Laparoscopic complete mesocolic excision: safe for right colon cancer?
Mené en Chine entre 2016 et 2019 sur 995 patients atteints d'un cancer du côlon droit (âge : 18-75 ans), cet essai randomisé multicentrique de phase III compare l'efficacité, du point de vue de la survie sans maladie à 3 ans, et la sécurité d'une résection mésocolique complète par rapport à une dissection D2 pendant une colectomie droite par voie laparoscopique
Four decades ago, Bill Heald championed total mesorectal excision for the surgical management of rectal cancer and taught surgeons internationally about the crucial importance of sharp dissection along the embryological planes in the pelvis, ultimately leading to a clinically significant reduction in the frequency of local recurrence. This new method led other surgeons to speculate on whether a similar approach to removal of lymph nodes for colon cancer would improve oncological outcomes. No consensus yet exists about the optimal extent of lymphadenectomy for colon cancer because meta-analyses comparing D2 and D3 dissections have not been conclusive.
The Lancet Oncology , commentaire, 2020