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Controlled Clinical Trial
. 2020 Mar;271(3):519-526.
doi: 10.1097/SLA.0000000000003012.

Efficacy and Safety of Complete Mesocolic Excision in Patients With Colon Cancer: Three-year Results From a Prospective, Nonrandomized, Double-blind, Controlled Trial

Zhidong Gao  1   2 , Chao Wang  1   3 , Yancheng Cui  1 , Zhanlong Shen  2   3 , Kewei Jiang  1   3 , Danhua Shen  4 , Yi Wang  5 , Siyan Zhan  6 , Peng Guo  1 , Xiaodong Yang  1 , Fangfang Liu  4 , Kai Shen  1 , Bin Liang  1 , Mujun Yin  1 , Qiwei Xie  1 , Youli Wang  1 , Shan Wang  1   2 , Yingjiang Ye  1   3
Affiliations
Controlled Clinical Trial

Efficacy and Safety of Complete Mesocolic Excision in Patients With Colon Cancer: Three-year Results From a Prospective, Nonrandomized, Double-blind, Controlled Trial

Zhidong Gao et al. Ann Surg. 2020 Mar.

Abstract

Objective: The aim of the study was to evaluate the oncological outcomes of complete mesocolic excision (CME) in colon cancer patients.

Summary background data: CME is considered a standard procedure for colon cancer patients. However, previous evidence regarding the effect of CME on prognosis has fundamental limitations that prevent it from being fully accepted.

Methods: Patients who underwent radical resection for colon cancer were enrolled between November 2012 and March 2016. According to the principles of CME, patients were stratified into 2 groups based on intraoperative surgical fields and specimen photographs. The primary outcome was local recurrence-free survival (LRFS). The clinicopathological data and follow-up information were collected and recorded. The final follow-up date was April 2016. The trial was registered in ClinicalTrials.gov (identifier: NCT01724775).

Results: There were 220 patients in the CME group and 110 patients in the noncomplete mesocolic excision (NCME) group. Baseline characteristics were well balanced. Compared with NCME, CME was associated with a greater number of total lymph nodes (24 vs 20, P = 0.002). Postoperative complications did not differ between the 2 groups. CME had a positive effect on LRFS compared with NCME (100.0% vs 90.2%, log-rank P < 0.001). Mesocolic dissection (100.0% vs 87.9%, log-rank P < 0.001) and nontumor deposits (97.2% vs 91.6%, log-rank P < 0.022) were also associated with improved LRFS.

Conclusions: Our findings demonstrate that, compared with NCME, CME improves 3-year LRFS without increasing surgical risks.

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