Highlights
- •The overall and recurrence-free survival in patients with segmental and anatomical colon resection are not different.
- •Anatomical resection has higher lymph node yield.
- •Higher age and tumor stage correlate with higher mortality.
- •Positive margins are associated with decreased recurrence free survival.
Abstract
Background
There is currently no consensus on surgical management of splenic flexure adenocarcinoma
(SFA).
Methods
Patients undergoing surgical resection for SFA between 1993 and 2015 were identified.
Postoperative outcomes were compared between patients who underwent segmental (SR)
vs. anatomical resection (AR).
Results
One-hundred and thirteen patients underwent SR and 89 underwent AR. More patients
in the SR group had open resections, but there were otherwise no differences in demographics
or surgical characteristics between the two groups. There were no differences in overall
(p = 0.29) or recurrence-free(p = 0.37) survival. On multivariable analysis, increased
age (HR 1.04, 1.01–1.07, p = 0.005), higher American Society of Anesthesiology classification
(HR 3.1, 1.7–5.71, p < 0.001), and higher tumor stage (HR 8.84, 3.76–20.82, p < 0.001)
were predictive of mortality.
Conclusions
Short and long-term outcomes after SR and AR for SFA are not different, making SR
a viable option for SFA surgical management.
Keywords
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Article info
Publication history
Published online: February 06, 2023
Accepted:
February 4,
2023
Received in revised form:
January 18,
2023
Received:
November 17,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
