The presentation "Insights and Outcomes in the Surgical Management of Gastric Cancer with Transverse Colon Involvement" explores the challenges of treating advanced gastric cancer extending to the transverse colon. It combines a systematic literature review with a retrospective analysis of four cases managed at the First Surgical Clinic in Târgu Mureș. The study evaluates surgical techniques, patient outcomes, and survival rates, emphasizing the need for personalized treatment strategies integrating clinical practice and academic research.

1. INSIGHTS AND OUTCOMES IN THE SURGICAL
MANAGEMENT OF GASTRIC CANCER WITH TRANSVERSE
COLON INVOLVEMENT
C. Cosma1,2
, M. Botoncea1,2
, G. Serac1,2
,V.O.Butiurca1,2
, C.Molnar 1,2
1
Chirurgie Generală I – Spitalul Clinic Judetean De Urgenta- Tg.Mure Romania
ș
2
Universitatea de Medicină, Farmacie, tiin e i Tehnologie ‘’George Emil Palade,, -Tg.Mure
Ș ț ș ș
INTRODUCTION: Gastric cancer's extension
to the transverse colon signifies a challenging
clinical scenario, necessitating intricate surgical
strategies for effective management. This
complexity demands an exploration of both
current literature and practical surgical
experiences to guide optimal treatment
approaches.
MATERIAL AND METHOD: The paper aims
to amalgamate insights from specialized
literature with clinical outcomes from the First
Surgical Clinic SCJU Tg. Mures that provides a
comprehensive overview of the management
strategies for gastric cancer with transverse
colon involvement. A dual approach was
adopted, comprising a systematic review of the
existing literature on the surgical management
of gastric cancer extending to the transverse
colon and a retrospective analysis of cases
handled at our institution. The focus was on
evaluating the surgical techniques, patient
demographics, treatment protocols, and
outcomes.
1. Comprehensive Diagnostic Evaluation Before
deciding on a management plan, perform a thorough diagnostic
evaluation, including endoscopy, imaging (CT, MRI), and biopsy, to assess
the extent of gastric cancer and its involvement in the transverse colon.
2. Multidisciplinary Team Approach Management
should involve a multidisciplinary team, including gastroenterologists,
surgical oncologists, medical oncologists, radiologists, and pathologists,
to tailor the treatment plan to the patient’s specific condition.
3. Surgical Resection For resectable advanced gastric cancer
with transverse colon involvement, a gastrectomy combined with partial
or total colectomy, ensuring clear margins, is the standard treatment to
achieve a potential cure.
4. Adjuvant Therapy Postoperative adjuvant therapy, such as
chemotherapy or chemoradiotherapy, should be considered to reduce
the risk of recurrence and improve survival outcomes based on tumor
staging and the patient’s health status.
5. Palliative Care In cases where surgical resection is not
feasible due to extensive disease or poor patient condition, focus on
palliative care, which includes palliative chemotherapy, nutritional
support, and pain management, to manage symptoms and improve
quality of life.
RESULTS: The most common approach involves
removing the stomach and affected colon sections
presented in systematic reviews of peer-reviewed
articles, clinical trials, and meta-analyses published
in the last decade. Our experience includes four
cases, all with personalized surgical treatment. The
outcomes reveal a 75% survival rate and 50%
comorbidity rate with an average of eight days of
admission.
CONCLUSION: Our study reinforces the
imperative for personalized strategies in treating
complex gastric cancer cases involving the
transverse colon. It calls for integrating academic
research with clinical practice to refine treatments
and improve patient outcomes.
Literature Review - Conclusion Analysis
Selective Bibliography:
1. Kim, J. W., Suh, Y. S., Kim, M. A., Kim, W. H., Lee, H., Lee, K. U., & Yang, H. (2011, January 8). Transverse Mesocolon Invasion in Advanced Gastric Cancer: Should We Reconsider Current T Staging? Annals of Surgical
Oncology. https://doi.org/10.1245/s10434-010-1485-2
2. Wang, G., Liu, Y., Gao, C., Wang, Y., Lv, H., Chen, B., Nie, C., Chen, X., & Luo, S. (2020, August 1). Surgical outcomes and survival for T4 gastric cancer extending to the transverse colon. Annals of Translational Medicine.
https://doi.org/10.21037/atm-20-3377
3. Prognosis of Gastric Carcinoma Invading the Mesocolon. (n.d.). CORE Reader. https://core.ac.uk/reader/82399740
4. Kim, J. W., Suh, Y. S., Kim, M. A., Kim, W. H., Lee, H., Lee, K. U., & Yang, H. (2011, January 8). Transverse Mesocolon Invasion in Advanced Gastric Cancer: Should We Reconsider Current T Staging? Annals of Surgical
Oncology. https://doi.org/10.1245/s10434-010-1485-2
5. Sonoda, H., Kawai, K., Yamaguchi, H., Murono, K., Kaneko, M., Nishikawa, T., Otani, K., Sasaki, K., Yasuda, K., Tanaka, T., Kiyomatsu, T., Hata, K., Nozawa, H., Ishihara, S., Aikou, S., Yamashita, H., Ushiku, T., Seto, Y.,
Fukayama, M., & Watanabe, T. (2017, December 1). Lymphogenous metastasis to the transverse colon that originated from signet-ring cell gastric cancer: A case report and review of the literature. Clinics and Research in
Hepatology and Gastroenterology. https://doi.org/10.1016/j.clinre.2017.04.002
The authors are not affiliated with any manufacturer of medical devices used in these communications and do not declare any conflict of interest. This study is not intended to promote the advertising of medical
devices. Written informed consent was obtained for the information and photographs in this paper.
Antral gastric stenotic
adenocarcinoma
Transverse colon – gastric
adenocarcinoma penetration
Postoperative resection specimens and end-to-end transverse colon
anastomosis