Adjuvant Chemotherapy Does Not Compensate for an Inadequate Right Colon Cancer Surgery: High Peritoneal Recurrence...

Area of Science:

• Oncology
• Surgical Oncology
• Gastrointestinal Oncology

Background:

• Optimal management for right colon cancer patients with inadequate initial surgery is unclear.
• Patients referred after non-oncological surgery require specific treatment strategies.

Purpose of the Study:

• To evaluate outcomes of right colon cancer patients treated with adjuvant chemotherapy after inadequate index surgery.
• To identify factors influencing survival and recurrence in this patient cohort.

Main Methods:

• Retrospective analysis of a prospectively maintained database (2013-2019).
• Inclusion of 97 patients with right colon cancer who had inadequate index surgery.
• Stratification based on lymph node harvest: Group A (<12), Group B (12-27), Group C (≥28).
• Management involved adjuvant chemotherapy followed by observation; surgery reserved for recurrence.

Main Results:

• Overall survival at 2 years was 71.5%; disease-free survival was 45.8%.
• Lymph node metastases and radiological locoregional residual disease significantly impacted survival.
• Peritoneal recurrence was common (63.8%), with limited salvageability (15.5%).
• Outcomes were inferior compared to historical cohorts treated differently.

Conclusions:

• Adjuvant chemotherapy alone after inadequate colectomy yields suboptimal survival and high peritoneal recurrence rates.
• Current treatment strategies for these patients require re-evaluation.
• Prospective studies are necessary to establish optimal management protocols.