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CC BY-NC-ND 4.0 · South Asian J Cancer 2024; 13(04): 251-258
DOI: 10.1055/s-0044-1801754
Original Article
Surgery

Complete Mesocolic Excision for Colon Cancer: The New Standard of Care?

Authors

  • Saumitra Rawat

    1   Department of Surgical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India

  • Shyam Aggarwal

    2   Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India

  • Purvish M. Parikh

    3   Department of Clinical Hematology, Sri Ram Cancer Center, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan, India

  • Adarsh Chaudhary

    4   Department of Surgical Gastroenterology, Medanta, Gurugram, Haryana, India

  • Manish Kumar

    5   Department of Medical Oncology, Cloud Physician, Bengaluru, Karnataka, India

  • Mohit Sharma

    6   Department of Medical Oncology, Fortis Hospital, Faridabad, Haryana, India

  • Peush Sahni

    7   Department of Surgical Gastroenterology, All India Institute of Medical Sciences (AIIMS), New Delhi, India

  • Ramesh Ardhanari

    8   Department of Surgical Gastroenterology, Meenakshi Mission Hospital, Madurai, Tamil Nadu, India

  • R. Pradeep

    9   Department of Surgical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, Telangana, India

  • Amitabh Yadav

    1   Department of Surgical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India

  • Suviraj John

    10   Minimal Access Surgery Department, Sir Ganga Ram Hospital, New Delhi, India

  • C. R. Selvasekar

    11   Clinical Services and Specialist Surgery, The Christie NHS Foundation Trust, Manchester, United Kingdom
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Abstract

Complete mesocolic excision (CME) for colorectal cancer builds on the success of total mesorectal excision (TME), the international gold standard for rectal cancer. In TME, removal of the primary tumor along with associated mesocolon and accompanying structures as single intact specimen allows in toto excision of all structures that could potentially lead to dissemination. Recent meta-analysis has confirmed that CME results in better disease-free survival (DFS) and overall survival (OS) rates. CME can be done in three ways—open, laparoscopic, and robotic-assisted. We conducted a survey to identify the real-world situation with the use of CME by surgical oncologists. A total of 116 responders shared their experiences and thoughts. The benefit of CME was primarily thought to be for both OS and DFS by 78/116 (67%). The majority of CMEs are being conducted by the open method (74/116; 64%). A total of 52/116 (45%) were of the opinion that 6 to 10 surgeries constitute the learning curve for new surgeons for this technique. Based on our survey results, as well as two recently published systematic reviews and meta-analysis, it is time to consider CME as one of the standards of care in colorectal surgery.

Keywords

gastrointestinal malignancy - survey - optimal surgery


Publication History

Article published online:
02 January 2025

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