eP666 - Surgical and Oncological Outcomes in Transverse Colon Carcinoma: Does Tumor Sublocation Make a Difference?

Purpose/Background: Transverse colon carcinomas have been seen as a collective entity in medical literature, despite their distinct embryological origins, unique anatomical surroundings, and diverse surgical management options. This study aims to shed light on potential disparities among transverse colon sublocations by comparing oncological outcomes, postoperative complications, pathological and demographic characteristics, and the impact on patients' quality of life.Methods/Interventions: We conducted a retrospective analysis of our prospectively maintained database, encompassing patients who underwent surgical treatment for transverse colon carcinomas between 2000 and 2018. We excluded patients with palliative resections, those with pathological tumor stage IV, and those with carcinomas associated with hereditary syndromes or inflammatory bowel disease. Tumor localization was defined by aligning operative notes with pathological and imaging reports. Surgical procedures were categorized based on the extent of vascular resection documented in the operative notes.Results/Outcomes: The study included 273 patients with a median age of 70 years (range 61), of whom 44% were female. The median BMI was 27.9 kg/m2 (range 34), and 61% were classified as ASA 3. Transverse colon carcinomas were distributed across the proximal (21.9%), the mid (42%), and the distal transverse colon (35.8%). Surgical procedures consisted of right hemicolectomy (68%), left hemicolectomy (15%), subtotal colectomy (11.6%), transverse colectomy (2.6%), and segmental colectomy (3.3%). Notably, mid transverse colon carcinomas exhibited the highest prevalence among female patients (53% vs. 35% proximal vs. 39% distal, p < 0.03) and were more prone to causing anemia (37.4% vs. 23.3% proximal vs. 20.4% distal, p=0.02). Proximal transverse carcinomas were more likely to cause bowel obstruction (13% vs. 3.5% mid vs. 8% distal, p < 0.05), and distal transverse colon carcinomas were prone to causing bleeding (37.8% vs. 20% proximal vs. 14.8% mid, p < 0.01). Moreover, proximal transverse colon carcinomas presented with a higher proportion of pathological stage II compared to mid and distal transverse carcinomas (68.3 vs. proximal vs. 44.3% mid vs. 49% distal, p=0.006). Tumor deposits were absent in mid transverse colon carcinomas (0% mid vs. 18.2% proximal vs. 21.9% distal, p=0.02). Analysis of intraoperative complications, 30-day postoperative morbidity and mortality between different surgical procedures and tumor location did not result in any significant difference. Location and rate of metastasis were similar between the different tumor locations. 5-year overall survival and 5-year disease free survival were similar when comparing for surgical procedures and tumor locations. Quality of life was comparable between tumor locations and surgical procedures.Conclusion/

Discussion: Transverse colon sublocation affects the type of symptoms patients express. However, tumor sublocation does not substantially impact intraoperative, postoperative, or oncological outcomes. Furthermore, the choice of surgical procedure showed no significant influence on patient outcomes, and quality of life remained consistent regardless of tumor sublocation or surgical approach.