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

Chi Zhang; Esteban Calderon; Yu Hui Chang; Ga-Ram Han; Scott R Kelley; Amit Merchea; Justin T Brady; Tonia M Young-Fadok; David A Etzioni; Nitin Mishra

doi:10.1016/j.amjsurg.2023.02.005

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

Am J Surg. 2023 Jul;226(1):77-82. doi: 10.1016/j.amjsurg.2023.02.005. Epub 2023 Feb 7.

Authors

Affiliations

¹ Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic Rochester, MN, USA.
² Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.
³ Department of Quantitative Health Sciences, Scottsdale, AZ, USA.
⁴ Division of Colon and Rectal Surgery, Mayo Clinic Rochester, Rochester, MN, USA.
⁵ Department of Colon and Rectal Surgery, Mayo Clinic Florida Jacksonville, FL, USA.
⁶ Department of Colon and Rectal Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.
⁷ Department of Colon and Rectal Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA. Electronic address: mishra.nitin@mayo.edu.

PMID: 36858866
DOI: 10.1016/j.amjsurg.2023.02.005

Abstract

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.

Keywords: Colon cancer; Outcomes; Recurrence; Splenic flexure; Survival.

MeSH terms

Adenocarcinoma* / pathology
Adenocarcinoma* / surgery
Colectomy
Colon, Transverse* / surgery
Colonic Neoplasms*
Humans
Laparoscopy*
Retrospective Studies
Treatment Outcome