Background/Objectives: Complete mesocolic excision (CME) has recently been proposed as a radical operation for the treatment of colon cancer. Increasing evidence suggests a survival benefit from this operation, although the exact reasons for this remain largely unknown. Methods: We have undertaken a comprehensive review of the literature in PubMed and Embase databases, examining the potential mechanisms explaining this oncologic benefit. Results: Complete mesocolic excision with central vascular ligation appears to improve the rates of radial margin negativity and is associated with increased lymph node yield and improved staging for colon cancer patients by removal of apical lymph nodes and removal of skip metastasis. The en bloc removal of the cancer-related mesentery along the interfascial plane between the mesocolon and retroperitoneal structures removes en bloc tumor deposits that appear to have a significant negative effect on cancer prognosis, irrespective of lymph node status. CME is associated with decreased rates of local recurrence and improved disease-free and overall survival. The existing literature suffers from a lack of data on molecular pathology and integration of prognostic pathologic factors such as tumor deposits in patients undergoing complete mesocolic excision. Conclusions: CME confers significant benefits in terms of local control of the disease and improves cancer-specific survival. Further research on the matter is necessary to incorporate prognostic pathologic and molecular parameters.
背景/目的：全结肠系膜切除术（CME）作为一种根治性手术，近年来被提出用于治疗结肠癌。尽管其确切原因尚不明确，但越来越多的证据表明该手术能带来生存获益。方法：我们对PubMed和Embase数据库中的文献进行了全面回顾，探讨了可能解释这种肿瘤学获益的潜在机制。结果：全结肠系膜切除术联合中央血管结扎似乎能提高环周切缘阴性率，并通过切除顶端淋巴结和跳跃性转移灶，增加结肠癌患者的淋巴结获取数量并改善分期。沿结肠系膜与腹膜后结构之间的筋膜间平面整块切除与肿瘤相关的肠系膜，可一并清除对癌症预后具有显著负面影响的肿瘤沉积物，无论淋巴结状态如何。CME与局部复发率降低、无病生存期和总生存期改善相关。现有文献缺乏关于接受全结肠系膜切除术患者的分子病理学数据以及肿瘤沉积物等预后病理因素的综合分析。结论：CME在局部疾病控制和提高癌症特异性生存率方面具有显著优势。有必要进一步研究，纳入预后病理学和分子参数。
Complete Mesocolic Excision for Colon Cancer: Insight into Potential Mechanisms of Oncologic Benefit
肿瘤(癌症)患者之家