Journal
CANCER RESEARCH AND TREATMENT
Volume 42, Issue 2, Pages 69-76Publisher
KOREAN CANCER ASSOCIATION
DOI: 10.4143/crt.2010.42.2.69
Keywords
Colonic neoplasms; Left colic flexure; Colectomy; Splenectomy
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Funding
- Minister of Health, Welfare and Family Affairs, Republic of Korea [A062254]
- Korea Health Promotion Institute [A062254] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
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Purpose This current study examined the clinicopathologic characteristics of patients with splenic flexure (SF) colon cancer and the association with the surgical outcomes to find the optimal procedure to treat this malady. Materials and Methods A total of 167 operated patients with SF colon cancer were consecutively recruited between 1993 and 2003. The clinicopathological, operative and survival data was reviewed and analyzed. Results For the SF colon cancer patients, the proportion of males was higher than that for the right-sided colon patients or the sigmoid-descending junction & sigmoid (SD & S) colon patients (p <= 0.05, respectively) and the age at the time of diagnosis was younger (p <= 0.05). Obstruction was more frequent in the patients with SF colon cancer than that for the patients with colon cancer at other sites (p <= 0.001). The incidence of mucinous adenocarcinoma for the SF patients was similar to that for the patients with right-sided colon cancer, but it was higher than that for the patients with SD & S colon cancer (11.4% vs. 6.5%, p=0.248 or 2.5%, respectively, p=0.001). Disease-free and overall survival did not differ between the patients who underwent a left hemicolectomy and extended surgery such as combined splenectomy or subtotal colectomy. Multivariate analysis showed that old age (>= 60 years) and a N1-2 and M1 status were the independent risk factors for overall survival. Conclusion The SF colon cancers exhibited exclusively different characteristics as compared to colon cancers at other site colon cancers. It appears that left hemicolectomy was generally sufficient for a satisfactory oncological outcome, obviating concurrent splenectomy.
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