Seretis Fotios, Panagaki Antonia, Seretis Charalambos, Sotiropoulou Maria, Psarologos Michail, Mamakos Nikolaos, Polyzois Konstantinos, Drakopoulos Vasileios, Kapiris Stylianos
Third Department of General Surgery, Evaggelismos General Hospital of Athens, 10676 Athens, Greece.
Department of Gastroenterology, Konstantopouleio-Patision General Hospital of Athens, Nea Ionia, 14233 Athens, Greece.
Cancers (Basel). 2025 Aug 21;17(16):2719. doi: 10.3390/cancers17162719.
BACKGROUND/OBJECTIVES: Complete mesocolic excision (CME) has recently been proposed as a radical operation for the treatment of colon cancer. Increasing evidence suggests a survival benefit from this operation, although the exact reasons for this remain largely unknown.
We have undertaken a comprehensive review of the literature in PubMed and Embase databases, examining the potential mechanisms explaining this oncologic benefit.
Complete mesocolic excision with central vascular ligation appears to improve the rates of radial margin negativity and is associated with increased lymph node yield and improved staging for colon cancer patients by removal of apical lymph nodes and removal of skip metastasis. The en bloc removal of the cancer-related mesentery along the interfascial plane between the mesocolon and retroperitoneal structures removes en bloc tumor deposits that appear to have a significant negative effect on cancer prognosis, irrespective of lymph node status. CME is associated with decreased rates of local recurrence and improved disease-free and overall survival. The existing literature suffers from a lack of data on molecular pathology and integration of prognostic pathologic factors such as tumor deposits in patients undergoing complete mesocolic excision.
CME confers significant benefits in terms of local control of the disease and improves cancer-specific survival. Further research on the matter is necessary to incorporate prognostic pathologic and molecular parameters.
背景/目的：完整结肠系膜切除术（CME）最近被提议作为治疗结肠癌的根治性手术。越来越多的证据表明该手术能带来生存获益，尽管其确切原因在很大程度上仍不清楚。
我们对PubMed和Embase数据库中的文献进行了全面综述，研究解释这种肿瘤学获益的潜在机制。
采用中央血管结扎的完整结肠系膜切除术似乎能提高环周切缘阴性率，并且通过切除顶端淋巴结和跳跃转移灶，可增加结肠癌患者的淋巴结获取数量并改善分期。沿着结肠系膜与腹膜后结构之间的筋膜平面整块切除与癌相关的系膜，可整块切除似乎对癌症预后有显著负面影响的肿瘤沉积物，而与淋巴结状态无关。CME与局部复发率降低以及无病生存期和总生存期改善相关。现有文献缺乏关于接受完整结肠系膜切除术患者的分子病理学数据以及诸如肿瘤沉积物等预后病理因素的整合数据。
CME在疾病局部控制方面具有显著益处，并可改善癌症特异性生存。有必要对此进行进一步研究，以纳入预后病理和分子参数。
