 in each group. The median follow-up was 70 months (IQR 54-81). Conversion rate, complications, and 90-day mortality were comparable in both groups. Five-year LRFS rates for CME patients was 100% and 95% for NCME (log-rank p = 0.044). At 5 years, there were no differences between the two groups in terms of overall survival and disease-free survival.

CONCLUSIONS

Laparoscopic CME for RCC is associated with a significant decrease in terms of LRFS. No benefit on long-term disease-free survival and overall survival was obtained.