Propensity score analysis of postoperative and oncological outcomes after surgical treatment for splenic flexure colon cancer

Int J Colorectal Dis. 2018 Sep;33(9):1201-1213. doi: 10.1007/s00384-018-3063-1. Epub 2018 May 29.

Abstract

Purpose: The surgical treatment of splenic flexure colon cancer (SFCC) is somehow not yet well standardized. Postoperative and oncological results of the three surgical techniques most commonly used to treat SFCC: extended right colectomy (ERC), egmental left colectomy (SLC), and left colectomy (LC) were evaluated.

Methods: The study included all patients with stage I-III SFCC treated by ERC, SLC, or LC between 2005 and 2016. Postoperative and long-term outcomes after the different surgical techniques were analyzed: Propensity score matching (PSM) was performed to compare the outcomes between these surgical techniques and survival analyses were performed using the Kaplan-Meier method and log-rank tests.

Results: A total of 170 SFCC patients were operated; ERC was performed in 71 (41.76%), SLC in 36 (21.18%), and LC in 63 (37.06%). There were no significant differences in the short and long-term postoperative outcomes. Three comparison groups were developed so that PSM could be performed between the surgical technique cases: ERC (n = 59) vs. LC (n = 50); ERC (n = 50) vs. SLC (n = 33); and SLC (n = 32) vs. LC (n = 44). No differences in the short or long-term outcomes of these techniques were observed.

Conclusion: The short and long-term outcomes between ERC, SLC, and LC are similar. SLC should be considered oncologically as appropiate as the other more extensive resections.

Keywords: Left colectomy; Right colectomy; Segmental left colectomy.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colectomy*
  • Colon, Transverse / surgery
  • Colonic Neoplasms / surgery*
  • Female
  • Humans
  • Laparoscopy*
  • Male
  • Middle Aged
  • Postoperative Complications
  • Propensity Score
  • Treatment Outcome