Yonsei Med J.  2009 Dec;50(6):803-806. 10.3349/ymj.2009.50.6.803.

En bloc Resection for Right Colon Cancer Directly Invading Duodenum or Pancreatic Head

• Lee WS
• Lee WY
• Chun HK
• Choi SH

• KMID: 1777094
• DOI: http://doi.org/10.3349/ymj.2009.50.6.803

Abstract

PURPOSE
We undertook this study to analyze clinical features and surgical outcome of en bloc resections of the right side colon cancer directly invading duodenum and/or pancreatic head.
MATERIALS AND METHODS
The records of all patients who underwent en bloc resection of duodenum and/or pancreas for right colon cancers were analyzed retrospectively. From September 1994 to September 2006, 1,016 patients underwent curative right hemicolectomy. Nine patients (0.9%) had en bloc resection of a right side colon cancer with duodenum or pancreatic head invasion.
RESULTS
The median operative time was 320 minutes (range, 200-420) and the median blood loss was 700 mL (range, 100-2,000). The mean size of tumor was 6.6 cm (range, 3.2-10.7). The mean preoperative carcinoembryonic antigen (CEA) was 10.6 ng/mL (range, 0.2-50.8). There was no 30 day perioperative mortality. The median disease-free survival was 23.5 months [95% confidence interval (CI) 5.2-41.8] and the median overall survival was 28.1 months (95% CI 9.7-46.5).
CONCLUSIONS
In patients with locally advanced right side colon cancer that directly invades the duodenum or pancreas can be safely resected with curative potential with minimum morbidity and mortality. Long term disease free survival can occur in a significant number of patients undergoing curative en bloc resection in this particular subset of patients.

Keyword

Colonic neoplasms; duodenectomy; pancreaticoduodenectomy; survival

MeSH Terms

Adult
Aged
Camptothecin/analogs & derivatives/pharmacology/therapeutic use
Chemotherapy, Adjuvant
Colonic Neoplasms/*complications/drug therapy/mortality/*surgery
Disease-Free Survival
Duodenal Neoplasms/drug therapy/mortality/*secondary/surgery
Duodenum/drug effects/*pathology/surgery
Female
Fluorouracil/pharmacology/therapeutic use
Humans
Leucovorin/pharmacology/therapeutic use
Male
Middle Aged
Organoplatinum Compounds/pharmacology/therapeutic use
Pancreas/drug effects/*pathology/surgery
Pancreatic Neoplasms/drug therapy/mortality/*secondary/surgery
Retrospective Studies
Treatment Outcome

Figure

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  Fig. 1 Overall survival (OS) (n = 9). CI, confidence interval.

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