Three courses of XELOX were administered postoperatively as adjuvant therapy and the patient has been recurrence-free for 9 years. 251 lymph node, leading to diagnosis of lymphatic metastasis from a peritoneal dissemination nodule. Two metastatic lymph nodes were found in the No. Histopathologic findings showed peritoneal metastasis of transverse colon cancer to the pararectal node. A nodule on the serosal surface of the anterior rectum was found in surgery, and low anterior resection was performed. courses of TEGAFIRI+Bev, the disease stabilized and the metastatic nodule was resected. However, 2 years and 11 months after surgery, recurrence of pelvic peritoneal dissemination was diagnosed by CT. After 6 courses of UFT/UZEL as adjuvant therapy, there was no recurrence. The pathological diagnosis was pT2N1, tub2, ly1, v2, pStage IIIa. The patient was a 75-year-old male who underwent laparoscopy-assisted left hemicolectomy for transverse colon cancer at age 72 years. To more effectively compare oncologic outcomes among different cancer registries, guidelines need to be developed to standardize each domain and avoid arbitrary definitions. While we found moderate consensus on preoperative diagnostic modalities and surgical management, the definition of splenic flexure remains ambiguous. This is the first internationally conducted Delphi consensus study regarding splenic flexure cancer. Only strong consensus was achieved on the surgical approach for minimally invasive surgery (88%). Moderate consensus was achieved on the technique of complete mesocolic excision and central vascular ligation principles for splenic flexure cancer (74%). Segmental colectomy was the preferred technique for management of splenic flexure cancer in the elective setting (72%). Also, experts recommended abdominopelvic computerized tomography scan plus intraoperative exploration (moderate consensus, 72%) for tumor localization and cancer registry splenic flexure recording. There was moderate consensus on the definition of splenic flexure (55%) as 10 cm from either side where the distal transverse colon turns into the proximal descending colon. Levels of recommendation based on voting concordance were graded as follows: more than 75% agreement was defined as strong, between 50-75% as moderate, and below 50% as weak. ![]() Out of 47 invited experts, 89% (n = 42) participated in the second and third rounds of the consensus.Ī total of 35 questions were created and sent via online questionnaire tool. ![]() For the second and third rounds, each expert in the first round was asked to invite 2 more colorectal surgeons from their region (n = 47). The first round included 18 experts from 12 different countries. To establish an expert international consensus on splenic flexure cancer management.Ī 3-round online-based Delphi study was conducted between September 2020 and April 2021. Surgical management of splenic flexure cancer remains controversial.
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