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Session: ePoster: Colon and Colorectal Cancer 18 (Tue8)

EP926 - Balancing Efficacy and Simplicity: Modified D3 Lymphadenectomy for Right-Sided Colon Cancer

Tuesday, May 13, 2025
8:16 AM – 8:21 AM PT

    ePoster Presenter(s)

  • Chungyeop Lee, MD (he/him/his)

    Fellowship
    Asan Medical Center
    Seoul, Seoul-t'ukpyolsi, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • In Ja Park, MD. PhD.

    Professor
    Asan Medical Center
    Seoul, Seoul-t'ukpyolsi, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Chungyeop Lee, M.D.: This individual has no financial relationships with ineligible companies.
In Ja Park, MD. PhD.: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Complete Mesocolic Excision (CME) is a technique designed to achieve superior oncologic outcomes through complete tumor removal and central vascular ligation; however, it is technically demanding with a steep learning curve. In contrast, Japan's D3 dissection focuses on the removal of major lymph nodes without requiring complex central vascular ligation as a mandatory component.

Methods/Interventions: A retrospective study was conducted on 1,757 patients who underwent right hemicolectomy for right-sided colon cancer at Asan Medical Center from 2013 to 2018. Patients who underwent robotic surgery, open surgery, had synchronous malignancies, stage 0 or stage 4 cancer, or appendiceal cancer were excluded. In the final analysis, 1,418 patients who received laparoscopic surgery were included. Clinicopathological characteristics, the number of lymph nodes harvested, 5-year recurrence-free survival (RFS), and overall survival (OS) were evaluated according to the surgical approach.

Results/Outcomes: A total of 1,418 patients who underwent laparoscopic right hemicolectomy for right-sided colon cancer at Asan Medical Center between 2013 and 2018 were included in the final analysis. The average number of harvested lymph nodes was 30.6 ± 12.8, and the mean number of metastatic lymph nodes was 0.7 ± 2.0. The 5-year recurrence-free survival (RFS) rates according to pathological stage were as follows: stage I, 98.4%; stage II, 90.0%; stage IIIa, 97.1%; stage IIIb, 81.8%; and stage IIIc, 48.0%. The 5-year overall survival (OS) rates were similarly stratified, with stage I patients showing a 97.3% survival rate, stage II at 90.1%, stage IIIa at 100%, stage IIIb at 87.9%, and stage IIIc at 56.0%. Recurrence rates were also analyzed, with a total recurrence rate of 4.3% in stage IIIb patients and 3.8% in stage IIIc patients. Notably, no local recurrences were observed in stage I and IIIa patients, while local recurrence rates were 6.0% in stage II, 4.3% in stage IIIb, and 3.8% in stage IIIc.

Conclusion/Discussion: This study confirmed that laparoscopic surgery provides superior survival outcomes in most stages of right-sided colon cancer, especially in stage II and IIIb patients. However, its effectiveness in stage IIIc patients is more limited, suggesting the need for a tailored approach in high-risk cases. Future research should focus on long-term outcomes and optimal strategies for these patients.