Evidence map›Paper›PMID 40325243›Full record

SynthesisSurgical endoscopy2025

A systematic review, meta-analysis and GRADE assessment of the evidence on complete mesocolic excision for right-sided colon cancer with SAGES and ESCP participation.

Alexander A Tzanis, Francesco Maria Carrano, Konstantinos Perivoliotis, Sunjay S Kumar, Christos Christogiannis, Dimitris Mavridis, Bright Huo, Nicole Bouvy, Niki Christou, Suzanne Dore and 12 more

Erratum issuedAbstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Prognostic factors of non-metastatic right colon adenocarcinoma: A multicentre retrospective analysis from the ATCCR database.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026
    Observational
  2. Article
  3. Review
  4. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

22 authors.

Alexander A Tzanis1st Department of Obstetrics and Gynaecology, Alexandra University Hospital, National and Kapodistrian University of Athens, Athens, Greece. alexandros.tzanis@gmail.com.ORCID http://orcid.org/0000-0003-0518-3419
Francesco Maria CarranoGuidelines Committee, European Association for Endoscopic Surgery, Eindhoven, Netherlands.
Konstantinos PerivoliotisDepartment of Surgery, General Hospital of Volos, Volos, Greece.
Sunjay S KumarDepartment of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Christos ChristogiannisDepartment of Primary Education, School of Education, University of Ioannina, Ioannina, Greece.
Dimitris MavridisGuidelines Committee, European Association for Endoscopic Surgery, Eindhoven, Netherlands.
Bright HuoGuidelines Committee, European Association for Endoscopic Surgery, Eindhoven, Netherlands.
Nicole BouvyDepartment of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Niki ChristouDepartment of Visceral Surgery, University Hospital of Limoges, Limoges, France.
Suzanne DorePatient Representative, Rayne, Essex, UK.
Audrius DulskasNational Cancer Center, Affiliate of Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania.
Christos Kontovounisios2nd Surgical Department, Evangelismos General Hospital, Athens, Greece.
Tim LubbersDepartment of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Francesco PalazzoDepartment of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Philip QuirkePathology and Data Analytics, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
Dimitra RepanaDepartment of Medical Oncology, St George's University Hospitals, London, UK.
Monica TerlizzoDepartment of Pathology, The Royal Marsden NHS Foundation Trust, London, UK.
Bethany J SlaterDepartment of Surgery, University of Chicago Medicine, Chicago, IL, USA.
Ivan D FlorezDepartment of Pediatrics, University of Antioquia, Medellin, Colombia.
Monica OrtenziDepartment of General and Emergency Surgery, Polytechnic University of Marche, Ancona, Italy.
Tan ArulampalamSchool of Medicine, Anglia Ruskin University, Chelmsford, UK.
Stavros A AntoniouGuidelines Committee, European Association for Endoscopic Surgery, Eindhoven, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundComplete mesocolic excision (CME) is a surgical approach for right-sided colon cancer, involving the resection of the primary tumour along with an intact mesocolon, central vascular ligation, and exposure of the superior mesenteric vein. It has been postulated to improve oncologic outcomes such as disease-free survival and reduce local recurrence compared to standard right colectomy. However, the clinical benefits are still debated.

objectiveThis systematic review and meta-analysis, sponsored by the European Association for Endoscopic Surgery, aims to compare the oncologic outcomes of CME with standard right colectomy for right-sided colon cancer, with the ultimate objective to inform clinical practice recommendations.

methodsWe followed the PRISMA 2020 reporting standards. A comprehensive literature search was conducted to identify relevant studies published from 2008 onwards, focusing on randomised trials and matched cohort studies comparing CME with standard right hemicolectomy. The GRADE methodology was used to assess the certainty of evidence, and minimal important differences were calculated to inform clinical relevance.

resultsThirteen studies, amongst which three randomised trials, were included. No difference was found between CME and standard colectomy in terms of 30-day mortality, major peri-operative morbidity, or major blood loss. However, patients who underwent CME showed improved overall survival (HR = 0.67, 95%CI [0.48 - 0.93], low certainty of evidence) and disease-free survival (HR = 0.78, 95% CI [0.63 - 0.96], low certainty of evidence) compared to those who underwent standard colectomy, though certainty of the evidence was low due to the high risk of bias in the observational studies.

conclusionComplete mesocolic excision may offer survival benefits over standard right colectomy for right-sided colon cancer. However, the evidence remains of low certainty, mainly due to the predominance of observational data with significant risk of bias. Future high-quality randomized trials are needed to confirm these findings and standardize surgical techniques to reduce heterogeneity and improve clinical outcomes.

Indexed as

ColectomyColonic NeoplasmsMesocolonDisease-Free SurvivalHumansLigationRandomized Controlled Trials as TopicCMEColon cancerComplete mesocolic excisionEAESGuidelines

Identifiers

PMID40325243

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.