eP194 - The Emperor Has No Clothes- there Is No Standard in Defining Anatomical Segments in the Management of Colon Cancers

Purpose/Background: Uniform definitions and tumor classification systems in cancer registries are critical for facilitating global comparisons of oncologic outcomes across different centers treating the same type of cancer. In the context of colon carcinoma, a standardized classification system that accurately delineates individual segments is currently absent within cancer registries.
To address this critical gap, our study undertook a comprehensive systematic literature review focusing on colon cancer, with the specific objective of providing precise definitions for each colon segment.Methods/Interventions: An independent systematic search of PubMed was conducted, encompassing studies on colon cancer published between 01/1993 and 10/2023. Only English-language original articles including cohort studies, case series, previous reviews, and meta-analyses, and randomized clinical trials were considered for inclusion. Exclusions comprised case reports, editorials, and letters. Following the removal of duplicates, the remaining articles were subjected to title/abstract and full-text screening. After the identification of the relevant studies, studies describing particular colon cancer segment were assessed. Type of surgery, number of patients, whether oncologic outcomes were assessed or not, any definition for particular colon cancer segment were used, study period, publication year, country of authors were reviewed and extracted for the data.Results/Outcomes: A total of 8712 articles were screened, and 2753 were deemed eligible for inclusion in this study. Among these, only 238 (8.6%) provided specific definitions for each colon segment in the manuscript [cecum 17 out of 80 (21%), ascending colon 7 out of 83 (8.43%), hepatic flexure 2 out of 6 (33%), transverse colon 40 out of 74 (54%), splenic flexure 35 out of 54 (65%), descending colon 34 out of 119 (29%), sigmoid colon 57 out of 2370 (2%), rectosigmoid colon 47 out of 95 (49%)]. Moreover, there were 3 distinct definitions for cecum, 1 for ascending, 2 for hepatic flexure, 8 for transverse colon, 4 for splenic flexure, 2 for descending colon, 13 for sigmoid colon, and 8 for rectosigmoid colon.Conclusion/

Discussion: Our study unveils discrepancies in the published literature, revealing that less than 9% of the literature on colon cancer provides various definitions for each colonic segment. Standardizing the definitions of colon cancer segments is essential to prevent the use of arbitrary definitions, which can result in inconsistency and hinder accurate outcome assessments.