D3-lymphadenectomy enhances oncological clearance in patients with right colon cancer. Results of a meta-analysis

Zutoia Balciscueta*, Izaskun Balciscueta, Natalia Uribe, Gianluca Pellino, Matteo Frasson, Eduardo García-Granero, Álvaro García-Granero

*Corresponding author for this work

Research output: Contribution to journalReview articleResearchpeer-review

14 Citations (Scopus)


Background: D3-Lymphadenectomy, together with complete mesocolic excision (CME), were introduced to provide oncological results after right colon cancer. The aim of this systematic review with meta-analysis was to assess the short and long-term outcomes of right-sided hemicolectomy with CME + D3 as compared with classic right hemicolectomy. Secondary aims included the prevalence of D3-metastasis and skip metastasis when performing CME + D3. Material and methods: A systematic review with meta-analysis was conducted, according to PRISMA methodology. Results: 29 studies were enrolled (2592 patients). No differences were accounted in morbidity variables associated with the measured techniques. CME + D3 was significantly associated with a greater distance between the tumour and the closest vascular tie, a longer colonic resection, a wider resection of mesentery and an increased number of harvested lymph nodes. Regarding to long-terms outcomes, we found a significant decrease in local recurrence in patients undergoing CME + D3 (HR:0.17) and a significant improvement in 3-year and 5-year overall survival rates (HR:0.53 vs. HR:0.57, respectively), as well as an improving survival in patients with stage II and III disease. Overall prevalence of patients with lymphatic metastases in D3-territory was of 8.6% and 2.2% of skip metastases. Conclusions: CME + D3 is a feasible surgical procedure that allows to obtain specimens with higher quality oncological resection, without greater associated morbidity, thus improving survival in patients with stage II and III right colon cancer.

Original languageEnglish
Pages (from-to)1541-1551
Number of pages11
JournalEuropean Journal of Surgical Oncology
Issue number7
Publication statusPublished - Jul 2021


  • Central vascular ligation
  • Central vessel ligation
  • Colon cancer
  • Complete mesocolic excision
  • D3 lymphadenectomy
  • Right hemicolectomy


Dive into the research topics of 'D3-lymphadenectomy enhances oncological clearance in patients with right colon cancer. Results of a meta-analysis'. Together they form a unique fingerprint.

Cite this