Short and long-term oncologic outcomes of patients with colon cancer of the splenic flexure

Background: There is currently no consensus on surgical management of splenic flexure adenocarcinoma (SFA). Methods: Patients undergoing surgical resection for SFA between 1993 and 2015 were identified. Postoperative outcomes were compared between patients who underwent segmental (SR) vs. anatomical resection (AR). Results: One-hundred and thirteen patients underwent SR and 89 underwent AR. More patients in the SR group had open resections, but there were otherwise no differences in demographics or surgical characteristics between the two groups. There were no differences in overall (p = 0.29) or recurrence-free(p = 0.37) survival. On multivariable analysis, increased age (HR 1.04, 1.01-1.07, p = 0.005), higher American Society of Anesthesiology classification (HR 3.1, 1.7-5.71, p < 0.001), and higher tumor stage (HR 8.84, 3.76-20.82, p < 0.001) were predictive of mortality. Conclusions: Short and long-term outcomes after SR and AR for SFA are not different, making SR a viable option for SFA surgical management.

Automated summary

There is no consensus on the surgical management of splenic flexure adenocarcinoma (SFA). A study compared postoperative outcomes between patients who underwent segmental resection (SR) and anatomical resection (AR) for SFA. The results showed no differences in overall or recurrence-free survival between the two groups. Age, American Society of Anesthesiology classification, and tumor stage were predictive of mortality. In conclusion, SR is a viable option for the surgical management of SFA.