ArticleSurgery today2025
Patterns of lymph node metastasis and long-term outcomes of splenic flexure colon cancer: a descriptive study from a Japanese high-volume center.
Article in Surgery today, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Comparison of the short-term and mid-term outcomes between robot-assisted and laparoscopic surgery for splenic flexure colon cancer.Surgery today · 2026Article
- Short- and Long-Term Outcomes of Laparoscopic Segmental Left Colectomy for Splenic Flexure Colon Cancer: A Multicenter Propensity Score-Matched Analysis from the Catholic Colorectal Group.Journal of clinical medicine · 2026Article
- Robotic Segmental Resection of the Splenic Flexure and Mid-Transverse Colon for Malignancy Treatment: A Systematic Review of Operative Techniques, Anastomotic Approaches, and Surgical and Oncological Outcomes.Journal of clinical medicine · 2025Review
- Complete Mesocolic Excision for Colon Cancer: Insight into Potential Mechanisms of Oncologic Benefit.Cancers · 2025Review
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Authors and funding
8 authors.
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Abstract
purposeThe pattern of lymph node metastasis and the appropriate extent of lymph node dissection in splenic flexure colon cancer remain unclear. This study aimed to describe the clinical characteristics, lymph node metastasis patterns, and oncological outcomes of patients with splenic flexure colon cancer.
methodsThe data of patients with splenic flexure cancer diagnosed with pathological stages I-III were extracted from a hospital database. Lymph nodes were mapped and numbered according to the guidelines of the Japanese Society for Cancer of the Colon and Rectum. Five-year disease-free survival (DFS) and overall survival (OS) rates were estimated using the Kaplan-Meier method.
resultsAmong 151 patients, 37.1% had lymph node metastasis. The proportion of lymph node metastasis were 30.1% at station 221, 5.1% at station 222, 2.8% at station 223, 19.8% at station 231, 2.7% at station 232, and 0% at station 253. Among the 59 patients with an accessory middle colic artery, 19 had lymph node metastasis only at stations 221 (14/47) and 231 (5/47). The 5-year estimated DFS rates were 100% for stage I, 94.4% (95% CI, 83.6-98.2) for stage II, and 79.9% (95% CI, 65.6-88.8) for stage III. Ten patients experienced distant recurrence: liver (n = 5), peritoneum (n = 2), para-aortic lymph node (n = 2), and lung metastasis (n = 1). No local recurrence was observed.
conclusionIn splenic flexure colon cancer, lymph node dissection around the IMA route may be omitted. Similarly, dissection along the left branch of the middle colic artery or the left colic artery may be unnecessary in the presence of an accessory middle colic artery.
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