Complete mesocolic excision: Is there enough evidence?

Standard therapy of nonmetastatic colon cancer is primary resection. Similar to the worldwide accepted concept of total mesorectal excision (TME) for rectal cancer, the concept of complete mesocolic excision (CME) was introduced for colon cancer and consists of resection of the mesocolon while respecting the integrity of the mesocolon as well as central vascular ligation (CVL) with radical lymph node dissection. Current data on CME shows strong evidence that specimens from CME resections have better histopathological quality criteria, including a higher number of resected lymph nodes and a higher dissection rate in the correct mesocolic plane than those after “conventional” colon resection. However, due to partly heterogeneous study results and weaknesses of previous studies (lack of subgroup analysis, comparison with historical collectives and enormous divergence in conventional colon resections), there is limited evidence for the oncological outcome and the comparison between open and laparoscopic CME. Further studies on oncological outcome after CME are needed in order that CME colon resection for colon cancer achieve the same status as TME rectal resection for rectal cancer. © 2018, Springer Medizin Verlag GmbH, ein Teil von Springer Nature.