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Session: ePoster Monitor 5-Colon Cancer 4

eP333 - A Comprehensive NCDB Analysis on Practice Trends and Outcomes of Right Colectomy for Colon Cancer in the United States

Sunday, June 2, 2024
10:39 AM – 10:44 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Zoe Garoufalia, MD (she/her/hers)

    Clinical Fellow
    Cleveland Clinic Florida
    Cleveland Clinic Florida
    Weston, FL, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Sameh Hany Emile, MBBCh, MSc, MD/PhD

    Project Scientist
    Cleveland Clinic Florida
    Cleveland Clinic Florida
    Weston, FL, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • Nir Horesh, MD

    Clinical Fellow
    Cleveland Clinic Florida
    Cleveland Clinic Florida
    Weston, FL, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • Ashley Shustak, MD

    Clinical Fellow
    Cleveland Clinic Florida
    Cleveland Clinic Florida
    Weston, FL, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • MO

    Marcus Oosenbrug, MD (he/him/his)

    Clinical Fellow
    Cleveland Clinic Florida
    Cleveland Clinic Florida
    Weston, FL, United States

    All relevant financial disclosures have been managed and will be listed below.
    This individual has no financial relationships with ineligible companies.

  • ES

    Ebram Salama, MD

    Clinical Associate - Colorectal Surgery
    Cleveland Clinic Florida
    Weston, Florida, United States

    Disclosure information not submitted.

  • RG

    Rachel Gefen, n/a

    fellow CORS/MIS
    Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL 33331, USA
    Weston, Florida, United States

    Disclosure information not submitted.

  • MB

    Marylise Boutros, MD (she/her/hers)

    Professor of Surgery
    Dr Marylise Boutros - Colorectal Surgeon, Cleveland Clinic Florida Professor of Surgery, McGill University, Montreal, Canada
    McGill University
    Weston, Florida, United States

    All relevant financial disclosures have been managed and will be listed below.
    This individual has no relevant relationships with ineligible companies.

    • Senior Author(s)

  • Steven D. Wexner, MD, PhD (Hon)

    Chairman
    Cleveland Clinic Florida
    Cleveland Clinic Lerner College of Medicine at Case Western Reserve University
    Weston, Florida, United States

    Disclosure information not submitted.

Purpose/Background: Right-sided colon cancer has been reported to have worse survival and recurrence rates than left-sided or rectal cancer. This could be due to different biology, non-standardized surgical treatment, or less use of neoadjuvant/adjuvant therapy. The aim of this study was to assess the oncological outcomes of right colectomy for colon cancer and to explore the treatment trends in the USA over a 15-year period.Methods/Interventions: Retrospective analysis of the National Cancer Database (NCDB) 2005-2019. The cohort was divided into 3 periods: 2005-2009 (1); 2010-2014 (2), and 2015-2019 (3). The three periods were compared with regards to patient and tumor characteristics, treatments, and outcomes. Crude statistical analysis was performed using EZR (version 1.55) software.Results/Outcomes: From 2005-2019, 312,884 patients (54.5% female) with a mean age of 70 (SD:12.5) years underwent hemicolectomy for right colon cancer. Periods 1, 2, and 3 included 104,265, 103,053, and 105,566 patients, respectively. A significant increase in the rates of laparoscopic surgery (45.6% to 53.4%) and robotic surgery (3% to 12.9%) was noted over time, while the rates of open surgery decreased (51.4% to 33.7%). The median number of harvested lymph nodes significantly increased over the years from 17 to 20. The use of chemotherapy significantly increased over time (15.6% to 20.9%). Neoadjuvant chemotherapy was significantly more often used in Period 3 (0.6% to 1.2%) while the use of adjuvant therapy remained stable (31.4% to 32.1%). A significant increase was noted in the median time from diagnosis to surgery, doubling in length in Period 3 compared to Period 1 (14 vs. 7 days). A significant increase was noted in surgical treatment of metastatic right colon cancer over time (18.3% to 30%). 30- and 90-day mortality decreased over time from 4.1% to 3% and from 7.6% to 5.5%. respectively. Overall survival significantly (p < 0.001) increased from a mean of 72.3 months (95% CI: 72.1-72.7) in Period 1 to 77.4 months (95% CI: 75.2-79.8) in Period 3.Conclusion/

Discussion: Colectomy for right colon cancer, although considered a “simple” operation, remains associated with a mean overall survival of 6 years, which has increased by 5 months over the study period. Further prospective data is required to elucidate potentially modifiable factors in surgical approach or perioperative therapeutic strategies.