Marching Towards Personalized Surgery, Fewer Complications, Higher Survival Rates

Öz

The past 15 years have resulted in dramatic changes in the treatment of colon cancer. The most significant development, since the work of Werner Hohenberger (1), lies in the fact that the Norwegian cancer registry demonstrates a steady improvement in 5- year survival rates within this same period. What is most astonishing is the fact that the chemotherapy regimen has been stable within the whole period. The conclusion drawn therefore is: it is possible to achieve better long-term survival rates through “just performing better surgery”. If correct, such a trend could in turn, lead to the decline of chemotherapy use in the treatment of colon cancer. Never the less, “just better surgery” does require a definition

Anahtar Kelimeler

• komplikasyon
• sağkalım

Marching towards personalized surgery, fewer complications, higher survival rates

Öz

The past 15 years have resulted in dramatic changes in the treatment of colon cancer. The most significant development, since the work of Werner Hohenberger (1), lies in the fact that the Norwegian cancer registry demonstrates a steady improvement in 5- year survival rates within this same period. What is most astonishing is the fact that the chemotherapy regimen has been stable within the whole period. The conclusion drawn therefore is: it is possible to achieve better long-term survival rates through “just performing better surgery”. If correct, such a trend could in turn, lead to the decline of chemotherapy use in the treatment of colon cancer. Never the less, “just better surgery” does require a definition

Anahtar Kelimeler

• complication
• survival
• Marching

Kaynakça

1. Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S (2009) Standardized surgery for colonic cancer: complete mesocolic excision and central ligation–technical notes and out- come. Colorectal Dis 11(4):354–364 discussion 64-5
2. Spasojevic M, Stimec BV, Dyrbekk AP, Tepavcevic Z, Edwin B, Bakka A et al (2013) Lymph node distribution in the d3 area of the right mesocolon: implications for an anatomically correct cancer resection. A postmortem study. Dis Colon Rectum 56(12):1381– 1387
3. Nesgaard JM, Stimec BV, Soulie P, Edwin B, Bakka A, Ignjatovic D (2018) Defining minimal clearances for adequate lymphatic re- section relevant to right colectomy for cancer: a post-mortem study. Surg Endosc 32:3806–3812
4. Nesgaard JM, Stimec BV, Bakka AO, Edwin B, Ignjatovic D (2015) Navigating the mesentery: a comparative pre- and per- operative visualization of the vascular anatomy. Colorectal Dis 17(9):810–818
5. Willard CD, Kjaestad E, Stimec BV, Edwin B, Ignjatovic D; RCC Study Group. Preoperative anatomical road mapping reduces variability of operating time, estimated blood loss, and lymph node yield in right colectomy with extended D3 mesenterectomy for cancer. Int J Colorectal Dis. 2018 Nov 1. doi: 10.1007/s00384-018-3177-5. [Epub ahead of print]