En bloc pancreaticoduodenectomy and right hemicolectomy for locally advanced right-sided colon cancer

Table 1 Patients’ characteristics

Case	Gender	Age (yr)	Site of colon cancer	Adjacent organ infiltration on preoperative CT	Preoperative CEA (ng/mL)	Preoperative CA19-9 (IU/mL)
1	Female	73	T	Du	120.8	22.5
2	Female	74	A	Du + Pa + St	36.6	20.3
3	Male	70	A	Du + Pa	0.5	49.2
4	Female	57	T	Du + Pa + Gb + SMV	2.6	13.7
5	Male	47	A	Du + Pa + SMV1	12.3	196.8

¹Tumor thrombosis in SMV. A: Ascending colon; T: Transverse colon; CEA: Carcinoembryonic antigen; CA19-9: Cancer antigen 19-9; CT: Computed tomography; Du: Duodenum; St: Stomach; Pa: Pancreas; Gb: Gallbladder; SMV: Superior mesenteric vein.

Table 2 Surgical findings and complications

Case	Operation	Adjacent organ infiltration in surgical exploration	OT (min)	OBL (mL)	DHS (d)	Complications
1	PD + RHC + DP	Du	406	940	35	PF (B)
2	PD + RHC + SMVR	Du + Pa + St + SMV	524	840	27	PF (C)
3	PD + RHC	Du + Pa + Gb	304	200	33	PF (A), DGE
4	PD + RHC + SMVR	Du + Pa + Gb + SMV	538	2760	36	PF (A)
5	PD + RHC + SMVR	Du + Pa + SMV1	506	2470	39	PF (A)

¹Tumor thrombosis in SMV. OT: Operation time; OBL: Operative blood loss; DHS: Duration of hospital stay; PD: Pancreaticoduodenectomy; RHC: Right hemicolectomy; DP: Distal pancreatectomy; SMVR: Superior mesenteric vein resection; Du: Duodenum; St: Stomach; Pa: Pancreas; Gb: Gallbladder; SMV: Superior mesenteric vein; PF: Pancreatic fistula; DGE: Delayed gastric emptying.

Table 3 Histological findings

Case	Stage			Histological infiltration	Histological type	R
	T	N	M
1	4b	0	1a (LYM1)	Du	Mod + NET	0
2	4b	1b	1b (LYM2, OTH3)	St	Muc	0
3	4b	0	0	Du + Pa	Well	0
4	4b	0	0	Du + Gb	Well	0
5	4b	1a	1a (OTH3)	Du + Pa	Well	0

¹Extra-regional lymph node metastasis (peripancreatic lymph node);

²Extra-regional lymph node metastasis (periduodenal lymph node);

³Tumor thrombosis in SMV. Mod: Moderately differentiated adenocarcinoma; Well: Well-differentiated adenocarcinoma; NET: Neuroendocrine tumor; Du: Duodenum; St: Stomach; Pa: Pancreas; Gb: Gallbladder.

Table 4 Chemotherapy and outcomes

Case	ACT	DFS (mo)	CT	OS (mo)	Status	CD
1	Cape	77	-	77	Alive
2	-	5	Cetu	11	Dead	LM
3	-	95	-	95	Alive
4	-	85	-	85	Alive
5	-	1	Cape + OX + Beva	11	Dead	LM

ACT: Adjuvant chemotherapy; CT: Chemotherapy; DFS: Disease-free survival; OS: Overall survival; CD: Cause of death; LM: Liver metastasis; Cape: Capecitabine; Cetu: Cetuximab; Beva: Bevacizumab; OX: Oxaliplatin.