QUALITY OF THE MESOCOLIC SPECIMEN AND ITS ASSOCIATION WITH SELECTED ONCOLOGIC RADICALITY FACTORS IN LAPAROSCOPIC COLON CANCER SURGERY
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Abstract
Background: The quality of the mesocolic specimen is a factor of adherence to embryological dissection planes and oncologic surgical quality. However, data on this parameter in laparoscopic colon cancer surgery in Vietnam remain limited. Objectives: To evaluate the quality of the mesocolic specimen and to analyze its association with selected oncologic radicality factors in laparoscopic colon cancer surgery. Materials and methods: This prospective descriptive study included 55 patients with colon cancer who underwent laparoscopic complete mesocolic excision with central vascular ligation at Can Tho University of Medicine and Pharmacy Hospital from May 2024 to December 2025. Results: Good-quality mesocolic specimens were achieved in 87.3% of cases, while 12.7% were classified as moderate. The mean lymph node yield was 13.94 ± 3.44 nodes, and the rate of retrieval of at least 12 lymph nodes was 84.1%. No case had a positive resection margin. A circumferential resection margin (CRM) greater than 1 mm was observed in 78.2% of cases. Specimen quality was significantly associated with nodal stage when analyzed across three categories (N0, N1, and N2) (p=0.002), tumor invasion depth (T stage) (p=0.005), tumor size (p=0.036), and circumferential resection margin (p=0.004). Conclusions: Most mesocolic specimens achieved good quality in laparoscopic surgery for colon cancer. Specimen quality was associated with tumor progression, the extent of regional nodal metastasis, and circumferential resection margin. Assessment of mesocolic specimen quality may contribute to the evaluation of local oncologic surgical quality and help guide postoperative management.
Keywords
Colon cancer, mesocolic specimen, specimen quality, laparoscopy, oncologic radicality
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References
2. West N. P., Hohenberger W., Weber K., Perrakis A., Finan P. J. et al. Complete mesocolic excision with central vascular ligation produces an oncologically superior specimen compared with standard surgery for carcinoma of the colon. J Clin Oncol. 2010. 28(2), 272-278, doi: 10.1200/JCO.2009.24.1448.
3. West N. P., Sutton K. M., Ingeholm P., Hagemann-Madsen R. H., Hohenberger W. et al. Improving the quality of colon cancer surgery through a surgical education program. Dis Colon Rectum. 2010. 53(12), 1594-1603, doi: 10.1007/DCR.0b013e3181f433e3.
4. Bertelsen C. A. Complete mesocolic excision: An assessment of feasibility and outcome. Dan Med J. 2017. 64(2), B5334. PMID: 28157065.
5. Seow-En I., Chen W. T. Complete mesocolic excision with central venous ligation/D3 lymphadenectomy for colon cancer - A comprehensive review of the evidence. Surg Oncol, 2022. 42(101755), https://doi.org/10.1016/j.suronc.2022.101755.
6. Gupta A., Garabetian C., Cologne K., Duldulao M. P. Complete mesocolic excision and extended lymphadenectomy: Where should we stand? J Surg Oncol. 2024. 129(2), 338-348, https://doi.org/10.1002/jso.27475.
7. Vogel J. D., Felder S. I., Bhama A. R., Hawkins A. T., Langenfeld S. J. et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Colon Cancer. Dis Colon Rectum. 2022. 65(2), 148-177, doi: 10.1097/DCR.0000000000002323.
8. West N. P., Morris E. J., Rotimi O., Cairns A., Finan P. J. et al. Pathology grading of colon cancer surgical resection and its association with survival: A retrospective observational study. Lancet Oncol. 2008. 9(9), 857-65, doi: 10.1016/S1470-2045(08)70181-5.