Comparison of surgical procedures and short- and mid-term outcomes for transverse colon cancer: A retrospective study from a single center.

Abstract

39 Background: For transverse colon cancers located in the right to mid portion, right hemicolectomy (RHC) and transverse colectomy (TC) are both surgical options. However, consensus and the criteria for selecting the procedure is lacking due to the low incidence of transverse colon cancer and the limited robust evidence. Aim: To compare short- and mid-term outcomes of RHC and TC among transverse colon cancer patients. Methods: We retrospectively reviewed 70 patients who underwent curative resection for transverse colon cancer at our institution between May 2018 and May 2025. Patients were categorized into the RHC group (n=51) and the TC group (n=19). Surgical approaches included robot-assisted (n=40), laparoscopic (n=26), and open (n=4). Clinicopathological characteristics and short- and mid-term outcomes were compared. Results: Patient backgrounds were comparable between groups. Clinical stage I/II/III/IV was 21/11/13/6 in the RHC group and 9/4/6/0 in the TC group. Median operative time was 216 minutes for the RHC group and 187 minutes for the TC group (p=0.15). Blood loss was minimal in both groups (0 mL vs. 5 mL, p=0.67). No Clavien-Dindo grade III or higher complications occurred. Grade II complications occurred in 6 (12%) RHC and 2 (11%) TC, with no significant difference. The number of harvested lymph nodes was significantly higher in the RHC group (33 vs. 14, p<0.01). The proximal and distal resection margins (PRM/DRM) were 230 mm and 98 mm in the RHC group, and 85 mm and 105 mm in the TC group, respectively. The PRM was significantly longer in the RHC group (p<0.01), while the DRM showed no difference (p=0.26). Among patients with stage I-III, the 3-year OS was 94.1% in the RHC group and 93.3% in the TC group, and the 3-year RFS was 100% in both groups, with no significant differences (median follow-up, 28 months). Conclusions: TC resulted in shorter operative time, whereas RHC achieved a higher lymph node yield and longer proximal margin; however, these differences did not translate into disparities in mid-term outcome. These results indicate that procedure selection should be individualized based on patient age, performance status, and tumor progression. Larger cohorts and longer follow-up are warranted.