Lancet oncol: Should right colon cancer excision clean the central lymph nodes?

Whether right colon cancer line lymph node cleaning will increase perioperative complications or improve survival is debatable.
trial aims to compare the efficacy and safety of the treatment of patients with right half colon cancer with complete colon membrane excision (CME) and D2 separation during laparoscopic right half colonectomy.
safety results of this trial are reported in this article.
This is a randomized controlled phase 3 dominant trial conducted in 17 hospitals in nine provinces in China, recruiting patients with histologically undiagnosed primary right-half colon cancer (between blind and horizontal colon right third) diagnosed with 18-75 years of age.
in laparoscopic right colonectomy, patients were treated with CME (including central lymph nodes) or D2 (excluding central lymph nodes) at random (1:1).
end of the disease is a three-year disease-free survival rate.
January 11, 2016 - December 26, 2019, a total of 1,072 patients were recruited, excluding 77 patients, and 995 were included in the corrected intent treatment population (495 in the CME group and 500 in the D2 separation group).
20% and 22% of surgical complications in the CME group and D2 groups (difference -2.2% ;p-0.39), respectively; The rates were similar (both 18%), but the incidence of Clavien-Dindo III-IV-level complications in the CME group was significantly lower than in the D2 group (1% vs 3% ;p x 0.022);
complications during surgery, the CME group had significantly more vascular damage than the D2 group (3% vs 1% ;p 0.045).
13 (3%) of the 394 patients who were cleaned of central district lymph nodes in the CME group detected central district lymph node metastasis;
, while CME surgery may increase the risk of vascular damage during surgery, it is usually safe and feasible for experienced surgeons.