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. 2010 Jun;42(2):69-76.
doi: 10.4143/crt.2010.42.2.69. Epub 2010 Jun 30.

Clinicopathologic characteristics, surgical treatment and outcomes for splenic flexure colon cancer

Chan Wook Kim  1 , Ui Sup Shin, Chang Sik Yu, Jin Cheon Kim
Affiliations

Clinicopathologic characteristics, surgical treatment and outcomes for splenic flexure colon cancer

Chan Wook Kim et al. Cancer Res Treat. 2010 Jun.

Abstract

Purpose: This current study examined the clinicopathologic characteristics of patients with splenic flexure (SF) colon cancer and the association with the surgical outcomes to find the optimal procedure to treat this malady.

Materials and methods: A total of 167 operated patients with SF colon cancer were consecutively recruited between 1993 and 2003. The clinicopathological, operative and survival data was reviewed and analyzed.

Results: For the SF colon cancer patients, the proportion of males was higher than that for the right-sided colon patients or the sigmoid-descending junction & sigmoid (SD & S) colon patients (p≤=0.05, respectively) and the age at the time of diagnosis was younger (p≤=0.05). Obstruction was more frequent in the patients with SF colon cancer than that for the patients with colon cancer at other sites (p≤=0.001). The incidence of mucinous adenocarcinoma for the SF patients was similar to that for the patients with right-sided colon cancer, but it was higher than that for the patients with SD & S colon cancer (11.4% vs. 6.5%, p=0.248 or 2.5%, respectively, p=0.001). Disease-free and overall survival did not differ between the patients who underwent a left hemicolectomy and extended surgery such as combined splenectomy or subtotal colectomy. Multivariate analysis showed that old age (≥=60 years) and a N1-2 and M1 status were the independent risk factors for overall survival.

Conclusion: The SF colon cancers exhibited exclusively different characteristics as compared to colon cancers at other site colon cancers. It appears that left hemicolectomy was generally sufficient for a satisfactory oncological outcome, obviating concurrent splenectomy.

Keywords: Colectomy; Colonic neoplasms; Left colic flexure; Splenectomy.

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Figures

Fig. 1
Fig. 1
Survival according to the primary tumor location. Note that there is no significant difference between the curves (p=0.125).
Fig. 2
Fig. 2
Effect of splenectomy on the incidence of postoperativecomplications.
Fig. 3
Fig. 3
Effect of splenectomy on disease-free survival (p=0.395).
Fig. 4
Fig. 4
Effect of splenectomy on overall survival (p=0.297).
See this image and copyright information in PMC

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