Optimal Surgical Approach for Mid-Transverse Colon Cancer; a systematic review and meta-analysis

Abstract

Abstract Background and Aim: The incidence of cancer colon below the age of 50 has increased dramatically. in addition to that, the database is lacking a review to analyze the outcomes of surgeries for mid-transverse colon cancer with several recent controversial studies. Our aim was to compare the outcomes of extended hemicolectomy versus transverse colectomy for mid-transverse colon cancer. Method PubMed, Scopes, Web of Science and Cochrane library were searched for eligible studies from inception to 1 May 2022 and a systematic review and meta-analysis were done to detect Results according to eligibility criteria 8 studies (2237 patients) were included in our study. The pooled results of the included studies showed no difference in the 5-year OS, 3-year DFS and 5-year DFS between the two types of surgery (5-year OS, RR = 1.15, 95% CI = 0.94–1.39, P = 0.17), (3-year OS, RR = 0.96, 95% CI = 0.88–1.06, P = 0.42) and (5-year DFS, RR = 1.21, 95% CI = 0.91–1.62, P = 0.20). In addition to that, the recurrence rate and the incidence of complications were similar in the two groups (Recurrence rate, RR = 1.08, 95% CI = 0.62–1.89, P = 0.79) and (Complications, RR = 1.07, 95% CI = 0.74–1.54, P = 0.72). however, the number of LN harvest and the time of the operation was more in case of extended hemicolectomy. Conclusion Despite harvesting less LN, transverse colectomy has similar oncological outcomes to extended hemicolectomy for mid-transverse colon cancer. In addition to that, no significant difference in the incidence of complications between the two surgeries.