Presentation Information
[JKS2-2]Which is the optimal approach for advanced transverse colon cancer, transverse colectomy or extended right hemicolectomy? -JCOG2304-
Tomonori Akagi1, Takumi Hasegawa1, Masafumi Inomata1 (1. Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Japan)
Based on previous reports, transverse colectomy for Stage II/III transverse colon cancer is expected to have the same long-term outcomes as extended right hemicolectomy and to reduce postoperative loss of bowel function. Although the short-term outcomes of both techniques are controversial, transverse colectomy has been reported to reduce postoperative loss of bowel function by preserving the organs. In general, small bowel-colon anastomosis is considered more advantageous than colo-colon anastomosis in terms of blood flow after reconstruction, and this has been one of the reasons for choosing extended right hemicolectomy. However, recent advances in surgical instruments and the introduction of ICG blood flow evaluation during anastomosis have enabled stable anastomosis even with colo-colon anastomosis. A survey conducted in October 2021 by the Colorectal Cancer Group on the selection of the surgical technique for this population from 47 centers showed that 58% of the patients underwent extended right hemicolectomy and 41% underwent transverse colectomy.
We designed the JCOG2304 trial to evaluate the efficacy of a transverse colectomy compared to an extended right hemicolectomy. The target population for this study is Stage II/III transverse colon cancer patients whose tumor responsible vessel is the middle colonic artery and who require D3 lymph node dissection. The primary endpoint is recurrence-free survival, and secondary endpoints include overall survival, Wexner score, LARS score, and quality of life assessment. A total of 498 patients are planned to be enrolled, with an enrollment period of 5 years, a follow-up period of 3 years after completion of enrollment, a 1-year analysis period, and a total study period of 9 years. The results of the questionnaire survey on transverse colon cancer in the JCOG Colorectal Cancer Group and an overview of new clinical trials will be reported.
We designed the JCOG2304 trial to evaluate the efficacy of a transverse colectomy compared to an extended right hemicolectomy. The target population for this study is Stage II/III transverse colon cancer patients whose tumor responsible vessel is the middle colonic artery and who require D3 lymph node dissection. The primary endpoint is recurrence-free survival, and secondary endpoints include overall survival, Wexner score, LARS score, and quality of life assessment. A total of 498 patients are planned to be enrolled, with an enrollment period of 5 years, a follow-up period of 3 years after completion of enrollment, a 1-year analysis period, and a total study period of 9 years. The results of the questionnaire survey on transverse colon cancer in the JCOG Colorectal Cancer Group and an overview of new clinical trials will be reported.