Right Colectomy for Colon Cancer Database (RCC). Surgical Technique, Route of Access and Quality of the Specimen

Aim of the project is to surveil results after extended lymphadenectomy for right sided colon resection for cancer with different operative techniques. Patients operated for right sided colon cancer will be involved. There are different operative methods used in terms of extend of lymphadenectomy and access (open, laparoscopic and robotic assisted) that are already implemented. The Norwegian standard operation contains less extended lymph node dissection. Patients operated by the standard method will serve as control group. Choice of access and extend of lymph node dissection in Norway is dependant on the surgeon and hospital. At Haukeland University Hospital extend and access of surgery are determined by a multidisciplinary team meeting. More radical surgery might result in more complications and the benefit for the patients in terms of oncological result and survival is uncertain. At Haukeland University Hospital, extended lymphadenectomy has been mostly performed by open surgery. During the study phase we will introduce extended lymphadenectomy by laparoscopy and robotassisted surgery. Hypothesis is that more radical surgery performed by minimal invasive surgery will result in equal or better oncological results, and less complications, shorter hospital stay and better quality of life. As method we choose a prospective observational study. All eligible patients with adenocarcinoma of the right colon without another ongoing oncological treatment for other cancers will be included. Patientdata will be prospectively registered in a web-based database. Aim of the study will be to define the optimal extend of lymphadenectomy to achieve the best oncological result. In addition, we will analyse the results dependent on the surgical access (open, laparoscopic or robotic). The assumed difference between the operative methods is small. Therefore, the study is designed and approved as a multicenter registration in order to achieve the necessary statistical power.

Sex

All

Minimum age

18 Years

Maximum age

99 Years

Inclusion Criteria:

* Patients with malignant tumor of the right colon at CT and/or colonoscopy.
* Confirmed adenocarcinoma
* Patients medically cleared by anesthesiologist for general anesthesia and oncological radical resection
* Informed consent

Exclusion Criteria:

* Patients under 18 years
* Patients with recurrent cancer after previous surgery
* Patients with ongoing treatment due to other cancer

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• BACKGROUNDBenz S, Tannapfel A, Tam Y, Grunenwald A, Vollmer S, Stricker I. Proposal of a new classification system for complete mesocolic excison in right-sided colon cancer. Tech Coloproctol. 2019 Mar;23(3):251-257. doi: 10.1007/s10151-019-01949-4. Epub 2019 Mar 5. PMID 30838463
• RESULTLygre KB, Eide GE, Forsmo HM, Dicko A, Storli KE, Pfeffer F. Complications after open and laparoscopic right-sided colectomy with central lymphadenectomy for colon cancer: randomized controlled trial. BJS Open. 2023 Jul 10;7(4):zrad074. doi: 10.1093/bjsopen/zrad074. PMID 37643373
• RESULTLygre KB, Eide GE, Liedenbaum MH, Augland IMB, Haldorsen IS, Pfeffer F. Short and equal vascular stump length after standardized laparoscopic and open surgery with central lymphadenectomy for right-sided colon cancer. Br J Surg. 2024 Jan 3;111(1):znad410. doi: 10.1093/bjs/znad410. No abstract available. PMID 38064678
• DERIVEDPfeffer F, Kalgraff P, Lygre KB, Nedrebo BS, Forsmo HM. Proposal of a new visual analogue scale to describe the extent of lymphadenectomy in right-sided colectomy for cancer-a prospective observational study. Tech Coloproctol. 2025 Sep 2;29(1):166. doi: 10.1007/s10151-025-03182-8. PMID 40892141