The choice of optimal lymph node dissection extent in surgical treatment for colon cancer: protocol the clinical trial

Abstract

Background. The choice of the best surgical approach to colon cancer treatment remains a complicated and controversial problem of modern coloproctology. Current data shows better long-term outcomes after procedures performed in accordance with embryological layers and concept of complete mesocolic excision, while level of vessel ligation remains debatable. In the US and Europe D3 lymph node dissection is not routinely performed for colon cancer, while in eastern countries it is considered to be a standard. Up-to-date there is no published data from randomized trials comparing long-term outcomes of D2 and D3 dissection. Materials and methods. A literature review was performed to evaluate current data on colon cancer lymph node dissection. A design of ran-domized trial was proposed to obtain the evidence on the superiority of D3 over D2 lymph node dissection. Discussion. As evidence regarding long-term outcomes of D3 lymph node dissection is lacking the choice of lymph node dissection is made according to surgeon’s or clinic preferences. Conclusion. To objectify the preferred lymph node dissection extent randomized controlled studies are needed.

Keywords

• colon cancer
• complete mesocolic excision
• lymph node dissection d2, d3
• randomized trial