110P - D3 lymph node dissection may be necessary in clinical stage I right colon cancer

Background

D3 lymph node dissection or complete mesocolic excision (CME) with central vascular ligation (CVL) is becoming standard procedure in advanced right colon cancer with increasing evidences of its oncologic benefit. However, clear indication has not been declared and evidences to lighten the undetermined area is not satisfactory yet. There is still a controversy whether D3 lymph node dissection is necessary in clinical stage I right colon cancer.

Methods

We retrospectively analyzed clinical stage I right colon cancer patients who underwent radical surgery in three Korea university hospitals from January 2015 to June 2018. We compared surgical complications and short-term oncologic outcome between D2 and D3 lymph node dissections in clinical stage I right colon cancer patients.

Results

602 patients had radical surgery for right colon cancer in the study period and the number of clinical stage I patients was 125 (20.8%). Among 125 patients, D2 lymph node dissection was done in 86 patients (68.8%) and 39 patients underwent D3 lymph node dissection. There was no statistically significant differences in clinicopathologic variables and surgical outcomes between two groups. Up-stagings were found in 15 patients (38.5%) in D3 group and 18 patients (20.9%) in D2 group. There were four recurrences in D2 lymph node dissection group but no recurrences in D3 group. Log-rank test was performed and there was no statistically significant difference in recurrence-free survival rate between two groups (p = 0.2).

Conclusions

There was no significant difference in recurrence-free survival rate between D2 and D3 lymph node dissection in clinical stage I right colon cancer patients. But recurrences had occurred in D2 group. Efforts to make clinical staging more accurate is required and more studies with better quality are needed.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.